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Nutritional issues and potential interventions in older people

Published online by Cambridge University Press:  25 May 2011

Catherine R Hankey  and
Wilma S Leslie
Catherine R Hankey*
Affiliation:
College of Medical, Veterinary & Life Sciences Life-Course Nutrition & Health, Centre for Population & Health Sciences, University of Glasgow
Wilma S Leslie
Affiliation:
College of Medical, Veterinary & Life Sciences Life-Course Nutrition & Health, Centre for Population & Health Sciences, University of Glasgow
*
Address for correspondence: Dr Catherine R Hankey, College of Medical, Veterinary & Life Sciences Life-Course Nutrition & Health, Centre for Population & Health Sciences, University of Glasgow, 4th Floor, Walton Building, Glasgow Royal Infirmary, 84 Castle Street, Glasgow G4 0SF. Email: Catherine.Hankey@glasgow.ac.uk
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Summary

The prevalence of undernutrition in older individuals, living independently in a community setting, or living in a supported setting, is considerable. The negative health effects of undernutrition are wide ranging, with implications for quality of life (QOL), well-being and general health, through to the individual's ability to recovery from acute disease. There are a number of key measures that indicate both nutritional status and the effectiveness of any intervention. These include conventional anthropometric and biochemical measures of nutrient status, as well as measures of QOL, well-being and depression. The latter have huge importance to the life of the individual, and to date appear to have undergone only preliminary investigation. This review suggests that the efficacy of interventions to address undernutrition and improve health in older people living in a variety of settings is highly variable, and that considerable opportunities for research in this area exist.

Keywords

nutritional statuswell-beingolder peopleinterventions
Type
Clinical geriatrics
Information
Reviews in Clinical Gerontology , Volume 21 , Issue 4 , November 2011 , pp. 286 - 296
Copyright
Copyright © Cambridge University Press 2011

