Malnutrition is an important cause of health for older persons, with community surveys showing that about 4 per cent of older persons are malnourished, while among hospitalized people, malnutrition can be as high as 15 per cent.
Between normal nutritional status and malnutrition, that is, the stage at risk of malnutrition, according to statistics, about 40% of the elderly are in this stage.
Although the impact is small on weekdays, if surgery is required for some diseases, postoperative recovery will be worse than that of the elderly with normal nutritional status.
01 Causes of nutritional problems in the elderly
/ Low nutrient intake /
The sense of smell and taste in the elderly will be reduced, and the chewing function of teeth may not be good, which will affect the intake of food.
The elderly generally have fewer social activities, low consumption, and a lower basal metabolic rate, which leads to a decrease in the amount of food in the elderly.
Some elderly people who live alone, no one to cook for themselves, and no atmosphere to eat, can also lead to insufficient nutritional intake.
In addition, the elderly usually coexist with multiple diseases, and taking multiple drugs every day can also affect appetite.
/ Poor nutrient absorption /
Physiological functions such as the gastrointestinal tract of the elderly decline, and the ability to absorb nutrients will also decline.
/ Chronic depletion /
Some chronic wasting diseases, such as diabetes, can cause metabolic abnormalities, and tumor diseases can increase the body's nutrient consumption, and malnutrition may occur.
02 How to tell if the elderly are malnourished
There are two test methods we can use at home:
/ Direct weight measurement /
We can compare our current weight with our weight 3 months ago. If you lose more than 3 kg of weight in the last 3 months, you may be at risk of malnutrition.
/ Calculate Body Mass Index (BMI) /
For people under 70 years of age, the body mass index should not be less than 18.5;
People over the age of 70, considering that height may be shortened due to osteoporosis, the minimum value of the body mass index is raised to 22, and if the BMI is lower than 22, there may be a risk of malnutrition.
Of course, if you can't judge yourself, or if you suspect that you may be at risk of malnutrition after the above calculations, you can go to the geriatric department or gastroenterology department of the hospital.
Doctors will measure based on 6 indicators to determine whether it is a normal nutritional status, a risk of malnutrition, or malnutrition. These indicators and scoring criteria are shown in the following figure:
If the score is at risk of malnutrition or malnutrition, pay special attention to the extent of weight loss, if the decline is more than 10%, it may indicate that malnutrition is already serious and requires immediate and effective treatment.
03 How to supplement nutrition in malnourished elderly people
/ Balanced Diet, Nutritional Supplementation /
First of all, if malnutrition is simply due to insufficient food intake, and there are no other diseases, the best way to supplement nutrition is to eat a balanced diet and make a recipe according to preferences.
Total calorie intake standard: The daily calorie intake of the elderly should be calculated according to 30-35 kcal per kilogram of body weight, such as 60 kg of weight, and the minimum daily intake should be 1800 kcal.
Carbohydrates and fats are the main sources of calories. Carbohydrates, which are staple foods such as rice and steamed buns that we usually eat, should account for 65% and fat should account for 35%.
Protein is mainly a nutrient that maintains muscle content in the body, as well as some other important physiological functions, because many elderly people have muscle mass loss, so protein requires additional requirements.
Protein intake standard: The daily protein intake of the elderly should be calculated according to 1-1.5g per kilogram of body weight, and if it is a hospitalized elderly person, the intake should be higher.
/ Additional Nutritional Supplements /
In addition, it is also necessary to take into account some trace elements, such as vitamin intake, many elderly people may have less fresh fruits and vegetables, then you can take some multivitamin preparations to supplement, you can also be targeted for drug correction.
For example, the elderly with severe malnutrition anemia can be appropriately supplemented with iron, folic acid, vitamin B12 and other drugs, but the best way is through dietary intake.
Some elderly people may eat according to the diet every day, still have malnutrition, may also be difficult to adhere to, the intake of calories is less than 80% of the daily demand, it is recommended to use some enteral nutrition preparations to help supplement nutrition.
Enteral nutrition preparations are configured according to the reasonable proportion of the three major nutrients and trace elements of the daily life, which can be supplemented as a meal between meals, and only the enteral nutrients can be flushed into water to drink, and the missing calories can be replenished.
Due to each person's different eating habits and disease conditions, the proportion and amount of specific nutrients should still be adjusted in the hospital under the guidance of a doctor.
04 Other precautions
/ Be wary of dehydration /
Severely malnourished elderly people may be unwilling to drink water due to drinking water choking cough and other reasons, so the elderly should pay attention to water intake while supplementing nutrition.
/ Mindset Alignment /
Aging is inevitable, even if nutritional supplementation is carried out, do not expect too much from the final effect, learn to live with the disease, and do your best to intervene in the development of the disease.
/ Attention To Exercise /
For the elderly, nutritional supplementation and moderate exercise are indispensable, even if the lower limbs can not move, you can try to exercise the upper limbs, as long as the exercise is stronger than no exercise.
References: Medical Microvision official website - Sun Xiaohong, Chief Physician of "Malnutrition in the Elderly"