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Ernährung im Alter

Grundlage für den Erhalt von Funktionalität und Lebensqualität

Nutrition in older persons

Basis for functionality and quality of life

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Zusammenfassung

Ein höheres Lebensalter bedingt Veränderungen von Metabolismus, Appetitregulation sowie Körperzusammensetzung, in deren Folge sich eine zunehmende Gefährdung für das Auftreten einer Mangelernährung entwickelt. Wenngleich deren höchste Prävalenz in Krankenhäusern und rehabilitativen Einrichtungen zu verzeichnen ist, finden sich in absoluten Zahlen die meisten älteren Menschen mit Mangelernährung im ambulanten Bereich. Hier weisen Personen mit chronischen Erkrankungen und funktionellen Einbußen das größte Ernährungsrisiko auf. Daher ist ein routinemäßiges Screening älterer Menschen bezüglich des Vorliegens einer Mangelernährung indiziert. Eine erfolgreiche Therapie der Mangelernährung setzt neben der Einleitung einer Ernährungstherapie die sorgfältige Prüfung medizinischer und sozialer Ursachen voraus. Hinsichtlich des Erhalts der Funktionalität kommt einer ausreichenden Eiweißzufuhr eine besondere Bedeutung zu. Neben der Verwendung von Zwischenmahlzeiten erweist sich die zeitlich begrenzte Verordnung von Trinknahrung als wertvoll. Insbesondere während und nach einem Krankenhausaufenthalt sollte auf das Zusammenwirken von Ernährung und körperlicher Bewegung hinsichtlich des Erhalts von Funktionalität und Lebensqualität geachtet werden.

Abstract

With increasing age alterations of metabolism, appetite regulation, and body composition have been observed. As a consequence the risk of malnutrition is much higher in older than in younger persons. Though the highest prevalence rates have been described for the hospital and rehabilitation setting, most older persons with overt malnutrition are found in the community. Here persons with chronic comorbidity and low functionality show the highest risk. Routine screening for malnutrition is therefore indicated in older persons. For the successful treatment of malnutrition it is important to consider also medical and social etiologic factors before starting nutritional therapy. With regard to the preservation of muscle mass and muscle strength, adequate protein intake deserves careful consideration. Besides the implementation of regular snacks between meals, temporary application of oral supplements which are high in energy and protein is indicated. Especially during and after hospital stays, the beneficial interaction between nutrition and exercise has to be considered with regard to functionality and quality of life in older persons.

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Literatur

  1. Alley DE, Koster A, Mackey D et al (2010) Aging and body composition study. Hospitalization and change in body composition and strength in a population-based cohort of older persons. J Am Geriatr Soc 58:2085–2091

    Article  PubMed  Google Scholar 

  2. Bauer JM, Haack A, Winning K et al (2010) Impaired postprandial response of active ghrelin and prolonged suppression of hunger sensation in the elderly. J Gerontol A Biol Sci Med Sci 65:307–311

    Article  PubMed  CAS  Google Scholar 

  3. Bauer JM, Kaiser MJ, Sieber CC (2010) Evaluation of nutritional status in older persons: nutritional screening and assessment. Curr Opin Clin Nutr Metab Care 13:8–13

    Article  PubMed  Google Scholar 

  4. Bauer JM, Volkert D, Wirth R et al; Teilnehmer des BANSS-Symposiums 2005 (2006) Diagnostik der Mangelernährung des älteren Menschen – Ergebnisse eines internationalen Experten-Meetings der BANSS-Stiftung. Dtsch Med Wochenschr 131:223–227

    Article  PubMed  CAS  Google Scholar 

  5. Bauer JM, Wirth R, Volkert D et al; Teilnehmer des BANSS-Symposiums 2006 (2008) Malnutrition, Sarkopenie und Kachexie im Alter – Von der Pathophysiologie zur Therapie. Ergebnisse eines internationalen Expertenmeetings der BANSS-Stiftung. Dtsch Med Wochenschr 133:305–310

    Article  PubMed  CAS  Google Scholar 

  6. Cesari M, Pahor M, Lauretani F et al (2009) Skeletal muscle and mortality results from the In CHIANTI Study. J Gerontol A Biol Sci Med Sci 64:377–384

    Article  PubMed  Google Scholar 

  7. Cruz-Jentoft AJ, Baeyens JP, Bauer JM et al (2010) European working group on sarcopenia in older people. Sarcopenia: European consensus on definition and diagnosis: Report of the european working group on sarcopenia in older people. Age Ageing 39:412–423

    Article  PubMed  Google Scholar 

  8. Darmon P, Kaiser MJ, Bauer JM et al (2010) Restrictive diets in the elderly: never say never again? Clin Nutr 29:170–174

    Article  PubMed  Google Scholar 

  9. Gariballa S, Forster S, Walters S et al (2006) A randomized, double-blind, placebo-controlled trial of nutritional supplementation during acute illness. Am J Med 119:693–699

    Article  PubMed  CAS  Google Scholar 

  10. Goodpaster BH, Park SW, Harris TB et al (2006) The loss of skeletal muscle strength, mass, and quality in older adults: the health, aging and body composition study. J Gerontol A Biol Sci Med Sci 61:1059–1064

    PubMed  Google Scholar 

  11. Guigoz Y (2006) The mini-nutritional assessment (MNA®) review of the literature – what does it tell us? J Nutr Health Aging 10:466–485

