Nutritional Status And Methods Of Its Evaluation In Elderly And In Demented Patients

Abnormal nutritional status (malnutrition) is a major clinical problem in the general population, and even more important in specific populations (children and elderly people). Unfortunately, prevalence of malnutrition is usually underestimated, its importance is often minimized, and the assessment overlooked in the routine examination of patients. The recommendations regarding the evaluation of nutritional status of hospitalized patients were introduced in Poland recently. Elderly population is one of the specific population at the highest risk of malnutrition. Among seniors the phenomenon of protein and energy deficiency (called protein-energy malnutrition, PEM) is observed. High incidence of malnutrition among seniors is a consequence of many factors. Some of them are general in nature, the other are typical of their age (including both biological and psychosocial factors). A long list of factors includes: processes of aging, loss of appetite, decreased sense of taste and/or odour, malabsorption, dental prosthetic, gastrointestinal diseases, systemic illness, medications, sensory deficits, altered level of activity and social changes for food preferences, physical condition and mental state. Malnutrition is frequent in demented patients and is associated with increased severity of neuropsychiatric symptoms (hallucinations, apathy, behaviour disorders, sleep disorders), worse prognosis, increased risk of nursing home placement and, consequently, an increase in mortality. In this context, it is essential to detect the improperly nourished cases. There is a wide array of diagnostic methods, ranging from simple screening instruments through very extensive questionnaires, to methods using specialized and expensive equipment (bioelectrical impedance analysis, dual X-ray absorptiometry).