Aktuelle Ernährungsmedizin 2013; 38(03): e1-e48
DOI: 10.1055/s-0033-1343169
DGEM-Leitlinie Klinische Ernährung
© Georg Thieme Verlag KG Stuttgart · New York

Leitlinie der Deutschen Gesellschaft für Ernährungsmedizin (DGEM) in Zusammenarbeit mit der GESKES, der AKE und der DGG

Klinische Ernährung in der Geriatrie – Teil des laufenden S3-Leitlinienprojekts Klinische ErnährungGuideline of the German Society for Nutritional Medicine (DGEM) in cooporation with the GESKES, the AKE and the DGGClinical Nutrition in Geriatrics – Part of the Running S3-Guideline Project Clinical Nutrition
D. Volkert
1   Friedrich-Alexander-Universität Erlangen-Nürnberg, Institut für Biomedizin des Alterns, Nürnberg, Deutschland
,
J. M. Bauer
2   Klinikum Oldenburg, Klinik für Geriatrie, Oldenburg, Deutschland
,
T. Frühwald
3   Krankenhaus Hietzing, Abteilung für Akutgeriatrie, Wien, Österreich
,
I. Gehrke
4   Krankenhaus vom Roten Kreuz Bad Cannstatt GmbH, Klinik für Akutgeriatrie und geriatrische Rehabilitation, Stuttgart, Deutschland
,
M. Lechleitner
5   Landeskrankenhaus Hochzirl, Anna Dengel Haus, Zirl, Österreich
,
R. Lenzen-Großimlinghaus
6   Dominikus-Krankenhaus Berlin-Hermsdorf, Abteilung für Geriatrie, Berlin, Deutschland
,
R. Wirth
7   St. Marien-Hospital Borken GmbH, Klinik für Geriatrie, Borken, Deutschland
,
C. Sieber
8   Friedrich-Alexander-Universität Erlangen-Nürnberg, Institut für Biomedizin des Alterns, Nürnberg und Krankenhaus Barmherzige Brüder Regensburg, Deutschland
,
und das DGEM Steering Committee › Author Affiliations
Further Information

Publication History

Publication Date:
16 May 2013 (online)

Zusammenfassung

Fragestellung: Ältere Menschen haben ein erhöhtes Risiko für Mangelernährung und sind häufig von Mangelernährung betroffen. Dabei besteht oft Unklarheit darüber, welche Maßnahmen in bestimmten Situationen für die Betroffenen von Nutzen sind. Ziel der vorliegenden Leitlinie ist es, evidenzbasierte Empfehlungen zur klinischen Ernährung älterer Menschen zu geben, um Mangelernährung so weit wie möglich zu vermeiden bzw. zu behandeln.

Material und Methodik: Die bestehenden Leitlinien der deutschen und europäischen ernährungsmedizinischen Fachgesellschaften (DGEM, ESPEN) zur enteralen und parenteralen Ernährung wurden zusammengeführt und in Einklang mit den Richtlinien der AWMF und des ÄZQ aktualisiert und erweitert.

Ergebnisse: Die Leitlinie beinhaltet 60 konsentierte Empfehlungen zur Ernährungsversorgung älterer Menschen hinsichtlich grundlegender Prinzipien klinischer Ernährung, relevanter Indikationen (allgemeine Indikation, Mangelernährung und Risiko für Mangelernährung, Gebrechlichkeit, Dysphagie, Hüftfrakturen, Depression, Demenz, Dekubitus, Delir) sowie spezifischer Struktur- und Prozessanforderungen für die Ernährungsversorgung in geriatrischen Institutionen. Generell sollen Ernährungsmaßnahmen bei älteren Menschen mit einem Risiko für Mangelernährung oder mit Mangelernährung ergriffen werden, um eine adäquate Zufuhr von Energie und Nährstoffen zu ermöglichen und die gravierenden Folgen von Mangelernährung zu vermeiden. Dabei kann die orale Ernährung durch ursachenorientierte, pflegerische und diätetische Maßnahmen gefördert werden. Enterale bzw. parenterale Ernährung sollten initiiert werden, wenn die orale bzw. enterale Nahrungsaufnahme unzureichend oder unmöglich und die Verlaufsprognose insgesamt positiv ist (nicht in terminalen Krankheitsstadien).

Schlussfolgerung: Unabhängig von der Indikation muss die Entscheidung für oder gegen bestimmte Maßnahmen immer individuell unter sorgfältiger Nutzen-Risiko-Abwägung, Berücksichtigung des (mutmaßlichen) Patientenwillens und der Prognose getroffen werden. Es wird empfohlen, Ernährungsmaßnahmen nicht erst bei schwerer Mangelernährung zu beginnen, sondern frühzeitig, sobald Hinweise auf Ernährungsrisiken vorliegen.

Abstract

Aim: Older people are at increased risk of malnutrition and are frequently affected by malnutrition. In clinical practice, it is often unclear, which strategies are useful in specific situations for the persons concerned. The present guideline intends to provide comprehensive evidence-based recommendations for clinical nutrition in older persons, in order to prevent and/or adequately treat malnutrition.

Methods: Existing guidelines of the German and European societies of nutritional medicine (DGEM, ESPEN) on enteral and parenteral nutrition in geriatrics were consolidated and in accordance with the principles of the AWMF and AEZQ revised and extended.

