2023-06-23 12:00:00
Definition: when is an elderly person undernourished?
For the High Authority for Health (HAS) and the French Nutrition Federation, a malnourished elderly person presents the state of an organism in nutritional imbalance. This is characterized by a negative energy and/or protein balance. Several factors can be at the origin of undernutrition: a deficit of protein-energy intake, an increase in energy expenditure, or an increase in energy and/or protein losses. Malnutrition can have serious consequences: epidemiological data show a excess mortality with IMC less than 22 in the elderly population.
What are the symptoms of malnutrition?
The diagnosis of malnutrition in the elderly is not always easy. Aging is accompanied by a change in body composition with a decrease in lean mass and an increase in fat mass. Often undernutrition is accompanied by unusual fatigue.
Weight loss, a major warning sign in the elderly
As soon as there is an imbalance, either because the contributions are reducedthat the person has appetite disorders, or trouble eating, this is a first warning sign. A person who has a loss of appetite decreases their nutritional intake. Losing 2-3 kg is a warning sign. When the weight loss is higher, the threshold of undernutrition is reached. But the goal is, when possible, to avoid getting to that and toanticipate weight loss long before she reaches the stage of malnutrition.
« For a young person, when she loses weight, it means she exercises more. When the person is old, the origin is often a disease : cancer or an unstabilized chronic disease, kidney or heart failure, repeated hospitalizations… The best reflection of the imbalance is weigh. This weight loss is the earliest indicator. It is essential to ask the person about their appetite and to know why they eat less “says geriatrician Manuel Sanchez.
A reduction in muscle strength
Moreover, the reduction of muscle strength alone, frequent in the elderly population, can be the sign of various pathologies (osteoarthritis, Parkinson’s disease, etc.), regardless of nutritional status. To assess nutritional status, it is therefore necessary toassociate a decrease in strength with a decrease in muscle mass in elderly subjects.
Prevention: what should you watch out for?
The HAS recommends weigh yourself once per mes and at each consultation. “The idea would be to set up a truly shared medical file with a weight history. Another method is to look at the clothes. It is indeed a population that does not redo its wardrobe every four mornings. If we see that the belt has been tightened by one or two notches, loose clothing, we can question ourselves. Another indicator is to ask the person their ideal weight », explained Manuel Sanchez.
Treatment: how to cure malnutrition?
It is necessary to be vigilant with the indicators of an undernutrition of the old person as early as possible. As soon as a beginning of weight loss or loss of appetite is identified, we should not wait to see how improve nutritional intake in terms of energy and protein, older people needing a diet richer in protein.
Increase protein intake to fight early malnutrition
You can set up power boost, such as adding fresh cream or grated cheese to soups. If the problem is taken care of quickly, this may be enough. Of course, the most protein-rich foods are foods with animal protein. It is also necessary that all the essential amino acids are represented in the foods that the elderly person eats.
Food supplements to meet nutritional needs
But in a phase of severe malnutrition in the elderly, this is not enough. In addition, it is necessary to administer nutritional supplements orals, drinks, biscuits… Developed by manufacturers, they are calibrated to contain vitamins, trace elements and an extremely high energy density in a given volume. It’s a high calorie and protein supplement which can usually be taken twice a day to increase nutritional intake.
Artificial nutrition in cases of severe malnutrition
If this does not work, or if the undernutrition is very severe, we use techniques of artificial nutrition, which provides effortless nutrient solutions for the patient. It is either enteral nutrition (feeding directly into the stomach), either parenteral nutritionby central venous route, which must be carried out in the hospital.
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