Food Fortification and Frail Elderly Nursing Home Residents

Abstract

In higher age, several factors may lead to decreased intake of food. Physiological age-related changes such as decrease in taste and smell and reduced sensation of thirst may reduce the drive to eat, while physical disability on the other hand may impair the capacity of providing, cooking, or eating meals. Besides, high morbidity and multiple medication which are frequently present in the elderly, as well as sociopsychological factors such as depression, isolation, poverty, or mental disorders may further contribute to insufficient nutritional intake (see Table 14.1). Recently, several studies have furthermore demonstrated an altered, decreased muscle protein synthesis following protein ingestion in the elderly [1, 2], placing them at high risk of developing sarcopenia, an age-associated phenomenon, where muscle mass and functional capacity are reduced [3]. The functional consequences of malnutrition very often lead to increasing isolation and a greater dependency that ultimately impair quality of life [4]. And vice versa, elderly nursing residents who exhibit various degrees of dependence are therefore at increased risk of malnutrition. An analysis combining data from 12 countries revealed a prevalence of malnutrition of 22.8 % in elderly subjects, with the highest occurrence in rehabilitation units, followed by hospitals and nursing homes, where nearly 14 % of residents were moderately or severely malnourished [5]. The prevalence of malnutrition in nursing homes can be considered an indicator of the quality of nutritional care, although it still remains unclear to what extent malnutrition is preventable in elderly nursing home residents.