Malnutrition
Consequences Of Undernutrition
In elderly people, weight loss and undernutrition affect functional and cognitive abilities, and the immune response (Chandra). This may result in serious complications including difficulty in swallowing, dehydration, and pressure ulcers. Poor nutritional status also leads to decreased lean body mass, and lessened muscular strength and aerobic capacity. These changes contribute to a state of chronic fatigue, as well as alterations in gait and balance, which increase the probability of falls and fractures. For many older people, this sequence of events leads to a deterioration in their overall quality of life, causing the affected individual to become increasingly dependent on others. The ultimate cost to the individual and society is great.
BRYNA SHATENSTEIN
See also CONGREGATE AND HOME DELIVERED MEALS; DEMENTIA; DENTAL CARE; NUTRITION; SARCOPENIA; TASTE AND SMELL; VITAMINS.
BIBLIOGRAPHY
American Dietetic Association. "Position of the American Dietetic Association: Nutrition, Aging, and the Continuum of Care." Journal of the American Dietetic Association. 100 (2000): 580–595.
AUSMAN, L. M., and RUSSELL, R. M. "Nutrition in the Elderly." In Modern Nutrition in Health and Disease, 9th ed. Edited by M. E. Shils, J. A. Olson, M. Shike, and A. C. Ross. Baltimore: Williams & Wilkins, 1999. Pages 869–881.
BARRETT-CONNOR, E.; EDELSTEIN, S.; COREY-BLOOM, J.; and WIEDERHOLT, W. "Weight Loss Precedes Dementia in Community-Dwelling Older Adults." Journal of American Geriatrics Society 44 (1996): 1147–1152.
BLUMBERG, J. "Nutritional Needs of Seniors." Journal of the American College of Nutrition 16 (1997): 517–523.
CHANDRA, R. K. "Effect of Vitamin and Trace Element Supplementation on Immune Response and Infection in Elderly Subjects." Lancet 340 (1992): 1124–1127.
CUMMINGS, S. R.; NEVITT, M. C.; BROWNER, W. S.; STONE, K.; FOX, K. M.; ENSRUD, K. E.; CAULEY, J.; BLACK, D.; and VOGT, T. M. "Risk Factors for Hip Fracture in White Women. Study of Osteoporotic Fractures Research Group." New England Journal of Medicine 332, no. 12 (1995): 767–773.
DONALDSON, K. E.; CARPENTER, W. H.; TOTH, M. J.; GORAN, M. I.; NEWHOUSE, P.; and POEHLMAN, E. T. "No Evidence for a Higher Resting Metabolic Rate in Noninstitutionalized Alzheimer's Disease Patients." Journal of American Geriatrics Society 44, no. 10 (1996): 1232–1234.
FERLAND, G. "The Vitamin K-Dependent Proteins: An Update." Nutrition Reviews 56, no. 8 (1998): 223–230.
FRANZONI, S.; FRISONI, G. B.; BOFFELLI, S.; ROZZINI, R.; and TRABUCCHI, M. "Good Nutritional Oral Intake is Associated with Equal Survival in Demented and Nondemented Very Old Patients." Journal of the American Geriatrics Society 44 (1996): 1366–1370.
GARRY, P. J., and VELLAS, B. J. "Aging and Nutrition." In Present Knowledge in Nutrition, 7th ed. Edited by E. E. Ziegler and L. J. Filer, Jr. Washington, D.C.: ILSI Press, 1996. Pages 414–419.
HALLFRISCH, J.; MULLER, D. C.; and SINGH, V. N. "Vitamin A and E Intakes and Plasma Concentrations of Retinol, Beta-Carotene, and Alpha-Tocopherol in Men and Women of the Baltimore Longitudinal Study of Aging." American Journal of Clinical Nutrition 60 (1994): 176–182.
HARRIS, T. B.; LOOKER, A. C.; MADANS, J.; and BACON, E. C. "Weight Loss and Risk of Hip Fracture in Postmenopausal White Women Aged 60–74. The NHANES-1 Epidemiologic Follow Up Study." Journal of American Geriatrics Society 40 (1992): SA5.
HEANEY, R. P. "Age Considerations in Nutrient Needs for Bone Health: Older Adults." Journal of the American College of Nutrition 15 (1996): 575–578.
JACQUES, P. F. "The Potential Preventive Effects of Vitamins for Cataract and Age-Related Macular Degeneration." International Journal of Vitamin and Nutrition Research 69 (1999): 198–205.