    PubMed  CAS  Google Scholar 

  12. Houston DK, Nicklas BJ, Ding J, Health ABC Study et al (2008) Dietary protein intake isassociated with lean mass change in older, community-dwelling adults: the Health, Aging, and Body Composition (Health ABC) Study. Am J Clin Nutr 87:150–155

    PubMed  CAS  Google Scholar 

  13. Janssen I (2007) Morbidity and mortality risk associated with an overweight BMI in older men and women. Obesity (Silver Spring) 15:1827–1840

    Google Scholar 

  14. Kaiser MJ, Bauer JM, Ramsch C et al (2009) MNA-International Group. Validation of the mini nutritional assessment short-form (MNA-SF): a practical tool for identification of nutritional status. J Nutr Health Aging 13:782–788

    Article  PubMed  CAS  Google Scholar 

  15. Kaiser MJ, Bauer JM, Ramsch C et al (2009) Validation of the mini nutritional assessment short-form (MNA®-SF): A practical tool for identification of nutritional status. J Nutr Health Aging 13:782–788

    Article  PubMed  CAS  Google Scholar 

  16. Kaiser MJ, Bauer JM, Rämsch C et al (2010) Mini nutritional assessment international group. Frequency of malnutrition in older adults: a multinational perspective using the mini nutritional assessment. J Am Geriatr Soc 58:1734–1738

    Article  PubMed  Google Scholar 

  17. Kaiser R, Winning K, Uter W et al (2010) Functionality and mortality in obese nursing home residents: an example of ‚risk factor paradox’? J Am Med Dir Assoc 11:428–435

    Article  PubMed  Google Scholar 

  18. Kortebein P, Ferrando A, Lombeida J et al (2007) Effect of 10 days of bed rest on skeletal muscle in healthy older adults. JAMA 297:1772–1774

    Article  PubMed  CAS  Google Scholar 

  19. Kruizenga HM, Van Tulder MW, Seidell JC et al (2005) Effectiveness and cost-effectiveness of early screening and treatment of malnourished patients. Am J Clin Nutr 82:1082–1089

    PubMed  CAS  Google Scholar 

  20. Meijers JM, Schols JM, van Bokhorst-de van der Schueren MA et al (2009) Malnutrition prevalence in The Netherlands: results of the annual dutch national prevalence measurement of care problems. Br J Nutr 101:417–423

    Article  PubMed  CAS  Google Scholar 

  21. Milne AC, Potter J, Vivanti A et al (2009) Protein and energy supplementationin elderly people at risk from malnutrition. Cochrane Database Syst Rev CD003288

  22. Netuveli G, Blane D (2008) Quality of life in older ages. Br Med Bull 85:113–126

    Article  PubMed  Google Scholar 

  23. Paddon-Jones D, Rasmussen BB (2009) Dietary protein recommendations and the prevention of sarcopenia. Curr Opin Clin Nutr Metab Care 12:86–90

    Article  PubMed  CAS  Google Scholar 

  24. Pirlich M, Schütz T, Norman K et al (2006) The German hospital malnutrition study. Clin Nutr 25:563–572

    Article  PubMed  Google Scholar 

  25. Roberts SB, Fuss P, Heyman MB et al (1994) Control of food intake in older men. JAMA 272:1601–1606

    Article  PubMed  CAS  Google Scholar 

  26. Rosen CJ (2011) Clinical practice. Vitamin D insufficiency. N Engl J Med 364:248–254

    Article  PubMed  CAS  Google Scholar 

  27. Rubenstein LZ, Harker JO, Salva A et al (2001) Screening for undernutrition in geriatric practice: developing the short-form mini nutritional assessment (MNA-SF). J Gerontol A Biol Sci Med Sci 56:M366–372

    Article  PubMed  CAS  Google Scholar 

  28. Stehle P, Junk K, Sack S et al (2000) Ernährung älterer Menschen. In: Deutsche Gesellschaft für Ernährung (Hrsg) Ernährungsbericht 2000. Heinrich, Frankfurt am Main 147–178

  29. Vellas B, Villars H, Abellan G et al (2006) Overview of the MNA® – its history and challenges. J Nutr Health Aging 10:456–465

    PubMed  CAS  Google Scholar 

  30. Visvanathan R, Chapman IM (2009) Undernutrition and anorexia in the older person. Gastroenterol Clin North Am 38:393–409

    Article  PubMed  Google Scholar 

  31. Volkert D, Berner YN, Berry E et al; German Society for Nutritional Medicine, European Society for Parenteral and Enteral Nutrition (2006) ESPEN Guidelines on enteral nutrition: geriatrics. Clin Nutr 25:330–360

    Article  PubMed  CAS  Google Scholar 

  32. Wallace JI, Schwartz RS, LaCroix AZ et al (1995) Involuntary weight loss in older outpatients: incidence and clinical significance. J Am Geriatr Soc 43:329–337

    PubMed  CAS  Google Scholar 

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Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehungen hin:

Forschungsprojekte mit Danone und Nestlé. Referent für Abbott, Danone und Nestlé.

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Bauer, J. Ernährung im Alter. Internist 52, 946–954 (2011). https://doi.org/10.1007/s00108-011-2806-7

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  • DOI: https://doi.org/10.1007/s00108-011-2806-7

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