Results: The present guideline comprises 60 consensus-based recommendations for nutritional care in the elderly having regard to basic principles of clinical nutrition, relevant indications (general indication, malnutrition and risk of malnutrition, frailty, dysphagia, hip fracture, depression, dementia, decubitus, delirium) as well as to specific structural and process needs for nutritional care in geriatric institutions. Generally, nutritional intervention is indicated in older persons with malnutrition or at risk of malnutrition in order to allow an adequate intake of energy and nutrients and to avoid the serious consequences of malnutrition. In this regard oral nutrition can be supported by cause oriented, nursing and dietary interventions. Enteral respectively parenteral nutrition should be initiated if oral respectively enteral nutrition is insufficient or impossible and the general prognosis is altogether favorable (not in terminal stages of disease).

Conclusion: Independent of the indication, the decision for or against specific interventions must always be made individually, after carefully weighing the particular risk-benefit relationship, taking the (assumed) patient will and prognosis into account. It is strongly recommended not to wait until severe malnutrition has developed but to start nutritional interventions early, as soon as nutritional risk becomes apparent.

* DGEM Steering Committee: Bischoff SC, Lochs H, Weimann A, Adolph M, Ockenga J, Sieber C.


 
  • Literatur

  • 1 Duursma S, Castleden M, Cherubini A et al. European Union Geriatric Medicine Society. Position statement on geriatric medicine and the provision of health care services to older people. J Nutr Health Aging 2004; 8: 190-195
  • 2 Volkert D. Leitlinie Enterale Ernährung der DGEM und DGG: Ernährungszustand, Energie- und Substratstoffwechsel im Alter. Aktuel Ernahrungsmed 2004; 29: 190-197
  • 3 Pirlich M, Schutz T, Norman K et al. The German hospital malnutrition study. Clin Nutr 2006; 25: 563-572
  • 4 Pauly L, Stehle P, Volkert D. Nutritional situation of elderly nursing home residents. Z Gerontol Geriatr 2007; 40: 3-12
  • 5 Guigoz Y. The Mini Nutritional Assessment (MNA) review of the literature – What does it tell us?. J Nutr Health Aging 2006; 10: 466-485; discussion 485 – 487
  • 6 Cereda E. Mini nutritional assessment. Curr Opin Clin Nutr Metab Care 2012; 15: 29-41
  • 7 Kaiser MJ, Bauer JM, Ramsch C et al. Frequency of malnutrition in older adults: a multinational perspective using the mini nutritional assessment. J Am Geriatr Soc 2010; 58: 1734-1738
  • 8 Rolland Y, Czerwinski S, Abellan Van Kan G et al. Sarcopenia: its assessment, etiology, pathogenesis, consequences and future perspectives. J Nutr Health Aging 2008; 12: 433-450
  • 9 Kaiser MJ, Bauer JM, Ramsch C et al. Validation of the Mini Nutritional Assessment short-form (MNA-SF): a practical tool for identification of nutritional status. J Nutr Health Aging 2009; 13: 782-788
  • 10 Kaiser MJ, Bauer JM, Uter W et al. Prospective validation of the modified mini nutritional assessment short-forms in the community, nursing home, and rehabilitation setting. J Am Geriatr Soc 2011; 59: 2124-2128
  • 11 Körner U, Biermann E et al. DGEM-Leitlinie Enterale Ernährung: Ethische und rechtliche Gesichtspunkte. Aktuel Ernahrungsmed 2003; 28: 36-41
  • 12 Körner U, Biermann E et al. Leitlinie Enterale Ernährung – Teil 2 der DGEM und DGG: Ethische und rechtliche Gesichtspunkte. Aktuel Ernahrungsmed 2004; 29: 226-230
  • 13 Oehmichen F, Ballmer PE, Druml C et al. Leitlinie der Deutschen Gesellschaft für Ernährungsmedizin (DGEM) – Ethische und rechtliche Gesichtspunkte der Künstlichen Ernährung. Aktuel Ernahrungsmed 2013; 38: 112-117
  • 14 Volkert D, Lenzen-Grossimlinghaus R et al. Leitlinie enterale Ernährung der DGEM und DGG – Teil 2. Enterale Ernährung in der Geriatrie und geriatrisch-neurologischen Rehabilitationen. Aktuel Ernahrungsmed 2004; 29: 198-225
  • 15 Volkert D, Berner YN, Berry E et al. ESPEN Guidelines on Enteral Nutrition: Geriatrics. Clin Nutr 2006; 25: 330-360
  • 16 Sobotka L, Schneider SM, Berner YN et al. ESPEN Guidelines on Parenteral Nutrition: geriatrics. Clin Nutr 2009; 28: 461-466
  • 17 Stingel K, Schütz T, Koller M et al. Leitlinie der Deutschen Gesellschaft für Ernährungsmedizin (DGEM) – Methodik zum Leitlinien-Update Klinische Ernährung. Aktuel Ernahrungsmed 2013; 38: 90-96
  • 18 Darmon P, Kaiser MJ, Bauer JM et al. Restrictive diets in the elderly: never say never again?. Clin Nutr 2010; 29: 170-174
  • 19 Zeanandin G, Molato O, Le Duff F et al. Impact of restrictive diets on the risk of undernutrition in a free-living elderly population. Clin Nutr 2012; 31: 69-73
  • 20 Niedert KC. American Dietetic Association. Position of the American Dietetic Association: Liberalization of the diet prescription improves quality of life for older adults in long-term care. J Am Diet Assoc 2005; 105: 1955-1965
  • 21 Lange-Alberts ME, Shott S. Nutritional intake. Use of touch and verbal cuing. J Gerontol Nurs 1994; 20: 36-40
