Thus, obesity is also a frequent problem among the elderly.
Nadim Haboubi, Consultant Physician.
This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited. This article has been cited by other articles in PMC. Abstract Nutrition is an important element of health in the older population and affects the aging process.
The prevalence of malnutrition is increasing in this population and is associated with a decline in: Older people often have reduced appetite and energy expenditure, which, coupled with a decline in biological and physiological functions such as reduced lean body mass, changes in cytokine and hormonal level, and changes in fluid electrolyte regulation, delay gastric emptying and diminish senses of smell and taste.
In addition pathologic changes of aging such as chronic diseases and psychological illness all play a role in the complex etiology of malnutrition in older people.
Nutritional assessment is important to identify and treat patients at risk, the Malnutrition Universal Screening Tool being commonly used in clinical practice. Management requires a holistic approach, and underlying causes such as chronic illness, depression, medication and social isolation must be treated.
Patients with physical or cognitive impairment require special care and attention. Oral supplements or enteral feeding should be considered in patients at high risk or in patients unable to meet daily requirements.
The difficulty is that with age it can be difficult to exclude pathological factors such as diabetes, pancreatitis, liver disease and malignancy, since these factors will have potential adverse effects on the intestine.
Selective neurodegeneration of the aging enteric nervous system can lead to gastrointestinal symptoms such as dysphagia, gastrointestinal reflux and constipation. Hypochlorhydia occurs due to chronic gastritis. Consequently, proton pump inhibitors are frequently used for prolonged periods in older people leading to suppressed acid secretions.
Procedures such as vagotomy and gastric resections both seen in older people cause reduced acid levels. The overall reduction in acid secretions predisposes the gut to small bowel bacterial overgrowth.
Healthy older people are less hungry and are fuller before meals, consume smaller meals, eat more slowly, have fewer snacks between meals and become satiated after meals more rapidly after eating a standard meal than younger people.
However in many older people the decrease in energy intake is greater than the decrease in energy expenditure, and therefore body weight is lost.“Do you think his assessment is accurate?” was the subject line of an email I got from a good friend recently.
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