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References

1http://news.bbc.co.uk/1/hi/business/6159233.stmGoogle Scholar
2http://www.dwp.gov.uk/policy/pensions-reform/Google Scholar
3http://apps.who.int/bmi/index.jsp?introPage=intro_3.htmlGoogle Scholar
4Guigoz, Y, Lauque, S, Vellas, BJ. Identifying the elderly at risk for malnutrition. The Mini Nutritional Assessment. Clin Geriatr Med 2002; 18: 737–57.CrossRefGoogle ScholarPubMed
5Elia, M, Ca, E. The ‘MUST’ report: nutritional screening of adults: a multidisciplinary responsibility. Development and use of the ‘Malnutrition Universal Screening Tool (MUST) for adults. A report by the Malnutrition Advisory Group of the British Association for Parenteral and Enteral Nutrition. Redditch: British Association for Parenteral and Enteral Nutrition (BAPEN). Available at: http://www.bapen.org.uk/musttoolkit.htmlGoogle Scholar
6Salva, A, Coll-Planas, L, Bruce, S, De Groot, L, Andrieu, S, Abellan, G, Vellas, B; Task Force on Nutrition and Ageing of the IAGG and the IANA, Andrieu, S, Bartorelli, L, Berner, YN, Bruce, S, Corman, B, Domingo, A, Egger, TP, de Groot, L, Guigoz, Y, Imedio, A, Planas, M, Porras, C, Rovira, JC, Salvà, A, Serra, JA, Vellas, B. Nutritional assessment of residents in long-term care facilities (LTCFs): recommendations of the task force on nutrition and ageing of the IAGG European region and the IANA. J Nutr Health Aging 2009; 13: 475–83.CrossRefGoogle ScholarPubMed
7Finch, S, Doyle, W, Lowe, C et al. National Diet and Nutrition Survey: people aged 65 years and over. Volume 1: Report of the diet and nutrition survey. 1998. HMSO, London.Google Scholar
8Guigoz, Y. The Mini Nutritional Assessment (MNA) review of the literature – what does it tell us? J Nutr Health Aging 2006; 10: 466–85.Google ScholarPubMed
9Chevalier, S, Saoud, F, Gray-Donald, K, Morais, JA. The physical functional capacity of frail elderly persons undergoing ambulatory rehabilitation is related to their nutritional status. J Nutr Health Aging 2008; 12: 721–26.CrossRefGoogle ScholarPubMed
10Pauly, L, Stehle, P, Volkert, D. Nutritional situation of elderly nursing home residents. Gerontol Geriatr 2007; 40: 3–12.CrossRefGoogle ScholarPubMed
11http://www.bapen.org.uk/pdfs/nsw/nsw07_report.pdfGoogle Scholar
12Hickson, M. Malnutrition and aging. Postgrad Med J 2006; 82: 2–8.CrossRefGoogle Scholar
13Watson, L, Leslie, W, Hankey, C. Undernutrition in old age: diagnosis and management. Rev Clin Gerontol 2006; 16: 23–34.CrossRefGoogle Scholar
14Ahmed, T, Haboubi, N. Assessment and management of nutrition in older people and its importance to health. Clin Interv Aging 2010; 5: 207–16.Google ScholarPubMed
15Saka, B, Kayo, O, Ozturk, GB, Erten, N, Karan, MA. Malnutrition in the elderly and its relationship with other geriatric syndromes. Clin Nutr 2010; 29: 745–48.CrossRefGoogle ScholarPubMed
16Newman, AB, Yanez, D, Harris, T, Duxbury, A, Enright, P, Fried, LP. Weight change in old age and its association with mortality. J Am Geriatr Soc 2001; 49: 1309–18.CrossRefGoogle ScholarPubMed
17Castillo, EM, Goodman-Gruen, D, Kritz-Silverstein, D, Morton, DJ, Wingard, DL, Barrett-Connor, E. Sarcopenia in elderly men and women: The Rancho Bernardo study. Am J Prev Med 2003; 25: 226–31.CrossRefGoogle ScholarPubMed
18Kim, JS, Wilson, JM, Lee, SR. Dietary implications on mechanisms of sarcopenia: roles of protein, amino acids and antioxidants. J Nutr Biochem 2010; 21: 1–13.CrossRefGoogle ScholarPubMed
19Kinney, JM. Nutritional frailty, sarcopenia and falls in the elderly. Curr Opin Clin Nut Metab Care 2004; 7: 15–20.CrossRefGoogle ScholarPubMed
20Muscaritoli, M, Anker, SD, Argilés, J, Aversa, Z, Bauer, JM, Biolo, G, Boirie, Y, Bosaeus, I, Cederholm, T, Costelli, P, Fearon, KC, Laviano, A, Maggio, M, Rossi Fanelli, F, Schneider, SM, Schols, A, Sieber, CC. Consensus definition of sarcopenia, cachexia and pre-cachexia: Joint document elaborated by Special Interest Groups (SIG) ‘cachexia-anorexia in chronic wasting diseases’ and ‘nutrition in geriatrics’. Clin Nutr 2010; 29: 154–59.CrossRefGoogle ScholarPubMed
21Bassey, JM, Harris, UJ. Normal values for handgrip strength in 920 men and women aged over 65 years, and longitudinal changes over 4 years in 620 survivors. Clin Science 1993; 84: 331–37.CrossRefGoogle ScholarPubMed
22Dietary reference values for food energy and nutrients for the United Kingdom. Report of the Panel on Dietary Reference Values of the Committee on Medical Aspects of Food Policy. Department of Health No 41. 1991. HMSO, London.Google Scholar
