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GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE
A Journal on Internal Medicine and Pharmacology
Indexed/Abstracted in: BIOSIS Previews, EMBASE, Scopus, Emerging Sources Citation Index
Gazzetta Medica Italiana Archivio per le Scienze Mediche 2000 August;159(4):139-42
Evaluation of malnutrition in the elderly. Personal series
Terra L. 1, Pellicanò S. 1, Calzone R. 2, Dattola O. L. 1, Mandica D. 2, Ciliberto E. 3
1 Regione Calabria - A.S.L. n. 5, Ospedale «S. Giovanni di Dio», Divisione di Malattie Infettive - Crotone;
2 Regione Calabria - A.S.L. n. 5, Ospedale «S. Giovanni di Dio», Dietista;
3 Regione Calabria - A.S.L. n. 5, Ospedale «S. Giovanni di Dio», Servizio di Gastroenterologia ed Endoscopia Digestiva
Background. Nutritional deficit in the elderly is more common than expected and it is often associated with a deterioration in general conditions. The most important repercussions involve a number of organs and apparatus: the immune response is damaged, respiratory function is depressed, there is poor intestinal absorption, diuresis becomes inadequate and the heart is liable to decompensation owing to protein depletion. The aim of this study is to draw up guidelines for evaluating the state of malnutrition in a series of 456 patients, including 212 males (46%) and 244 females (54%) aged over 60 who were enrolled from 2375 (19%) attending our Division during the period 1993-1998.
Methods. The evaluation is based on an analysis of eating habits, the trend of bodyweight and the real ability to intake food. An objective examination of patients was made and blood testg were performed. Nutritional deficits were then quantified and a differential diagnosis was made of deficits together with a study of the etiology. The classification of elderly patients in groups of increasing risk is based on the association between dietary medical history, laboratory and immunological data and anthropometric tests.
Results. 79% of patients show signs of malnutrition with a variety of associated causes: dehydration (312), anemia (44), altered dentition (31), neoplasms (9), hypothyroidism (7). A weight loss of less than 10% provides grounds for suspected initial malnutrition syndrome; between 20-30% there is a high risk of malnutrition; a weight loss of over 30% results in an increase in morbidity.
Conclusions. The dietary requirements of the elderly are not very different to other age groups, but it is advisable to restrict calorie intake, ensure a carbohydrate intake of 50-55% and 30% fats. The introduction of liquids based on fluid losses is also recommended, including at least 400 ml/day of milk; wholemeal bread, fruit and vegetables. Clearly, an adequate prevention programme must be introduced to ensure early diagnosis of malnutrition.