tailieunhanh - Weight loss and malnutrition in the elderly

Mistreatment of older people has been identified in facilities for continuing care (such as nursing homes, residential care, hospitals and day care facilities) in almost every country where such institutions exist. Various people may be responsible for the abuse: a paid member of the staff, another resident, a voluntary visitor, or relatives or friends. An abusive or neglectful relationship between the older person and their caregiver at home may not necessarily end once the older person has entered institutional care; the abuse may sometimes continue in a new setting. A distinction must be made between individual acts of abuse or neglect in institutional settings and institutionalized abuse – where the prevailing regime of the institution. | CLINICAL PRACTICE g Gemma Sampson BNutrDiet Hons is a clinical dietician Aged Care and Rehab Balmain Hospital New South Wales. Weight loss and malnutrition in the elderly The shared role of GPs and APDs This article forms part of a series looking at the relationship between diet and good health and the role of the dietician in the primary health care team. This review highlights some of the physical social and medical factors that can indicate compromised nutritional status in the elderly the screening tools available to detect malnutrition and when to involve a dietician. Malnutrition is broadly defined as a nutritional deficit undernutrition excess overnutrition or 2 Malnutrition and unintentional weight loss are issues frequently underestimated in older people that can be limited managed and controlled by timely nutrition intervention. Malnutrition and unintentional weight loss impact mortality morbidity length of stay and re-admission to hospital 3 with nutrition support reducing readmission by more than 29 4 5 Malnutrition is closely linked with recurrent falls and fractures lost independence requiring support and care poor wound healing and an increase in complications including infections pressure sores and skin Clinical features of protein energy malnutrition include reduced body weight muscle wastage and decreased strength reduced respiratory and cardiac muscular ability skin thinning decreased metabolic rate hypothermia apathy oedema and Muscle loss in the elderly may reflect sarcopenia wasting or 8 Sarcopenia is a progressive component of aging exacerbated by limited physical activity resulting in decreased functionality and increased 9 Wasting is primarily a result of inadequate dietary intake while cachexia is characterised by catabolism an increased metabolic rate and protein Calcium vitamin D vitamin B12 and folate are micronutrients frequently underconsumed in older people. .