中国食物与营养2026，Vol.32Issue(9)：56-67,12.
共病与日常生活能力在老年衰弱患者营养状况和认知功能关系中的链式中介效应
Chain Mediating Effect of Comorbidity and Activities of Daily Living on the Association Between Nutritional Status and Cognitive Function in Frail Elderly Patients
摘要
Abstract
[Objective]To explore the chain mediating role of comorbidity and Activities of Daily Living(ADL)in the association between nutritional status and cognitive function among frail elderly patients.[Method]Using convenience sampling,364 frail elderly patients admitted to a tertiary hospital between January 2021 and September 2024 were enrolled.Data were collected using a general information questionnaire,the Fried Frailty Phenotype(FP)scale,the Short-Form Mini Nutritional Assessment(MNA-SF),the Charlson Comorbidity Index(CCI),the Barthel Index(BI),and the Mini-Cog scale.Spearman correlation analysis was employed to examine relationships between variables.The PROCESS macro was used to test the chain mediating effects of comorbidity and ADL on the association between nutritional status and cognitive function.[Result]The frail group exhibited significantly higher age,more solitary living arrangements,and higher prevalence of falls in the past year compared to the pre-frail group(P<0.05).Nutritional status(MNA-SF)was 12.00(10.00,13.00);Comorbidity(CCI)was 8.20±2.37;ADL(Barthel Index)was 82.50(60.00,95.00);Cognitive function(Mini-Cog)was 3.00(2.00,5.00).MNA-SF score was negatively correlated with CCI(r=-0.227,P<0.01),BI(r=-0.358,P<0.01),and Mini-Cog scores(r=-0.232,P<0.01).CCI score was negatively correlated with BI(r=-0.461,P<0.01)but positively correlated with Mini-Cog(r=0.203,P<0.01).BI score was positively correlated with Mini-Cog(r=0.357,P<0.01).Mediation analysis revealed a significant total effect of MNA-SF on Mini-Cog(β=0.122,P<0.01),with a significant direct effect(β=0.073,P<0.05).In the chain mediation model:Path 1(Nutrition→Comorbidity→Cognitive Function):No significant mediation effect.Path 2(Nutrition→ADL→Cognitive Function):Indirect effect was 0.048(40.16％of total effect).Path 3(Nutrition→Comorbidity→ADL→Cognitive Function):Indirect effect was 0.002(1.63％of total effect).[Conclusion]Comorbidity and ADL exhibit a chain mediating effect on the relationship between nutritional status and cognitive function in frail elderly patients.Healthcare professionals should prioritize nutritional screening and support,enhance functional exercise for daily living,and improve comorbidity management to delay or mitigate cognitive decline,thereby improving the quality of life for frail elderly patients.关键词
衰弱/营养/共病/日常生活活动能力/认知功能/中介效应Key words
frailty/nutrition/comorbidity/activities of daily living(ADL)/cognitive function/mediation effect引用本文复制引用
胡洁琼,石小天,王斗,孙颖,张炜..共病与日常生活能力在老年衰弱患者营养状况和认知功能关系中的链式中介效应[J].中国食物与营养,2026,32(9):56-67,12.基金项目
科技创新2030-"新一代人工智能"重大项目(项目编号:2021ZD0111002) （项目编号:2021ZD0111002）
京友谊医院科研启动基金资助项目(项目编号:yyqdkt2019-63). （项目编号:yyqdkt2019-63）
