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Books > Medicine > Clinical & internal medicine
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Malnutrition in the Elderly (Paperback, Softcover reprint of the original 1st ed. 1999)
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Malnutrition in the Elderly (Paperback, Softcover reprint of the original 1st ed. 1999)
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H. B. Stahelin "Under-or malnutrition is a frequent and serious
problem in geriatric patients" (8). Today there is no doubt that
malnutrition contributes significantly to morbidity and mortality
in the aged. The immune function is impaired, the risk for falls
and fractures increases, in acute illness, recovery is delayed, and
complications are frequent. Acute and chronic illnesses lead to a
catabolic metabolism and hence increase the signs and symptoms of
malnutrition. Cytokines related to inflamma tion block the
synthesis of albumin and shift protein synthesis to acute phase pro
teins. The activation of the ubiquitine-proteasome pathway leads to
a degradation of muscle protein, which leads to an additional loss
of muscle mass which occurs as age-dependent sarcopenia, and adds
to the already existing frailty (2, 4). It is often difficult to
decide to what extent the metabolic alterations result from
malnutrition or concomitant illness. Psychological factors
contribute as a circulus vitiosus significantly to anorexia and,
thus, aggravate the condition. They are the most important causes
of failure to thrive in old age (7). It is evident that next to the
therapy of the underlying illness, an adequate support with calorie
and nutrient intake over weeks becomes essen tial under these
conditions. Clear-cut improvements are often only seen after 6 or
more weeks. Besides a clinical, clearly visible malnutrition,
selective nutrient deficits are much more frequent. Numerous and
highly different mechanisms may lead to a marginal or insufficient
supply with micronutrients."
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