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Malnutrition in the Elderly

  • W. O. Seiler
  • H. B. Stähelin

Table of contents

  1. Front Matter
    Pages i-viii
  2. Introduction

    1. Hannes B. Stähelin
      Pages 1-2
  3. Epidemiology of malnutrition

    1. D. Schlettwein-Gsell, B. Decarli, J. A. Amorim Cruz, J. Haller, C. P. G. M. de Groot, W. A. van Staveren
      Pages 3-11
    2. Walter O. Seiler
      Pages 13-18
  4. Physiopathology of malnutrition

  5. Consequences of malnutrition

    1. Hannes B. Stähelin
      Pages 43-47
    2. René Rizzoli, J.-P Bonjour
      Pages 49-58
  6. Causes of malnutrition

    1. David R. Thomas
      Pages 59-68
  7. Diagnosis of malnutrition

    1. S. Lauque, F. Nourhashemi, B. Vellas
      Pages 69-81
    2. Hans-Peter Roth, Manfred Kirchgessner
      Pages 83-95
  8. Treatment of malnutrition

    1. Eva Eisenbart, Peter Oster, Matthias Schuler, Günter Schlierf
      Pages 97-104
    2. A. Jordan, W. F. Caspary, J. Stein
      Pages 105-112
  9. Prevention of malnutrition

    1. Barbara E. Millen
      Pages 121-132

About these proceedings

Introduction

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.

Keywords

Catabolic metabolism Food intake Malnutrition Nutritional status food health immune system muscle nutrition osteoporosis prevention

Editors and affiliations

  • W. O. Seiler
    • 1
  • H. B. Stähelin
    • 1
  1. 1.Geriatrische Universitätsklinik KantonsspitalBaselSwitzerland

Bibliographic information