| Popis: |
Undernutrition and dehydration in older adults is of concern for healthcare professionals as well as the individuals and their families. The consequences of undernutrition, which are serious in all ages, however they are especially prominent in the older population. Being generally more vulnerable as well as not being able to recover promptly, older people are at higher risk of falls, more frequent and longer hospital stays, increased infections as well as increased risk of dying. Reduced appetite and thirst along with physical and cognitive impairments can make it difficult for older people to consume sufficient amount of food and fluids. The subsequent adverse events such as falls or infections can further influence nutritional status, creating a vicious cycle of undernutrition and disease. Once established, the cycle is almost impossible to escape. This is a major public concern, not only because quality of life is compromised for those affected but also due to the economic impact that these events have on society.\ud Due to numerous functional and physiological alterations associated with age, older people frequently do not consume sufficient amounts of food and fluid and the diet is usually of poor quality. As a result, the prevalence of macro- and micronutrient undernutrition is high in both free-living and institutionalised older adults. It is estimated that prevalence of protein energy malnutrition may be as high as 15% in community dwelling older people, 25-65% in care home residents and 35-65% in older hospital patients. Early detection of undernutrition may be difficult because it cannot rely solely on anthropometric measurements and needs consideration of other factors. BMI for instance, is an established marker for nutritional status in younger populations but is not useful when assessing nutritional status in older persons. Sarcopenic obesity, which is a common problem within clinical setting and is especially prevalent in older patients, gives the impression that the person is over-nourished due to increased amount of fat mass but is in fact a type of undernutrition arising from an extensive muscle wastage caused by protein deficiency. This type of undernutrition usually occurs as a result of an acute decrease in food intake e.g., due to a sudden illness or food withdrawal. Recovering the muscle mass in older people is difficult, if not impossible in some circumstances. Chronic undernutrition on the other hand depletes all energy stores, leaving a person with little fat and muscle reserves. At this stage, micronutrient deficiencies are also common. People with dementia are particularly vulnerable to chronic undernutrition because they may forget to eat or they may lose the skills necessary for feeding, e.g. how to use the eating utensils. |