  • 22 Van Ort S, Phillips LR. Nursing intervention to promote functional feeding. J Gerontol Nurs 1995; 21: 6-14
  • 23 Kayser-Jones J, Schell E. The mealtime experience of a cognitively impaired elder: ineffective and effective strategies. J Gerontol Nurs 1997; 23: 33-39
  • 24 Kayser-Jones J. Mealtime in nursing homes: the importance of individualized care. J Gerontol Nurs 1996; 22: 26-31; quiz 51
  • 25 Simmons SF, Schnelle JF. Individualized feeding assistance care for nursing home residents: staffing requirements to implement two interventions. J Gerontol A Biol Sci Med Sci 2004; 59: M966-973
  • 26 Manning AM, Means JG. A self-feeding program for geriatric patients in a skilled nursing facility. J Am Diet Assoc 1975; 66: 275-276
  • 27 Sidenvall B, Ek AC. Long-term care patients and their dietary intake related to eating ability and nutritional needs: nursing staff interventions. J Adv Nurs 1993; 18: 565-573
  • 28 Simmons SF, Osterweil D, Schnelle JF. Improving food intake in nursing home residents with feeding assistance: a staffing analysis. J Gerontol A Biol Sci Med Sci 2001; 56: M790-794
  • 29 Simmons SF, Keeler E, Zhuo X et al. Prevention of unintentional weight loss in nursing home residents: a controlled trial of feeding assistance. J Am Geriatr Soc 2008; 56: 1466-1473
  • 30 Simmons SF, Garcia ET, Cadogan MP et al. The minimum data set weight-loss quality indicator: does it reflect differences in care processes related to weight loss?. J Am Geriatr Soc 2003; 51: 1410-1418
  • 31 Walton K, Williams P, Bracks J et al. A volunteer feeding assistance program can improve dietary intakes of elderly patients – a pilot study. Appetite 2008; 51: 244-248
  • 32 Hickson M, Frost G. An investigation into the relationships between quality of life, nutritional status and physical function. Clin Nutr 2004; 23: 213-221
  • 33 Pedersen PU. Nutritional care: the effectiveness of actively involving older patients. J Clin Nurs 2005; 14: 247-255
  • 34 Beattie ER, Algase DL, Song J. Keeping wandering nursing home residents at the table: improving food intake using a behavioral communication intervention. Aging Ment Health 2004; 8: 109-116
  • 35 Coyne ML, Hoskins L. Improving eating behaviors in dementia using behavioral strategies. Clin Nurs Res 1997; 6: 275-290
  • 36 Cassens D, Johnson E, Keelan S. Enhancing taste, texture, appearance, and presentation of pureed food improved resident quality of life and weight status. Nutr Rev 1996; 54: S51-54
  • 37 Young KW, Greenwood CE, van Reekum R et al. A randomized, crossover trial of high-carbohydrate foods in nursing home residents with Alzheimer’s disease: associations among intervention response, body mass index, and behavioral and cognitive function. J Gerontol A Biol Sci Med Sci 2005; 60: 1039-1045
  • 38 Odlund Olin A, Koochek A, Cederholm T et al. Minimal effect on energy intake by additional evening meal for frail elderly service flat residents – a pilot study. J Nutr Health Aging 2008; 12: 295-301
  • 39 Winograd CH, Brown EM. Aggressive oral refeeding in hospitalized patients. Am J Clin Nutr 1990; 52: 967-968
  • 40 Biernacki C, Barratt J. Improving the nutritional status of people with dementia. Br J Nurs 2001; 10: 1104-1114
  • 41 Barton AD, Beigg CL, Macdonald IA et al. A recipe for improving food intakes in elderly hospitalized patients. Clin Nutr 2000; 19: 451-454
  • 42 Lorefalt B, Wissing U, Unosson M. Smaller but energy and protein-enriched meals improve energy and nutrient intakes in elderly patients. J Nutr Health Aging 2005; 9: 243-247
  • 43 Gall MJ, Grimble GK, Reeve NJ et al. Effect of providing fortified meals and between-meal snacks on energy and protein intake of hospital patients. Clin Nutr 1998; 17: 259-264
  • 44 Cluskey M, Dunton N. Serving meals of reduced portion size did not improve appetite among elderly in a personal-care section of a long-term-care community. J Am Diet Assoc 1999; 99: 733-735
  • 45 Taylor KA, Barr SI. Provision of small, frequent meals does not improve energy intake of elderly residents with dysphagia who live in an extended-care facility. J Am Diet Assoc 2006; 106: 1115-1118
  • 46 Olin AO, Osterberg P, Hadell K et al. Energy-enriched hospital food to improve energy intake in elderly patients. JPEN J Parenter Enteral Nutr 1996; 20: 93-97
  • 47 Odlund Olin A, Armyr I, Soop M et al. Energy-dense meals improve energy intake in elderly residents in a nursing home. Clin Nutr 2003; 22: 125-131
  • 48 Smoliner C, Norman K, Scheufele R et al. Effects of food fortification on nutritional and functional status in frail elderly nursing home residents at risk of malnutrition. Nutrition 2008; 24: 1139-1144
  • 49 Faxen-Irving G, Cederholm T. Energy dense oleic acid rich formula to newly admitted geriatric patients – feasibility and effects on energy intake. Clin Nutr 2011; 30: 202-208
  • 50 Ha L, Hauge T, Spenning AB et al. Individual, nutritional support prevents undernutrition, increases muscle strength and improves QoL among elderly at nutritional risk hospitalized for acute stroke: a randomized, controlled trial. Clin Nutr 2010; 29: 567-573
