Malnutrition and nutritional therapy dilemmas in geriatrics
Journal Title: Postępy Nauk Medycznych - Year 2011, Vol 24, Issue 8
Abstract
The risks for malnutrition and micronutrient deficiency increase as people age. Estimates for the prevalence for protein-energy undernutrition vary from 1-15% in community-dwelling older adults to 25-85% in long-term care facilities. The condition is often associated with other geriatric syndromes, functional impairments and increased mortality, but is frequently unrecognized and untreated in elderly persons within hospitals as well as in long-term care facilities.The malnutrition is a result of the combination of many factors that interrupt the balance between intake and need. These include social (e.g. financial limitations, isolation), psychological (e.g. cognitive impairment, depression) and medical (e.g. chronic diseases, medication side effects and functional deficits) issues. The prevalence of the syndrome increases with number of chronic illnesses and number of medications taken every day.Nutrition assessment combines anthropometric, biochemical and clinical evaluation. A number of screening tools, such as Mini Nutritional Assessment and NSI Determine Checklist, have been developed for identifying older adults at risk for poor nutrition.Nutritional intervention and the use of an interdisciplinary team approach have been successful to prevent poor outcomes of malnutrition in older people. However, in certain vulnerable groups of persons who are near the end of life, as in the case of patients with severe cognitive impairment, an ethical dilemma develops regarding the appropriate use of enteral and parenteral feeding.
Authors and Affiliations
Beata Wojszel
Keywords
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