Malnutrition in the Elderly with Dementia
What is Malnutrition?
Malnutrition is a state of nutrition (under or over nutrition) in which a lack of protein, energy and other nutrients causes measurable adverse effects on tissue and/or body form, composition, function or clinical outcome. We will focus on under nutrition as a nutritional concern. The main cause for concern among older people in the UK is that they are not eating enough to maintain good nutrition. Among the population of older people in residential care there are many more underweight people than there are overweight or obese people, and in old age being underweight poses a far greater risk to health than being overweight. The most recent information on the nutritional status of older people in Britain was reported in the National Diet and Nutrition Survey (NDNS) of people aged 65 years and over in 1998. In this survey, 3% of men and 6% of women living at home were underweight, while comparable figures for those in residential care were 16% and 15% respectively. It is suggested, however, that risk of undernutrition is still not adequately identified in older people and that undernutrition is often associated with hospitalisation and poor health status.1 The level of undernutrition among older people with dementia in residential care is likely to be even higher, with estimates that as many as 50% of older people with dementia have inadequate energy intakes. Undernutrition is related to increased mortality, increased risk of fracture, increased risk of infections and increased risk of specific nutrient deficiencies leading to a variety of health-related conditions that can greatly affect the quality of life. Disease can also exert a potent influence on malnutrition as medical conditions can reduce food intake and impair digestion and absorption of nutrients as well as affect how the body metabolises and utilises them. The causes of undernutrition in older people in residential care are often...
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