  • 51 Hoekstra JC, Goosen JH, de Wolf GS et al. Effectiveness of multidisciplinary nutritional care on nutritional intake, nutritional status and quality of life in patients with hip fractures: a controlled prospective cohort study. Clin Nutr 2011; 30: 455-461
  • 52 Rufenacht U, Ruhlin M, Wegmann M et al. Nutritional counseling improves quality of life and nutrient intake in hospitalized undernourished patients. Nutrition 2010; 26: 53-60
  • 53 Starke J, Schneider H, Alteheld B et al. Short-term individual nutritional care as part of routine clinical setting improves outcome and quality of life in malnourished medical patients. Clin Nutr 2011; 30: 194-201
  • 54 Feldblum I, German L, Castel H et al. Individualized nutritional intervention during and after hospitalization: the nutrition intervention study clinical trial. J Am Geriatr Soc 2011; 59: 10-17
  • 55 Christensson L, Ek AC, Unosson M. Individually adjusted meals for older people with protein-energy malnutrition: a single-case study. J Clin Nurs 2001; 10: 491-502
  • 56 Gants R. Detection and correction of underweight problems in nursing home residents. J Gerontol Nurs 1997; 23: 26-31
  • 57 Keller HH, Gibbs AJ, Boudreau LD et al. Prevention of weight loss in dementia with comprehensive nutritional treatment. J Am Geriatr Soc 2003; 51: 945-952
  • 58 Boffelli S, Rozzini R, Trabucchi M. Nutritional intervention in special care units for dementia. J Am Geriatr Soc 2004; 52: 1216-1217
  • 59 Duncan DG, Beck SJ, Hood K et al. Using dietetic assistants to improve the outcome of hip fracture: a randomised controlled trial of nutritional support in an acute trauma ward. Age Ageing 2006; 35: 148-153
  • 60 Rypkema G, Adang E, Dicke H et al. Cost-effectiveness of an interdisciplinary intervention in geriatric inpatients to prevent malnutrition. J Nutr Health Aging 2004; 8: 122-127
  • 61 Stenvall M, Olofsson B, Nyberg L et al. Improved performance in activities of daily living and mobility after a multidisciplinary postoperative rehabilitation in older people with femoral neck fracture: a randomized controlled trial with 1-year follow-up. J Rehabil Med 2007; 39: 232-238
  • 62 Stenvall M, Olofsson B, Lundstrom M et al. A multidisciplinary, multifactorial intervention program reduces postoperative falls and injuries after femoral neck fracture. Osteoporos Int 2007; 18: 167-175
  • 63 Olofsson B, Stenvall M, Lundstrom M et al. Malnutrition in hip fracture patients: an intervention study. J Clin Nurs 2007; 16: 2027-2038
  • 64 Lundstrom M, Olofsson B, Stenvall M et al. Postoperative delirium in old patients with femoral neck fracture: a randomized intervention study. Aging Clin Exp Res 2007; 19: 178-186
  • 65 Marcantonio ER, Flacker JM, Wright RJ et al. Reducing delirium after hip fracture: a randomized trial. J Am Geriatr Soc 2001; 49: 516-522
  • 66 Lundstrom M, Edlund A, Lundstrom G et al. Reorganization of nursing and medical care to reduce the incidence of postoperative delirium and improve rehabilitation outcome in elderly patients treated for femoral neck fractures. Scand J Caring Sci 1999; 13: 193-200
  • 67 Inouye SK, Bogardus Jr ST, Charpentier PA et al. A multicomponent intervention to prevent delirium in hospitalized older patients. N Engl J Med 1999; 340: 669-676
  • 68 Singh NA, Quine S, Clemson LM et al. Effects of high-intensity progressive resistance training and targeted multidisciplinary treatment of frailty on mortality and nursing home admissions after hip fracture: a randomized controlled trial. J Am Med Dir Assoc 2012; 13: 24-30
  • 69 Vidan MT, Sanchez E, Alonso M et al. An intervention integrated into daily clinical practice reduces the incidence of delirium during hospitalization in elderly patients. J Am Geriatr Soc 2009; 57: 2029-2036
  • 70 Beck AM, Damkjaer K, Beyer N. Multifaceted nutritional intervention among nursing-home residents has a positive influence on nutrition and function. Nutrition 2008; 24: 1073-1080
  • 71 Beck AM, Damkjaer K, Sorbye LW. Physical and social functional abilities seem to be maintained by a multifaceted randomized controlled nutritional intervention among old (>65 years) Danish nursing home residents. Arch Gerontol Geriatr 2010; 50: 351-355
  • 72 Shizgal HM, Martin MF, Gimmon Z. The effect of age on the caloric requirement of malnourished individuals. Am J Clin Nutr 1992; 55: 783-789
  • 73 Schneider SM, Al-Jaouni R, Pivot X et al. Lack of adaptation to severe malnutrition in elderly patients. Clin Nutr 2002; 21: 499-504
  • 74 Hebuterne X, Schneider S, Peroux JL et al. Effects of refeeding by cyclic enteral nutrition on body composition: comparative study of elderly and younger patients. Clin Nutr 1997; 16: 283-289
  • 75 Hebuterne X, Broussard JF, Rampal P. Acute renutrition by cyclic enteral nutrition in elderly and younger patients. JAMA 1995; 273: 638-643
  • 76 Valentini L, Volkert D, Schütz T et al. Leitlinie der Deutschen Gesellschaft für Ernährungsmedizin (DGEM) – DGEM-Terminologie in der Klinischen Ernährung. Aktuel Ernahrungsmed 2013; 38: 97-111
  • 77 Avenell A, Handoll HH. Nutritional supplementation for hip fracture aftercare in older people. Cochrane Database Syst Rev 2010; Jan 20, (01) CD001880. doi: DOI: 10.1002/14651858. CD001880.pub5
