Abstract
The nutritional needs of the geriatric patient are influenced by many factors. Changes associated with aging, individual behavior, drugs, and disease augment nutritional risk for older adults. As with persons of all ages, proper nutrition and maintaining a healthy weight are very important in elderly Long-term care (LTC) residents (including subacute care, assisted living, and nursing homes, all herein generically grouped together under the rubric of “LTC”). Optimal nutrition should ideally improve health, functioning, and quality of life and reduce the risk of morbidity, mortality, and complications such as osteoporosis, weakness, pressure sores, impaired immunity, frailty, and sarcopenia. Weight loss is a negative quality indicator and risk factor for poor outcomes – survival is markedly improved with appropriate and adequate nutrition. However, maintaining appropriate nutrition, hydration, oral intake, and weight may be challenging particularly in some elderly LTC residents. Those who have dementia, depression, and gastrointestinal, neurological, musculoskeletal, or psychiatric disorders or indeed any medical condition or drug that may impair appetite, mobility, swallowing, chewing, feeding, digestion, and bowel function are especially at nutritional risk.
An erratum to this chapter can be found at http://dx.doi.org/10.1007/978-1-60761-142-4_17
An erratum to this chapter can be found at http://dx.doi.org/10.1007/978-1-60761-142-4_17
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References
Morley JE, Silver AJ. Nutritional issues in nursing home care. Ann Intern Med 1995;123:850–859.
American Medical Directors Association. Dehydration and Fluid Maintenance. Clinical Practice Guideline, 2001, Rev. 2009.
American Medical Directors Association. Altered Nutritional Status. Clinical Practice Guideline, 2001.
Bouillanne O, Morineau G, Dupont C, et al. Geriatric nutritional risk index: a new index for evaluating at-risk elderly medical patients. Am J Clin Nutr 2005;82(4):777–783.
Seltzer MH, Bastidas A, Cooper DM, et al. Instant nutritional assessment. JPEN J Parenter Enteral Nutr 1979;3:157–159.
Corti MC, Guralnik JM, Salive ME, Sorkin JD. Serum albumin level and physical disability as predictors of mortality in older patients. JAMA 1994;272:1036–1042.
Wilson MM, Vaswani S, Liu D, et al. Prevalence and causes of undernutrition in medical. Am J Med 1998;104:56.
Thomas DR, Ashmen W, Morley JE, et al. Nutritional management in long-term care: development of a clinical guideline. J Gerontol Med Sci 2000;55A:M725–M734.
Prospective Studies Collaboration. Body mass index and cause specific mortality in 900000 adults: collaborative analysis of 57 prospective studies. Lancet 2009;373:1083–1096.
Orpana HM, Berthelot JM, Kaplan MS, et al. BMI and mortality: results from a national longitudinal study of Canadian adults. Obesity 2010;18(1):214–218.
Thomas DR. But is it malnutrition? JAMDA 2009;10(5):295–297.
American Psychiatric Association Practice Guideline for the Treatment of Patient Residents with Major Depressive Disorder, 2nd Edition. Available online at http://www.psychiatryonline.com/pracGuide/pracGuideTopic_7.aspx. Accessed 26 June, 2009.
Thomas DR, Tariq SH, et al. Physician misdiagnosis of dehydration in older adults. JAMDA 2003;4:251–254.
Gaffney-Stomberg E, Insogna KL, Rodriguez NR, Kerstetter JE. Increasing dietary protein requirements for elderly people for optimal muscle and bone health. JAGS 2009;57:1073–1079.
Goldberg TH, Hassan T, Grant R. High prevalence of vitamin D deficiency in elderly nursing home patients despite vitamin supplements (abstract). JAMDA 2008;9(3):B15.
Morley JE. Should all long-term care residents receive vitamin D? JAMDA 2007;8:69–70.
Vitale CA, Monteleoni C, et al. Strategies for improving care for patients with advanced dementia and eating problems: optimizing care through physician and speech pathologist collaboration. Ann LTC 2009;17(5):32–39.
Nijs K, Graaf C, Staveren W, et al. Malnutrition and mealtime ambience in nursing homes. JAMDA 2009;10:226–229.
Yeh S, Lovitt S, Schuster MW. Pharmacological treatment of geriatric cachexia: evidence and safety in perspective. JAMDA 2007;8(6):363–377.
Miller LJ, et al. Pharmacological treatment of undernutrition in the geriatric patient. Consult Pharm 2002;17:739–747.
Finucane TE, Christmas C, Travis K. Tube feeding in patients with advanced dementia: a review of the evidence. JAMA 1999;282:1365–1370.
Kuo S, Rhodes R, Mitchell SL, et al. Natural history of feeding tube use in nursing home residents with advanced dementia. JAMDA 2009; 10:264–270.
American Medical Directors Association. Synopsis of Federal Regulations in the Nursing Facility: Implications for Attending Physicians and Medical Directors, Rev. 2007. Available online at http://www.amda.com .
Miller ER, Pastor-Barriuso R, Dalal D, et al. Meta-analysis: high dosage vitamin E supplementation may increase all cause mortality. Ann Intern Med 2005;142(1):37–46.
Fick DM, Cooper JW, Wade WE, Waller JL, Maclean JR, Beers MH. Updating the Beers criteria for potentially inappropriate medication use in older adults: results of a US consensus panel of experts. Arch Intern Med 2003;163:2716–2724.
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Goldberg, T.H., Levine, J.A. (2011). Weight and Nutrition. In: Fenstemacher, P., Winn, P. (eds) Long-Term Care Medicine. Current Clinical Practice. Humana Press. https://doi.org/10.1007/978-1-60761-142-4_9
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DOI: https://doi.org/10.1007/978-1-60761-142-4_9
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