Download advies Undernutrition in The Elderly.fm

Executive summary
In recent years, there has been an increasing focus on the issue of undernutrition
in the elderly. Hospitals and care institutions are alert to the risk of protein and
energy deficiency in the elderly and provide nutritional supplementation where
this is deemed to be necessary. This is considered to be a necessary step to
improve the health of elderly people. The Minister of Health, Welfare and Sport
has asked the Health Council of the Netherlands to provide a scientific basis for
the way undernutrition is dealt with. What is the exact scope of the problem,
what is the best way of identifying cases of undernutrition, and how can this
condition best be treated? The Health Council has now collated the available data
on this issue.
Over the long term, inadequate protein and energy intake is known to be harmful
to health. However, it is not clear exactly where the boundary lies. When can
someone be said to be undernourished? In practice, a range of methods is used to
measure undernutrition (such as recent weight loss, and a low Body Mass Index).
There is no “gold standard” (i.e. a reliable method). While various studies have
demonstrated the existence of a link between undernutrition and mortality rate,
for example, it is not known whether a causal connection exists. In other words,
are elderly people at greater risk of dying as a result of undernutrition, or is their
higher mortality risk mainly due to other factors, such as disease? As long as
there is no clarity on this issue, there will be no reliable data on the severity and
scope of the problem of undernutrition in the elderly.
Executive summary
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Furthermore, many questions still remain to be answered concerning the
effectiveness of dietary interventions in the elderly. While a great deal of
research has been published in this area, the quality of the research in question is
substandard. According to the Health Council, nutritional supplementation with
extra protein and energy should produce clear health gains, such as shorter
hospital stays or a lower mortality risk. However, it is impossible to identify
those cases to which this would apply.
The current approach to undernutrition in the elderly is based on the view that the
treatment of this condition is always worthwhile. However, this view is very
much open to debate. Given the lack of a reliable method of measurement, too
many elderly people may be classified as being undernourished. Accordingly, for
some of these individuals, nutritional supplementation with extra protein and
energy may not actually help to improve their health. Part of the elderly people
who have experienced weight loss due to illness may also recover by receiving
proper medical treatment, without a contributing effect of nutritional
supplementation. There is another category of undernourished elderly people,
however, for whom nutritional supplementation is essential to their health. As
yet, there are no exact details concerning the cases to which this would apply. A
better understanding of this issue is needed if undernutrition is to be dealt with
effectively.
Undernutrition can be harmful to health, so it is vital to ensure that elderly people
enjoy a good nutritional status. However, solid scientific research is needed to
identify the magnitude of the problem, and the most effective way of dealing
with it. According to the Health Council, collaboration between care providers is
needed to achieve studies of good quality and sufficient scope.
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Undernutrition in the elderly