  • 78 Milne AC, Potter J, Vivanti A et al. Protein and energy supplementation in elderly people at risk from malnutrition. Cochrane Database Syst Rev 2009; Apr 15, (02) CD003288. doi: DOI: 10.1002/14651858. CD003288.pub3
  • 79 Stratton RJ, Green CJ, Elia M. Disease-related malnutrition: An evidence-based approach to treatment. CABI Publishing; 2003
  • 80 Stratton RJ, Elia M. A review of reviews: A new look at the evidence for oral nutritional supplements in clinical practice. Clinical Nutrition 2007; 2: 5-23
  • 81 Nieuwenhuizen WF, Weenen H, Rigby P et al. Older adults and patients in need of nutritional support: review of current treatment options and factors influencing nutritional intake. Clin Nutr 2010; 29: 160-169
  • 82 Fiatarone MA, O’Neill EF, Ryan ND et al. Exercise training and nutritional supplementation for physical frailty in very elderly people. N Engl J Med 1994; 330: 1769-1775
  • 83 Gray-Donald K, Payette H, Boutier V. Randomized clinical trial of nutritional supplementation shows little effect on functional status among free-living frail elderly. J Nutr 1995; 125: 2965-2971
  • 84 Larsson J, Unosson M, Ek AC et al. Effect of dietary supplement on nutritional status and clinical outcome in 501 geriatric patients – a randomised study. Clin Nutr 1990; 9: 179-184
  • 85 Lawson RM, Doshi MK, Ingoe LE et al. Compliance of orthopaedic patients with postoperative oral nutritional supplementation. Clin Nutr 2000; 19: 171-175
  • 86 Ovesen L. The effect of a supplement which is nutrient dense compared to standard concentration on the total nutritional intake of anorectic patients. Clin Nutr 1992; 11: 154-157
  • 87 Payette H, Boutier V, Coulombe C et al. Benefits of nutritional supplementation in free-living, frail, undernourished elderly people: a prospective randomized community trial. J Am Diet Assoc 2002; 102: 1088-1095
  • 88 Roebothan BV, Chandra RK. Relationship between nutritional status and immune function of elderly people. Age Ageing 1994; 23: 49-53
  • 89 Volkert D, Hubsch S, Oster P et al. Nutritional support and functional status in undernourished geriatric patients during hospitalization and 6-month follow-up. Aging (Milano) 1996; 8: 386-395
  • 90 Williams CM, Driver LT, Older J et al. A controlled trial of sip-feed supplements in elderly orthopaedic patients. Eur J Clin Nutr 1989; 43: 267-274
  • 91 Stratton RJ. Should food or supplements be used in the community for the treatment of disease-related malnutrition?. Proc Nutr Soc 2005; 64: 325-333
  • 92 Turic A, Gordon KL, Craig LD et al. Nutrition supplementation enables elderly residents of long-term-care facilities to meet or exceed RDAs without displacing energy or nutrient intakes from meals. J Am Diet Assoc 1998; 98: 1457-1459
  • 93 Norregaard O, Tottrup A, Saaek A et al. Effects of oral supplements to adults with chronic obstructive pulmonary disease. Clin Resp Physiol 1987; 23: 388
  • 94 Jensen MB, Hessov I. Dietary supplementation at home improves the regain of lean body mass after surgery. Nutrition 1997; 13: 422-430
  • 95 Bos C, Benamouzig R, Bruhat A et al. Nutritional status after short-term dietary supplementation in hospitalized malnourished geriatric patients. Clin Nutr 2001; 20: 225-233
  • 96 Hübsch S, Volkert D, Oster P et al. Möglichkeiten und Grenzen der Anwendung flüssiger Nährstoffkonzentrate in der Therapie der Mangelernährung geriatrischer Patienten. Aktuel Ernahrungsmed 1994; 19: 109-114
  • 97 Fiatarone Singh MA, Bernstein MA, Ryan AD et al. The effect of oral nutritional supplements on habitual dietary quality and quantity in frail elders. J Nutr Health Aging 2000; 4: 5-12
  • 98 Meredith CN, Frontera WR, O’Reilly KP et al. Body composition in elderly men: effect of dietary modification during strength training. J Am Geriatr Soc 1992; 40: 155-162
  • 99 Wouters-Wesseling W, Van Hooijdonk C, Wagenaar L et al. The effect of a liquid nutrition supplement on body composition and physical functioning in elderly people. Clin Nutr 2003; 22: 371-377
  • 100 Bourdel-Marchasson I, Joseph PA, Dehail P et al. Functional and metabolic early changes in calf muscle occurring during nutritional repletion in malnourished elderly patients. Am J Clin Nutr 2001; 73: 832-838
  • 101 Sullivan DH, Walls RC. Impact of nutritional status on morbidity in a population of geriatric rehabilitation patients. J Am Geriatr Soc 1994; 42: 471-477
  • 102 Lumbers M, Driver LT, Howland RJ et al. Nutritional status and clinical outcome in elderly female surgical orthopaedic patients. Clin Nutr 1996; 15: 101-107
  • 103 Antonelli Incalzi R, Landi F, Cipriani L et al. Nutritional assessment: a primary component of multidimensional geriatric assessment in the acute care setting. J Am Geriatr Soc 1996; 44: 166-174
  • 104 Davalos A, Ricart W, Gonzalez-Huix F et al. Effect of malnutrition after acute stroke on clinical outcome. Stroke 1996; 27: 1028-1032
  • 105 Delmi M, Rapin CH, Bengoa JM et al. Dietary supplementation in elderly patients with fractured neck of the femur. Lancet 1990; 335: 1013-1016