23Evans, WJ. Exercise and nutritional needs of elderly people: effects on muscle and bone. Gerodontology 1998; 15: 15–24.CrossRefGoogle ScholarPubMed
24Rao, SS, Go, JT. Update on the management of constipation in the elderly: treatment options. Clin Interv Aging 2010; 5: 163–71.CrossRefGoogle ScholarPubMed
25Sturtzel, B, Elmadfa, I. Intervention with dietary fiber to treat constipation and reduce laxative use in residents of nursing homes. Ann Nutr Metab 2008; 52: 54–56.CrossRefGoogle ScholarPubMed
26Volkert, D, Kreuel, K, Heseker, H, Stehle, P. Energy and nutrient intake of young-old, old-old and very-old elderly in Germany. Eur J Clin Nutr 2004; 58: 1190–200.CrossRefGoogle ScholarPubMed
27Flood, VM, Burlutsky, G, Webb, KL, Wang, JJ, Smith, WT, Mitchel, P. Food and nutrient consumption trends in older Australians: a 10-year cohort study. Eur J Clin Nutr 2010; 64: 603–13.CrossRefGoogle ScholarPubMed
28Moreiras, O, van Staveren, WA, Amorim Cruz, JA, Carbajal, A, de Henauw, S, Grunenberger, F, Roszkowski, W. Longitudinal changes in the intake of energy and macronutrients of elderly Europeans. SENECA Invesitagors. Eur J Clin Nutr 1996; 50: S67–76.Google ScholarPubMed
29Bianchetti, A, Rozzini, R, Carabellese, C, Zanetti, O, Trabucchi, M. Nutritional intake, socioeconomic conditions, and health status in a large elderly population. J Am Geriatr Soc 1990; 38: 521–26.CrossRefGoogle Scholar
30Vetta, F, Ronzoni, S, Taglier, G, Bollea, MR. The impact of malnutritrion on the quality of life in the elderly. Clin Nutr 1999; 18: 259–67.CrossRefGoogle Scholar
31Maaravi, Y, Berry, EM, Ginsberg, G, Cohen, A, Stessman, J. Nutrition and quality of life in the aged: the Jerusalem 70-year-olds longitudinal study. Aging 2000; 12: 173–79.Google ScholarPubMed
32Hankey, CR, Cullen, A, Wynne, HA, Death, J, Kenny, RA. Non starch polysaccharide/dietary fibre supplementation using small meals in long stay frail elderly patients. Eur J Clin Nutr 1993; 47: 521–24.Google ScholarPubMed
33George, LK. Still happy after all these years: research frontiers on subjective well-being in later life. J Gerontol Soc Sci 2010; 65B: 331–39.CrossRefGoogle ScholarPubMed
34Wilhelmson, K, Andersson, C, Waern, M, Allebeck, P. Elderly people's perspectives on quality of life. Ageing Soc 2005; 25: 585–600.CrossRefGoogle Scholar
35Ware, J, Snow, KK, Kosisnki, M, Gandek, B. SF-36 health survey: manual and interpretation guide. Boston. The Health Institute, New England Medial Center, 1993.Google Scholar
36Webb, E, Blane, D, McMunn, A, Netuveli, G. Proximal predictors of change in quality of life at older ages. J Epidemiol Comm Health 2010 (Epub ahead of print, 6 August).CrossRefGoogle Scholar
37American Dietetic Association. Position of the American Dietetic Assocation: liberalisation of the diet prescription improves quality of life for older adults in long-term care. J Amer Diet Assoc 2005; 105: 1955–65.CrossRefGoogle Scholar
38Schlettwein-Gsell, D. Nutrition and quality of life: a measure for the outcome of nutritional intervention? Am J Clin Nutr 1992; 55: 1263–66s.CrossRefGoogle ScholarPubMed
39Baldwin, C, Parson, TJ. Dietary advice and nutritional supplements in the management of illness-related malnutrition. Clin Nutr 2004; 23: 1267–79.CrossRefGoogle ScholarPubMed
40Milne, AC, Potter, J, Vivanti, A, Avenell, A. Protein and energy supplementation in elderly people at risk from malnutrition. Cochrane Database Syst Rev 2009, issue 2. Mini nutritional assessment. Clin Ger Med 2002; 18: 737–57.Google Scholar
41Krondl, M, Coleman, PH, Bradley, CL, Lau, D, Ryan, N. Subjectively healthy elderly consuming a liquid nutrition supplement maintained body mass index and improved some nutritional parameters and perceived well-being. J Am Diet Assoc 1999; 99: 1542–48.CrossRefGoogle ScholarPubMed
42Saudny-Unterberger, H, Martin, JG, Gray-Donald, K. Impact of nutritional support on functional status during acute exacerbation of chronic obstructive pulmonary disease. Amer J Resp Crit Car Med 1997; 156: 794–99.CrossRefGoogle ScholarPubMed
43FOODtrial 2005. Routine and nutritional supplementation for stroke patients in hospital (FOOD): a multicentre randomised controlled trial. Lancet 2005; 365: 755–63.CrossRefGoogle Scholar
