Malnutrition : What are the risks for seniors ?
Frequence of malnutrition :
. 4% to 10% of independent seniors
. 15% to 38% of nursing home residents
. 30% to 70% of hospitalized patients
The chronic decrease of muscular strength affects 30% of the elderly people over the age of 60, and can go beyond 50% for the elderly people over 80 (2)
A large number of eldery do not get enough nourishment in quantity and in variety to order meet their essential energy and nutritional requirements (3). Protein and energy malnutrition is also frequent in the hospital (4).
Malnutrition limits autonomy, it decreases the quality of life while increasing the risk of bedsores, infections and hip or vertebraes fractures. Malnutrition also increases the risk of complications in case of hospitalization and it increases mortality rates. This condition alters the quality of life and increases the number of medical examinations and hospital stays (3,5-7). Malnutrition increases the costs for the elderly living at home and in institutions (2,3,7,8).
There is a physiological decrease of the muscle quotient. However, if a person carries on having a constant quantity of good quality proteins whilst ageing, there will not be any change in the person's metabolism for protein synthesis (6-14).
The nutritional risk exists when there is an insufficient nutritional intake, or an undesired weight loss > 5% in 3 months or > 10% in 6 months, or a body mass index (BMI) < 20 kg/m (7).
Malnutrition is multifactorial, favoured by :
It is easier to prevent than to treat malnutrition (6,10). In the case of undesired weight loss, the early intake of enriched food, or nutritional complements, increases significantly the chances of success in regards to nutrition, improvement of the autonomy and general condition (3,7).
Despite differences in the use efficiency, age does not alter the ability of synthesis of muscular proteins after the intake of protein rich food (6). It has been demonstrated that protein intake increases weight and decreases mortality (15). It is preferable to distribute the protein intake through out the day (lunch, dinner, and two snacks at 10am and 4pm) rather than offer protein rich food (meat, fish, eggs) at lunch and dinner only (2). Moreover, a recent circular precises that elderly people should not remain more than 12h without eating: it is thus recommended to give an additional snack at 9pm. (French National Food Council, notice n°53 of 15 December 2005).
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