  • 106 Stableforth PG. Supplement feeds and nitrogen and calorie balance following femoral neck fracture. Br J Surg 1986; 73: 651-655
  • 107 Tidermark J, Ponzer S, Carlsson P et al. Effects of protein-rich supplementation and nandrolone in lean elderly women with femoral neck fractures. Clin Nutr 2004; 23: 587-596
  • 108 Daniels L, Miller M, Bannerman E et al. Weight loss post lower limb fracture despite an intensive oral nutrition and exercise intervention. Clinical Nutrition 2003; 22 (Suppl. 01) S86
  • 109 Hankins C. Dietary supplementation with sustagen in elderly patients with fractured neck of femur (PhDThesis). Sydney University; 1996
  • 110 Madigan C. Benefits of dietary supplementation in elderly patients with fractured neck of femur (MSc dissertation). Sydney University; 1994
  • 111 Botella-Carretero JI, Iglesias B, Balsa JA et al. Effects of oral nutritional supplements in normally nourished or mildly undernourished geriatric patients after surgery for hip fracture: a randomized clinical trial. JPEN J Parenter Enteral Nutr 2008; 32: 120-128
  • 112 Efthimiou J, Fleming J, Gomes C et al. The effect of supplementary oral nutrition in poorly nourished patients with chronic obstructive pulmonary disease. Am Rev Respir Dis 1988; 137: 1075-1082
  • 113 McMurdo ME, Price RJ, Shields M et al. Should oral nutritional supplementation be given to undernourished older people upon hospital discharge? A controlled trial. J Am Geriatr Soc 2009; 57: 2239-2245
  • 114 Chapman IM, Visvanathan R, Hammond AJ et al. Effect of testosterone and a nutritional supplement, alone and in combination, on hospital admissions in undernourished older men and women. Am J Clin Nutr 2009; 89: 880-889
  • 115 Unosson M, Larsson J, Ek AC et al. Effects of dietary supplement on functional condition and clinical outcome measured with a modified Norton scale. Clin Nutr 1992; 11: 134-139
  • 116 Woo J, Ho SC, Mak YT et al. Nutritional status of elderly patients during recovery from chest infection and the role of nutritional supplementation assessed by a prospective randomized single-blind trial. Age Ageing 1994; 23: 40-48
  • 117 Potter JM. Oral supplements in the elderly. Curr Opin Clin Nutr Metab Care 2001; 4: 21-28
  • 118 Kwok T, Woo J, Kwan M. Does low lactose milk powder improve the nutritional intake and nutritional status of frail older Chinese people living in nursing homes?. J Nutr Health Aging 2001; 5: 17-21
  • 119 Persson M, Hytter-Landahl A, Brismar K et al. Nutritional supplementation and dietary advice in geriatric patients at risk of malnutrition. Clin Nutr 2007; 26: 216-224
  • 120 Collins CE, Kershaw J, Brockington S. Effect of nutritional supplements on wound healing in home-nursed elderly: a randomized trial. Nutrition 2005; 21: 147-155
  • 121 Faxen-Irving G, Andren-Olsson B, af Geijerstam A et al. The effect of nutritional intervention in elderly subjects residing in group-living for the demented. Eur J Clin Nutr 2002; 56: 221-227
  • 122 Krondl M, Coleman PH, Bradley CL et al. Subjectively healthy elderly consuming a liquid nutrition supplement maintained body mass index and improved some nutritional parameters and perceived well-being. J Am Diet Assoc 1999; 99: 1542-1548
  • 123 Gariballa S, Forster S. Dietary supplementation and quality of life of older patients: a randomized, double-blind, placebo-controlled trial. J Am Geriatr Soc 2007; 55: 2030-2034
  • 124 Hampson G, Martin FC, Moffat K et al. Effects of dietary improvement on bone metabolism in elderly underweight women with osteoporosis: a randomised controlled trial. Osteoporos Int 2003; 14: 750-756
  • 125 Edington J, Barnes R, Bryan F et al. A prospective randomised controlled trial of nutritional supplementation in malnourished elderly in the community: clinical and health economic outcomes. Clin Nutr 2004; 23: 195-204
  • 126 Callahan CM, Haag KM, Weinberger M et al. Outcomes of percutaneous endoscopic gastrostomy among older adults in a community setting. J Am Geriatr Soc 2000; 48: 1048-1054
  • 127 Ciocon JO, Silverstone FA, Graver LM et al. Tube feedings in elderly patients. Indications, benefits, and complications. Arch Intern Med 1988; 148: 429-433
  • 128 Abitbol V, Selinger-Leneman H, Gallais Y et al. Percutaneous endoscopic gastrostomy in elderly patients. A prospective study in a geriatric hospital. Gastroenterol Clin Biol 2002; 26: 448-453
  • 129 Fay DE, Poplausky M, Gruber M et al. Long-term enteral feeding: a retrospective comparison of delivery via percutaneous endoscopic gastrostomy and nasoenteric tubes. Am J Gastroenterol 1991; 86: 1604-1609
  • 130 Vetta F, Gianni W, Ronzoni S et al. Role of aging in malnutrition and in restitution of nutritional parameters by tube feeding. Arch Gerontol Geriatr 1996; 22 (Suppl. 01) 599-604
  • 131 Golden A, Beber C, Weber R et al. Long-term survival of elderly nursing home residents after percutaneous endoscopic gastrostomy for nutritional support. Nurs Home Med 1997; 5: 382-389
  • 132 Levinson Y, Dwolatzky T, Epstein A et al. Is it possible to increase weight and maintain the protein status of debilitated elderly residents of nursing homes?. J Gerontol A Biol Sci Med Sci 2005; 60: 878-881
