Introduction
In this short article we will talk about malnutrition in the elderly ; more precisely what it consists of, how to classify it and above all how to prevent it.
However, it is advisable to keep in mind that geriatric nutritional complications are extremely “delicate” to treat, because they are sometimes potentially risky. It is therefore always good practice, when in doubt, to consult your doctor.
Malnutrition in the Third Age
What is meant by malnutrition and why it affects the elderly more
By malnutrition we mean a state of functional , structural and developmental modification of the organism, consequent to the alteration of the balance between the needs and the income (or use) of dietary nutrients, which favors morbidity and increases the risk of mortality .
Malnutrition occurs more easily in the elderly than in other age groups.
This is also because, due to aging , the organism reduces many of its physiological capacities causing a change in body composition such as:
- Lean mass ratio (FFM)/ fat mass (FM) in favor of fat ;
- Reduction of overall hydration ;
- Reduction of bone mineralization .
All this is then aggravated by a reduced perception of bodily stimuli ( hunger and thirst ) and by the predisposition to psychiatric comorbidities ( depressive and/or anxious disorders ) or neuro-degenerative diseases ( Alzheimer’s disease , Parkinson ‘s , etc.).
How is malnutrition classified in the elderly?
Malnutrition in the elderly can be classified into primary and secondary .
- Primary malnutrition is linked to inappropriate eating behaviors influenced by physiological, pathological, socio-economic and environmental factors ;
- Secondary malnutrition mainly depends on impaired digestive capacity , reduced intestinal absorption potential, ineffective blood transport and poor metabolization of nutrients .
Body weight and nutritional deficiencies
Can the elderly “should” or “should” lose weight?
The malnutrition trend in the elderly affects all nutrients, including dietary fiber and water .
They are mostly related to an insufficient overall dietary intake which, if sometimes it is the result of inappropriate food choices – or forced by precarious socio-economic conditions – in other cases concerns a nutritional strategy aimed at combating overweight .
This is because, in old age , the overall energy expenditure decreases due to the lowering of the basal metabolic rate (MB) and the level of physical activity (LAF), favoring excess weight. Sometimes, in order to prevent or remedy this condition, we intervene by reducing the caloric intake.
On the other hand, doing so risks compromising the recommended servings of essential nutrients . Moreover, in these subjects, a modest increase in adipose mass plays a protective role against bone fractures caused by contusion . Restrictive diets should therefore be limited as much as possible.
Sometimes unfortunately – as in the presence of severe obesity or important metabolic pathologies or cardio -respiratory complications – the application of a slimming diet is inevitable , as it constitutes the “lesser evil”. It must be the specialist’s care to prevent nutritional deficiencies by minutely balancing the diet or supplementing if necessary.
Diseases and Disorders
What conditions can make the situation worse?
Malnutrition in the elderly is often aggravated by pathological conditions of significant entity which can compromise both eating habits and levels of nutrient absorption . It is the case of:
- Esophageal disease ( dyspepsia , reflux and diverticulosis )
- Gastric ( gastritis , ulcers , dyspepsia)
- swallowing ( dysphagia ) _
- Intestinal ( constipation , diverticulosis, Crohn’s disease , etc.)
It should also be emphasized that other pathologies of a different nature can determine an increase in certain needs; are indicative examples:
- Sarcopenia : requires a greater intake of essential amino acids ;
- Osteoporosis : requires a greater intake of vitamin D.
Etc.
Prevent Malnutrition
How to prevent malnutrition in the elderly?
Preventing malnutrition in the elderly is essential to ensure a better quality of life and life expectancy .
The most important precautions are:
- Guarantee the intake of proteins of good biological value containing essential amino acids useful for the preservation of muscle mass ;
- Monitor that the intake of carbohydrates is not excessive with the risk of compromising the energy -nutritional balance;
Note : since most of the elderly tend to consume little meat, fish , eggs and low-fat cheeses , by replacing some cereal- based foods with those containing legumes , it is possible to increase the protein quota at the expense of that of carbohydrates;
- Encourage the consumption of fresh vegetables and fruit containing an abundant ration of vitamins; water solubles , trace elements , antioxidants , water and dietary fiber;
- Make sure that the intake levels of essential fatty acids fall within the minimum requirement , as omega 3s participate in the health of the central nervous system in the elderly ;
- Limit the consumption of alcoholic beverages;
- Promote water consumption.
Conclusions
In order to guarantee natural aging and limit health interventions on geriatric patients, it is very important to reduce the incidence of malnutrition in the elderly and to promote, when possible, the maintenance of general fitness through an accurate cardiovascular training and muscle strengthening plan .
