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2024
- ISIDORE Id: 10670/1.63c7fd...
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Older persons Older adults Seniors (Older people) Elderly people Old people Senior citizens Aging people AgedCiter ce document
Dorothee Volkert et al., « ESPEN guidelines on clinical nutrition and hydration in geriatrics », Gériatrie et Psychologie Neuropsychiatrie du Vieillissement, ID : 10670/1.63c7fd...
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BackgroundMalnutrition and dehydration are common in older people, and obesity is an increasing problem. In clinical practice, it is often unclear which strategies are most suitable and effective to counteract these key health threats.AimTo provide evidence-based recommendations for clinical nutrition and hydration in older persons in order to prevent and/or treat malnutrition and dehydration. In addition, to address whether weight loss interventions are appropriate for overweight or obese older persons.MethodsThis guideline was developed according to the standard operating procedure for ESPEN guidelines and consensus papers. A comprehensive literature search for systematic reviews and primary studies was performed based on 33 clinical questions in PICO format. Existing evidence was graded according to the SIGN grading system. Recommendations were developed and agreed through a multistage consensus process.ResultsWe provide 82 evidence-based recommendations regarding nutritional care for older persons, covering four main topics: basic questions and general principles; recommendations for older persons with malnutrition or at risk of malnutrition; recommendations for older patients with specific diseases; and recommendations to prevent, identify, and treat dehydration. Overall, we recommend that all older persons routinely be screened for malnutrition in order to identify an existing risk early. Oral nutrition can be supported by nursing interventions, education, nutritional counseling, food modification, and oral nutritional supplements. Enteral nutrition should be initiated if oral nutrition is insufficient or impossible, and parenteral nutrition should be initiated if enteral nutrition is insufficient or impossible, provided that the patient’s overall prognosis is favorable. Dietary restrictions should generally be avoided, and weight-loss diets should only be considered in obese older persons with weight-related health problems. Such diets should also be combined with physical exercise. All older persons should be considered at risk of low-intake dehydration and encouraged to consume adequate amounts of liquid. Generally, interventions should be individualized, comprehensive, and part of a multimodal and multidisciplinary team approach.ConclusionA range of effective interventions are available to support adequate nutrition and hydration in older persons in order to maintain or improve their nutritional status, clinical progress, and quality of life. These interventions should be implemented in clinical practice and routinely used.
