It is especially important to ask older patients about alcohol intake, which may replace or suppress the consumption of foods with superior nutritional value.
Prior medical complications and the medications prescribed following her hip surgery are another cause for concern. For patients who require tube feeding, it has been determined that patients with significant dysphagia who undergo gastronomy tube feeding have less risk of aspiration, earlier discharge from hospital, and higher albumen levels with gastrostomy tube feeding than those who undergo nasogastric tube feeding Milne et al Regular weight assessment at office appointments is a simple but important way to monitor weight changes in elderly patients.
For example, studies of long-term care patients such as Mr T have shown that although nutritionally supplemented patients have less risk of developing pressure ulcers High ; Houwing et al ; Dambach et alvitamin supplementation has not been found to significantly accelerate the healing of pre-existing pressure ulcers Mathus-Vliegen Referral to a clinical dietician or nurse educator is recommended following general dietary advice from a physician Patterson Living alone, as Mrs E does, further compounds the risk of malnutrition.
Other important antioxidants with possibly beneficial outcomes include foods with high levels of phytochemicals and flavonoids. The following checklist may serve as a preliminary guide to ensuring adequate nutrition among elderly patients: Malnutrition during hospitalization is also associated with an increased length of stay Pichard et al ; Avenell and Handollreadmission, mortality, skin The elderly and malnutrition essay, and infection.
Mr T needs a comprehensive physical and cognitive examination, and laboratory tests to exclude new medical problems as contributing causes for his weight loss.
There are increased allowances for the elderly for calcium, magnesium, vitamin D, fluoride, niacin, folate, vitamin B12, and vitamin E, clinical studies of which have suggested improved outcomes in nutritional status in the elderly Jensen et al ; Nilsson et al ; Gazotti ; Lehmann et al Mrs A may have had poor oral intake because of her diarrheal illness, or from the side effects of antibiotics used to treat C.
Collateral history from family or caregivers is very important in assessing a person with dementia.
Although the Canadian Task Force on Preventive Health Care acknowledges that the elderly particularly those living alone or in institutions have a high prevalence of nutritional deficiency, they cite insufficient evidence to recommend for or against routine screening for malnutrition.
Vitamin C and zinc have shown some promise in improved outcomes relating to pressure sores Frias Soriano et albut there exists some controversy in the literature pertaining to the efficacy of vitamin and trace mineral supplementation in their treatment and prevention. Oral nutritional supplements in elderly patients with hip fracture, like Mrs A, have been associated with lowered complication rates and length of stay, as well as improved clinical outcomes and nutritional indices Potter et al ; Arnaurd-Battandier et al Compromised nutritional status has also been linked to impaired immunity, respiratory and muscle function, and delays in wound healing Aptaker et al ; Sullivan and Walls These children are seen as problematic.
These findings are usually coupled with biochemical investigations such as laboratory tests that investigate complete blood count with differential, albumin, ferritin, electrolytes, blood urea nitrogen, fasting glucose, and creatinine Patterson ; Reuben et al Although a recent secondary prevention randomized controlled trial failed to demonstrate a decrease in morbid vascular outcomes in stroke patients following supplementation with vitamins B6, B12, and folate over two years, it was suggested that confounding factors such as the initiation of folate fortification in grain supply concurrent with the study might explain the null findings Toole et al Dietary recommendations Following careful nutritional assessment, guidelines have been developed to improve and maintain nutritional status in community-dwelling and hospitalized elderly patients.
Depressive symptoms such as these are important considerations when evaluating the nutritional health of a senior patient Hazzard et al ; Kane et al ; Williams ; Refai and Seidner The physical exam does not usually aid in the detection of early malnutrition in the elderly, as some of the loss of muscle bulk may be similar to age-related processes.
This is a cause for concern. Calcium and vitamin D supplementation have been shown to reduce hip fracture rates and are recommended for patients over 65 years of age. Summary More than other adults, patients over the age of 65 are at nutritional risk because of the greater burden of comorbid illnesses coupled with common physiological changes due to aging.
In hospitalized patients, maintain a high index of suspicion for pre-existing nutritional deficiencies. Several randomized control trials have demonstrated the benefits of oral nutritional supplementation in the hospitalized elderly. Many elderly hip fracture patients have muscle deconditioning as a result of being hospitalized and consequently require increased protein supplementation.
Iron deficiency for example seems like a very simple problem to fix. Vitamin deficiencies, particularly vitamin B12, B6, and folate, are associated with cognitive impairment Nilsson et al ; Gill and Alibhai ; Lehmann et al For persons with moderate to severe Alzheimer disease, forgetting to eat, inability to access food, and apraxia with utensils may further impair oral intake.
For example, cholinesterase inhibitors as a class can cause nausea, vomiting, anorexia, or diarrhea and can be associated with weight loss. Because of the impact of coexisting disease on overall nutritive status, a comprehensive, multidisciplinary approach is often helpful in addressing all contributing factors in the diagnosis and treatment of compromised nutritional health in the elderly.
Used alone in a three-year placebo-controlled study, a daily dosage of vitamin E IU was not shown to slow the rate of progression to Alzheimer disease in patients with MCI Petersen et al Early tube feeding following stroke has been associated with decreased mortality in older patients Dennis et al Those with lower caloric intake had a higher mortality rate than those whose intake more closely matched their caloric expenditure Elmstahl et al Treatment with vitamin D prevents seasonal variations in vitamin D levels and can reduce hip fractures, nonvertebral fractures, and the risk of developing osteoporosis Hazzard et al ; Dawson-Hughes et al ; Ilich et al ; Holick Malnutrition is a state of nutrition (under or over nutrition) in which a lack of protein, energy and other nutrients causes measurable adverse effects on tissue and/or body form, composition, function or clinical outcome.
The UK elderly population is rising, currently about 16 per cent of the population is above 65 (Hickson, ) and by over 30 per cent European population will be over 60 which will result in prevalence of malnutrition to rise (European Nutrition for.
Essay on Malnutrition Words | 8 Pages.
Introduction Malnutrition is a global challenge in low-income and middle-income countries particularly in sub-Saharan Africa and south Asia (Shetty,Black, et al., ). The Elderly and Malnutrition - The Elderly and Malnutrition At any age, nutrition is vital to maintaining health and enhancing quality of life.
However, achieving good nutrition can be especially difficult for the elderly, the fastest growing portion of America's population. The Elderly and Malnutrition Essay - The Elderly and Malnutrition At any age, nutrition is vital to maintaining health and enhancing quality of life.
However, achieving good nutrition can be especially difficult for the elderly, the fastest. Malnutrition in Elderly with Dementia. This is a Premium essay for upgraded members Upgrade to access full essay Malnutrition has shown to be an important concern in women, children, and the elderly.
Because of pregnancies and breastfeeding, women have additional nutrient requirements..Download