44Hampson, G, Martin, FC, Moffat, K, Vaja, S, Sankaralingam, S, Cheung, J, Blake, GM, Fogelman, I. Effects of dietary improvement on bone metabolism in elderly underweight women with osteoporosis: a randomised controlled trial. Osteopor Int 2003; 14: 750–56.CrossRefGoogle Scholar
45Barr, SI, McCarron, DA, Heaney, RP, Dawson-Hughes, B, Berga, SL, Stern, JS, Oparil, S. Effects of increased consumption of fluid milk on energy and nutrient intake, body weight, and cardiovascular risk factors healthy older adults. J Am Diet Assoc 2000; 100: 810–17.CrossRefGoogle ScholarPubMed
46Collins, CE, Kershaw, J, Brockington, S. Effect of nutritional supplements on wound healing in home-nursed elderly: a randomised trial. Nutr 2005; 21: 147–55.CrossRefGoogle Scholar
47Edington, J, Barnes, R, Bryan, F, Dupree, E, Frost, G, Hickson, M, Lancaster, J, Mongia, S, Smith, J, Torrance, A, West, R, Pang, F, Coles, SJ. A prospective randomised controlled trial of nutritional supplementation in malnourished elderly in the community: clinical and health economic outcomes. Clin Nutr 2004; 23: 195–204.CrossRefGoogle ScholarPubMed
48NICE 2006. National Collaborating Centre for Acute Care. Nutrition support in adults. Oral nutrition support, enteral tube feeding and parenteral nutrition. UK National Institute for Health and Clinical Excellence.Google Scholar
49Frongillo, EA, Wolfe, WS. Impact of participation in home-delivered meals on nutrient intake, dietary patterns, and food insecurity of older persons in New York state. J Nutr Elder 2010; 29: 293–310.CrossRefGoogle ScholarPubMed
50Gollub, EA, Weddle, DO. Improvements in nutritional intake and qualify of life among frail homebound older adults receiving home-delivered breakfast and lunch. J Am Diet Assoc 2004; 104: 1227–35.CrossRefGoogle Scholar
51Kaiser, MJ, Bauer, JM, Rämsch, C, Uter, W, Guigoz, Y, Cederholm, T, Thomas, DR, Anthony, PS, Charlton, KE, Maggio, M, Tsai, AC, Vellas, B, Sieber, CC. Mini Nutritional Assessment International Group. Frequency of malnutrition in older adults: a multinational perspective using the mini nutritional assessment. J Am Geriatr Soc 2010; 58: 1734–38.CrossRefGoogle Scholar
52Wong, A, Burford, S, Wyles, CL, Mundy, H, Sainsbury, R. Evaluation of strategies to improve nutrition in people with dementia in an assessment unit. J Nutr Health Aging 2008; 12: 309–12.CrossRefGoogle Scholar
53Hickson, M, Bulpitt, C, Nunes, M, Peters, R, Cooke, J, Nicholl, C, Frost, G. Does additional feeding support provided by health care assistants improve nutritional status and outcome in actuely ill older in-patients? A randomised control trial. Clin Nutr 2004; 23: 69–77.CrossRefGoogle Scholar
54Simmons, SF, Keeler, E, Zhuo, X, Hickey, KA, Sato, HW, Schnelle, JF. Prevention of unintentional weight loss in nursing home residents: a controlled trial of feeding assistance. J Am Geriatr Soc 2008; 56: 1466–73.CrossRefGoogle ScholarPubMed
55Smoliner, C, Norman, K, Scheufele, R, Hartig, W, Pirlich, M, Lochs, H. Effects of food fortification on nutritional and functional status in frail elderly nursing home residents at risk of malnutrition. Nutr 2008; 24: 1139–44.CrossRefGoogle ScholarPubMed
56Odlund Olin, A, Koochek, A, Cederholm, T, Ljungqvist, O. Minimal effect on energy intake by additional evening meal for frail elderly service flat residents – a pilot study. J Nutr Health Aging 2008; 12: 295–301.CrossRefGoogle ScholarPubMed
57Arvanitakis, M, Coppends, P, Doughan, L, Van Gossum, A. Nutrition in care homes and home care: recommendations – a summary based on the report approved by the Counci of Europe. Clin Nutr 2009; 28: 492–96.CrossRefGoogle Scholar
58Dahlin-Ivanoff, S, Gosman-Hedström, G, Edberg, AK, Wilhelmson, K, Eklund, K, Duner, A, Ziden, L, Welmer, AK, Landahl, S. Elderly persons in the risk zone. Design of a multidismensional health-promoting, randomised three-armed controlled trial ‘prefrail’ people of 80+ years living at home. BMC Geriat 2010; 10: 27.CrossRefGoogle ScholarPubMed
59El-Kadiki, A, Sutton, AJ. Role of multivitamins and mineral supplements in preventing infections in elderly people: systematic review and meta-analysis of randomised controlled trials. BMJ 2005; 330: 871.CrossRefGoogle ScholarPubMed
60Avenell, A, Campbell, MK, Cook, JA, Hannaford, PC, Kilonzo, MM, McNeill, G, Milne, AC, Ramsay, CR, Seymour, DG, Stephen, AI, Vale, LD. Effect of multivitamin and multimineral supplements on morbidity from infections in older people (MAVIS trial): pragmatic, randomised, double blind, placebo controlled trial. BMJ 2005; 331: 324–29.CrossRefGoogle ScholarPubMed