  • 133 Peck A, Cohen CE, Mulvihill MN. Long-term enteral feeding of aged demented nursing home patients. J Am Geriatr Soc 1990; 38: 1195-1198
  • 134 Volkert D, Pauly L, Stehle P et al. Prevalence of malnutrition in orally and tube-fed elderly nursing home residents in Germany and its relation to health complaints and dietary intake. Gastroenterol Res Pract 2011; 2011: 247-315
  • 135 Okada K, Yamagami H, Sawada S et al. The nutritional status of elderly bed-ridden patients receiving tube feeding. J Nutr Sci Vitaminol (Tokyo) 2001; 47: 236-241
  • 136 Donini LM, Savina C, Ricciardi LM et al. Predicting the outcome of artificial nutrition by clinical and functional indices. Nutrition 2009; 25: 11-19
  • 137 Kaw M, Sekas G. Long-term follow-up of consequences of percutaneous endoscopic gastrostomy (PEG) tubes in nursing home patients. Dig Dis Sci 1994; 39: 738-743
  • 138 Paillaud E, Bories PN, Merlier I et al. Prognosis factors of short and long-term survival in elderly hospitalized patients after percutaneous endoscopic gastrostomy. Gastroenterol Clin Biol 2002; 26: 443-447
  • 139 Panos MZ, Reilly H, Moran A et al. Percutaneous endoscopic gastrostomy in a general hospital: prospective evaluation of indications, outcome, and randomised comparison of two tube designs. Gut 1994; 35: 1551-1556
  • 140 Sitzmann JV. Nutritional support of the dysphagic patient: methods, risks, and complications of therapy. JPEN J Parenter Enteral Nutr 1990; 14: 60-63
  • 141 Nair S, Hertan H, Pitchumoni CS. Hypoalbuminemia is a poor predictor of survival after percutaneous endoscopic gastrostomy in elderly patients with dementia. Am J Gastroenterol 2000; 95: 133-136
  • 142 Abuksis G, Mor M, Segal N et al. Percutaneous endoscopic gastrostomy: high mortality rates in hospitalized patients. Am J Gastroenterol 2000; 95: 128-132
  • 143 Skelly RH, Kupfer RM, Metcalfe ME et al. Percutaneous endoscopic gastrostomy (PEG): change in practice since 1988. Clin Nutr 2002; 21: 389-394
  • 144 Sanders DS, Carter MJ, D’Silva J et al. Survival analysis in percutaneous endoscopic gastrostomy feeding: a worse outcome in patients with dementia. Am J Gastroenterol 2000; 95: 1472-1475
  • 145 Wirth R, Volkert D, Bauer JM et al. PEG tube placement in German geriatric wards – a retrospective data-base analysis. Z Gerontol Geriatr 2007; 40: 21-30
  • 146 Bourdel-Marchasson I, Dumas F, Pinganaud G et al. Audit of percutaneous endoscopic gastrostomy in long-term enteral feeding in a nursing home. Int J Qual Health Care 1997; 9: 297-302
  • 147 Rudberg MA, Egleston BL, Grant MD et al. Effectiveness of feeding tubes in nursing home residents with swallowing disorders. JPEN J Parenter Enteral Nutr 2000; 24: 97-102
  • 148 Mitchell SL, Kiely DK, Lipsitz LA. The risk factors and impact on survival of feeding tube placement in nursing home residents with severe cognitive impairment. Arch Intern Med 1997; 157: 327-332
  • 149 Mitchell SL, Kiely DK, Lipsitz LA. Does artificial enteral nutrition prolong the survival of institutionalized elders with chewing and swallowing problems?. J Gerontol A Biol Sci Med Sci 1998; 53: M207-213
  • 150 Weaver JP, Odell P, Nelson C. Evaluation of the benefits of gastric tube feeding in an elderly population. Arch Fam Med 1993; 2: 953-956
  • 151 Sanders H, Newall S, Norton B et al. Gastrostomy feeding in the elderly after acute dysphasgic stroke. J Nutr Health Aging 2000; 4: 58-60
  • 152 Iizuka M, Reding M. Use of percutaneous endoscopic gastrostomy feeding tubes and functional recovery in stroke rehabilitation: a case-matched controlled study. Arch Phys Med Rehabil 2005; 86: 1049-1052
  • 153 Horn SD, DeJong G, Smout RJ et al. Stroke rehabilitation patients, practice, and outcomes: is earlier and more aggressive therapy better?. Arch Phys Med Rehabil 2005; 86: S101-S114
  • 154 James R, Gines D, Menlove A et al. Nutrition support (tube feeding) as a rehabilitation intervention. Arch Phys Med Rehabil 2005; 86: S82-S92
  • 155 Verhoef MJ, Van Rosendaal GM. Patient outcomes related to percutaneous endoscopic gastrostomy placement. J Clin Gastroenterol 2001; 32: 49-53
  • 156 Jordan S, Philpin S, Warring J et al. Percutaneous endoscopic gastrostomies: the burden of treatment from a patient perspective. J Adv Nurs 2006; 56: 270-281
  • 157 Schneider SM, Pouget I, Staccini P et al. Quality of life in long-term home enteral nutrition patients. Clin Nutr 2000; 19: 23-28
  • 158 Bozzetti F. Quality of life and enteral nutrition. Curr Opin Clin Nutr Metab Care 2008; 11: 661-665
  • 159 Brotherton AM, Carter B. Percutaneous endoscopic gastrostomy feeding in nursing homes: relatives’ perceptions. Clin Nurs Res 2007; 16: 350-369
  • 160 Brotherton A, Lyons C. The impact of HETF for adults with neurological conditions. Br J Community Nurs 2006; 11: 511-518
  • 161 Enoki H, Hirakawa Y, Masuda Y et al. Association between feeding via percutaneous endoscopic gastrostomy and low level of caregiver burden. J Am Geriatr Soc 2007; 55: 1484-1486