KELLER, H. H. "Weight Gain Impacts Morbidity and Mortality in Institutionalized Older Persons." Journal of American Geriatrics Society 43, no. 2 (1995): 165–169.
KELLER, H. H., and OSTBYE, T. "Do Nutrition Indicators Predict Death in Elderly Canadians with Cognitive Impairment?" Canadian Journal of Public Health 91, no. 3 (2000): 220–224.
KROMHOUT, D. "Fatty Acids, Antioxidants, and Coronary Heart Disease from an Epidemiological Perspective." Lipids 34, supp. (1999): S27–S31.
LOSONCZY, K. G.; HARRIS, T. B.; CORNONI-HUNTLEY, J.; SIMONSICK, E. M.; WALLACE, R. B.; COOK, N. R.; OSTFELD, A. M.; and BLAZER, D. G. "Does Weight Loss from Middle Age to Old Age Explain the Inverse Weight Mortality Relation in Old Age?" American Journal of Epidemiology 141, no. 4 (1995): 312–321.
MASAKI, K. H.; LOSONCZY, K. G.; IZMIRLIAN, G.; FOLEY, D. J.; ROSS, G. W.; PETROVITCH, H.; HAVLIK, R.; and WHITE, L. R. "Association of Vitamin E and C Supplement Use with Cognitive Function and Dementia in Elderly Men." Neurology 54 (2000): 1265–1272.
MELTON, L. J.; KHOSLA, S.; CROWSON, C. S.; O'CONNOR, M. K.; O'FALLON, W. M.; and RIGGS, B. L. "Epidemiology of Sarcopenia." Journal of the American Geriatrics Society 48 (2000): 625–630.
National Academy of Sciences (NAS). "Dietary Reference Intakes: Applications in Dietary Assessment," 2000. www.nap.edu
OMRAN, M. L., and MORELY, J. E. "Assessment of Protein Energy Malnutrition in Older Persons, Part 1: History, Examination, Body Composition, and Screening Tools." Nutrition 16 (2000): 50–63.
PAYETTE, H.; COULOMBE, C.; BOUTIER, V.; and GRAY-DONALD, K. "Weight Loss and Mortality Among the Free-Living Frail Elderly: A Prospective Study." Journal of Gerontology: Medical Sciences 54A (1999): M440–M445.
PERKINS, A. J.; HENDRIE, H. C.; CALLAHAN, C. M.; GAO, S.; UNVERZAGT, F. W.; XU, Y.; HALL, K. S.; and HUI, S. L. "Association of Antioxidants with Memory in the Multiethnic Elderly Sample Using the Third National Health and Nutrition Examination Survey." American Journal of Epidemiology 150 (1999): 37–44.
POEHLMAN, E. T. "Energy Expenditure and Requirements in Aging Humans." Journal of Nutrition 122 (1992): 2057–2065.
ROSENBERG, I. H. "Sarcopenia: Origins and Clinical Relevance." Journal of Nutrition 127 (1997): 990S–991S.
ROSENBERG, I. H., and MILLER, J. W. "Nutritional Factors in Physical and Cognitive Functions of Elderly People." American Journal of Clinical Nutrition 55 supp. (1992): 1237S–1243S.
ROUBENOFF, R., and HARRIS, T. B. "Failure to Thrive, Sarcopenia, and Functional Decline in the Elderly." Clinical Geriatric Medicine 13 (1997): 613–621.
RUSSELL, R. M.; RASMUSSEN, H.; and LICHTENSTEIN, A. H. "Modified Food Guide Pyramid for People Over Seventy Years of Age." Journal of Nutrition 129, no. 3 (1999): 751–753.
SHATENSTEIN, B., and FERLAND, G. "Absence of Nutritional or Clinical Consequences of Decentralized Bulk Food Portioning in Elderly Nursing Home Residents with Dementia in Montreal." Journal of the American Diet Association 100, no. 11 (2000): 1354–1360.
SULLIVAN, D. H., and WALLS, R. C. "Impact of Nutritional Status on Morbidity in a Population of Geriatric Rehabilitation Patients." Journal of the American Geriatrics Society 42 (1994): 471–477.
WHITE, H.; PIEPER, C.; SCHMADER, K.; and FILLENBAUM, G. "Weight Change in Alzheimer's Disease." Journal of the American Geriatrics Society 44, no. 3 (1996): 265–272.
MANAGED CARE
See MEDICARE
Additional topics
Medicine EncyclopediaAging Healthy - Part 3Malnutrition - Food And Nutrient Needs, Causes Of Malnutrition, Prevalence Of Malnutrition, Weight Loss And Undernutrition In Dementia