Malnutrition in Older Adults - Urgent Need for Action: A Plea for Improving the Nutritional Situation of Older Adults

Volkert, Dorothee

doi:10.1159/000346142

Cited by 126 publications

(105 citation statements)

References 36 publications

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“…59 As age increases there is a natural trend to decrease food intake, resulting in the anorexia of aging. 60 Some authors hypothesize that this lack of appetite could be the result of a physiological adaptation to the decrease in calorie requirements, as a consequence of the changes in body composition and reduction of physical activity. 61 Multiple factors could explain the reduction in the appetite in seniors: among homeostatic factors, there is a clear deregulation in the secretion and response to some of principal hormones related with the control of food intake such as cholecystokinin, ghrelin or insulin.…”

Section: Physiological and Immune Status In The Elderlymentioning

confidence: 99%

Nutrition and the gut microbiome in the elderly

et al. 2016

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The gut microbiota is the assembly of microorganisms living in our intestine and their genomes are known as the microbiome. The correct composition and functionality of this microbiome is essential for maintaining a "healthy status." Aging is related to changes in the gut microbiota which are frequently associated with physiological modifications of the gastrointestinal tract, as well as, to changes in dietary patterns, together with a concomitant decline in cognitive and immune function, all together contributing to frailty. Therefore, nutritional strategies directed at restoring the microbiota in the elderly have to be addressed from a global perspective, considering not only the microbiota but also other extra-intestinal targets of action. The present review aims at summarizing the current knowledge on intestinal microbiota alterations and other functions impaired in the elderly and to analyze tools for implementing nutritional strategies, through the use of probiotics, prebiotics or specific nutrients in order to counterbalance such alterations.

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Section: Physiological and Immune Status In The Elderlymentioning

confidence: 99%

Nutrition and the gut microbiome in the elderly

et al. 2016

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“…A better understanding of the reasons behind such a paradoxical association is pivotal to help determine target SUA levels for elderly people and other patient groups different from the general population 15, 16. Older adults have age‐related change of appetite regulation and are predisposed to decreased food intake and malnourishment 17, 18. Malnourishment is an independent risk factor for all‐cause and CVD‐related mortality in older people 19.…”

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confidence: 99%

U‐Shaped Association Between Serum Uric Acid Levels With Cardiovascular and All‐Cause Mortality in the Elderly: The Role of Malnourishment

Tseng

Chen

et al. 2018

JAHA

136

103

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BackgroundThe link between elevated serum uric acid (SUA) levels and cardiovascular disease (CVD)–related mortality in the elderly population remains inconclusive. Nutritional status influences both SUA and CVD outcomes. Therefore, we investigated whether SUA‐predicted mortality and the effect‐modifying roles of malnourishment in older people.Methods and ResultsA longitudinal Taiwanese cohort including 127 771 adults 65 years and older participating in the Taipei City Elderly Health Examination Program from 2001 to 2010 were stratified by 1‐mg/dL increment of SUA. Low SUA (<4 mg/dL) strata was categorized by malnourishment status defined as Geriatric Nutritional Risk Index <98, serum albumin <38 g/L, or body mass index <22 kg/m2. Study outcomes were all‐cause and CVD‐related mortality. Cox models were used to estimate hazard ratios (HRs) of mortality, after adjusting for 20 demographic and comorbid covariates. Over a median follow‐up of 5.8 years, there were 16 439 all‐cause and 3877 CVD‐related deaths. Compared with the reference SUA strata of 4 to <5 mg/dL, all‐cause mortality was significantly higher at SUA <4 mg/dL (HR, 1.16; 95% confidence interval, 1.07–1.25) and ≥8 mg/dL (HR, 1.13; confidence interval, 1.06–1.21), with progressively elevated risks at both extremes. Similarly, increasingly higher CVD‐related mortality was found at the SUA level <4 mg/dL (HR, 1.19; confidence interval, 1.00–1.40) and ≥7 mg/dL (HR, 1.17; confidence interval, 1.04–1.32). Remarkably, among the low SUA (<4 mg/dL) strata, only malnourished participants had greater all‐cause and CVD‐related mortality. This modifying effect of malnourishment remained consistent across subgroups.Conclusions SUA ≥8 or <4 mg/dL independently predicts higher all‐cause and CVD‐related mortality in the elderly, particularly in those with malnourishment.

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“…The time has come for inclusion of preventive practices, such as screening for nutrition risk and selfmanagement, into the routine care of older adults [31] and Nutri-eSCREEN® can be part of an integrated process. The gender, age and risk factor associations found in this study are consistent with prior work, further demonstrating the utility of Nutri-eSCREEN®.…”

Section: Discussionmentioning

confidence: 99%

Nutri-eSCREEN®: descriptive analysis of a self-management site for older adults (50+ years)

Keller

2016

BMC Nutr

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Background: Older adults (50+ years of age) are a prime target for prevention programs and nutrition education that can improve their eating habits. Yet, most programs target specific disease groups or more vulnerable older adults. As well, the majority of nutrition education programs evaluated to date have been delivered in-person by a health provider. Self-management for upstream nutrition problems that lead to nutrition risk is needed. The internet has made possible the opportunity for the spread of credible nutrition education that can promote awareness and improve knowledge. The purpose of this paper is to describe an internet-based self-management site for older adults focused on nutrition behaviours and present descriptive results of users between 2012 and 2015. Methods: Nutri-eSCREEN® (http://www.nutritionscreen.ca/escreen/) is based on SCREENII, a valid and reliable nutrition screening tool for older adults. It was developed over an 18-month period, which included focus groups, key informant interviews and a usability analysis. Descriptive and bivariate analysis have subsequently been completed on over 15,000 Nutri-eSCREEN® users over the age of 50 years. Results: Most older adult users were between the ages of 50 and 74 years and were women (80.2 %). Nutrition risk was common and increased with age (e.g. 68 % of 85+ year olds were high risk). Several age and gender differences in prevalence of nutrition behaviours were noted. For example, swallowing problems were more likely to occur in the oldest age group (χ 2 = 511.8 p < 0.0001). Key nutrition behaviours were also associated with each other. For example, chewing problems were associated with lower intake of fruits and vegetables (χ 2 = 825.7 p < 0.0001).

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Malnutrition in Older Adults - Urgent Need for Action: A Plea for Improving the Nutritional Situation of Older Adults

Cited by 126 publications

References 36 publications

Nutrition and the gut microbiome in the elderly

Nutrition and the gut microbiome in the elderly

U‐Shaped Association Between Serum Uric Acid Levels With Cardiovascular and All‐Cause Mortality in the Elderly: The Role of Malnourishment

Nutri-eSCREEN®: descriptive analysis of a self-management site for older adults (50+ years)

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