Info

1.1(f)

Source: Adapted from Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, Dietary Reference Intakes, National Academy Press, Washington, D.C., 1998. With permission.

Source: Adapted from Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, Dietary Reference Intakes, National Academy Press, Washington, D.C., 1998. With permission.

swallowing, dry mouth, dental problems, depression, or dementia, the patient will often take in far fewer calories than are necessary during a time of illness.75

Malnutrition in the Elderly Adult

Malnutrition in the elderly adult is a significant problem worldwide. Survey estimates indicate that 4 to 31% of free living older adults living independently have clinical malnutrition,82 and this number may approach 60% in institutionalized or nursing home patients.83,84 These numbers are not surprising when one considers the daily living conditions of the elderly adult: approximately 30% of older adults live alone, 25% require assistance with activities of daily living, and many suffer from poor dentition, decreased smell and taste sensitivity, as well as psychosocial factors such as depression.75 In addition, common disease processes found in the elderly population can mandate fluid restriction or result in gastrointestinal malabsorption, further limiting nutritional intake in these patients.75 The majority of elderly adults consume insufficient quantities of vitamin D, vitamin E, folate, calcium, dairy products, grains, fruits, and vegetables.78

Thus when an elderly patient presents with a surgical disease process, the patient is often found to have associated deficiencies in macro- or micronutrients. The clinical implications of malnutrition in this population are significant. Hospitalized elderly adults with concomitant malnutrition have increased lengths of hospital stay and increased risk of morbidity and mortality during admission and within the first 90 d of discharge.84 There are several clinical signs that can be used to assess for malnutrition in elderly patients and, if present, could warrant dietary supplementation to optimize recovery. Signs to watch for include cheilosis and angular stomatitis, dehydration, glossitis, poorly healing wounds or ulcers, loss of subcutaneous fat, and loss of muscular mass. In addition, a decreased level of plasma zinc, a low lymphocyte count, and low albumin are all markers of malnutrition81 (Table 13.7).

The role of supplemental nutrition for elderly patients both during hospitalization and in the pre-hospital period is a current focus of clinical nutritional research. In general, both macronutrient and micronutrient supplementation has proven beneficial for elderly patients. For example, in elderly outpatients, dietary supplementation

Weight Loss Funnel

Weight Loss Funnel

Who Else Wants To Discover The 3 Most Effective Fat Burning Methods The Weight Loss Industry Does NOT Want You To Know About.

Get My Free Ebook


Post a comment