  • 162 Mitchell SL, Tetroe JM. Survival after percutaneous endoscopic gastrostomy placement in older persons. J Gerontol A Biol Sci Med Sci 2000; 55: M735-739
  • 163 Janes SE, Price CS, Khan S. Percutaneous endoscopic gastrostomy: 30-day mortality trends and risk factors. J Postgrad Med 2005; 51: 23-28; discussion 28 – 29
  • 164 Rimon E, Kagansky N, Levy S. Percutaneous endoscopic gastrostomy; evidence of different prognosis in various patient subgroups. Age Ageing 2005; 34: 353-357
  • 165 Smith BM, Perring P, Engoren M et al. Hospital and long-term outcome after percutaneous endoscopic gastrostomy. Surg Endosc 2008; 22: 74-80
  • 166 Arinzon Z, Peisakh A, Berner YN. Evaluation of the benefits of enteral nutrition in long-term care elderly patients. J Am Med Dir Assoc 2008; 9: 657-662
  • 167 Attanasio A, Bedin M, Stocco S et al. Clinical outcomes and complications of enteral nutrition among older adults. Minerva Med 2009; 100: 159-166
  • 168 Chong VH, Vu C. Percutaneous endoscopic gastrostomy outcomes: can patient profiles predict mortality and weaning?. Singapore Med J 2006; 47: 383-387
  • 169 Figueiredo FA, da Costa MC, Pelosi AD et al. Predicting outcomes and complications of percutaneous endoscopic gastrostomy. Endoscopy 2007; 39: 333-338
  • 170 Kirchgatterer A, Bunte C, Aschl G et al. Long-term outcome following placement of percutaneous endoscopic gastrostomy in younger and older patients. Scand J Gastroenterol 2007; 42: 271-276
  • 171 Suzuki Y, Tamez S, Murakami A et al. Survival of geriatric patients after percutaneous endoscopic gastrostomy in Japan. World J Gastroenterol 2010; 16: 5084-5091
  • 172 Tokunaga T, Kubo T, Ryan S et al. Long-term outcome after placement of a percutaneous endoscopic gastrostomy tube. Geriatr Gerontol Int 2008; 8: 19-23
  • 173 Malmgren A, Hede GW, Karlstrom B et al. Indications for percutaneous endoscopic gastrostomy and survival in old adults. Food Nutr Res 2011; 55 10.3402/fnr.v55i0.6037. Epub 2011 Jul 20
  • 174 Wirth R, Voss C, Smoliner C et al. Complications and mortality after percutaneous endoscopic gastrostomy in geriatrics: a prospective multicenter observational trial. J Am Med Dir Assoc 2012; 13: 228-233
  • 175 Peter JV, Moran JL, Phillips-Hughes J. A metaanalysis of treatment outcomes of early enteral versus early parenteral nutrition in hospitalized patients. Crit Care Med 2005; 33: 213-220; discussion 260 – 261
  • 176 Pritchard C, Duffy S, Edington J et al. Enteral nutrition and oral nutrition supplements: a review of the economics literature. JPEN J Parenter Enteral Nutr 2006; 30: 52-59
  • 177 Koretz RL, Avenell A, Lipman TO et al. Does enteral nutrition affect clinical outcome? A systematic review of the randomized trials. Am J Gastroenterol 2007; 102: 412-429; quiz 468
  • 178 Jeejeebhoy KN. Enteral nutrition versus parenteral nutrition – the risks and benefits. Nat Clin Pract Gastroenterol Hepatol 2007; 4: 260-265
  • 179 Schoevaerdts D, Gazzotti C, Cornette P et al. Peripheral parenteral nutrition in geriatric wards. Acta Clin Belg 2006; 61: 170-175
  • 180 Howard L, Malone M. Clinical outcome of geriatric patients in the United States receiving home parenteral and enteral nutrition. Am J Clin Nutr 1997; 66: 1364-1370
  • 181 Thomas DR, Zdrodowski CD, Wilson MM et al. A prospective, randomized clinical study of adjunctive peripheral parenteral nutrition in adult subacute care patients. J Nutr Health Aging 2005; 9: 321-325
  • 182 Eneroth M, Olsson UB, Thorngren KG. Nutritional supplementation decreases hip fracture-related complications. Clin Orthop Relat Res 2006; 451: 212-217
  • 183 Crook MA, Hally V, Panteli JV. The importance of the refeeding syndrome. Nutrition 2001; 17: 632-637
  • 184 Crook MA, Panteli JV. The refeeding syndrome and hypophosphataemia in the elderly. J Intern Med 2005; 257: 397-398
  • 185 Mehanna HM, Moledina J, Travis J. Refeeding syndrome: what it is, and how to prevent and treat it. BMJ 2008; 336: 1495-1498
  • 186 Walston J, Hadley EC, Ferrucci L et al. Research agenda for frailty in older adults: toward a better understanding of physiology and etiology: summary from the American Geriatrics Society/National Institute on Aging Research Conference on Frailty in Older Adults. J Am Geriatr Soc 2006; 54: 991-1001
  • 187 Fried LP, Tangen CM, Walston J et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 2001; 56: M146-156
  • 188 Cruz-Jentoft AJ, Baeyens JP, Bauer JM et al. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing 2010; 39: 412-423
  • 189 Bartali B, Frongillo EA, Bandinelli S et al. Low nutrient intake is an essential component of frailty in older persons. J Gerontol A Biol Sci Med Sci 2006; 61: 589-593
  • 190 Tieland M, Borgonjen-Van den Berg KJ, van Loon LJ et al. Dietary protein intake in community-dwelling, frail, and institutionalized elderly people: scope for improvement. Eur J Nutr 2012; 51: 173-179
  • 191 Landi F, Abbatecola AM, Provinciali M et al. Moving against frailty: does physical activity matter?. Biogerontology 2010; 11: 537-545
  • 192 Shaw D, Cook I, Dent J. Age influences oropharyngeal and upper esophageal sphincter function during swallowing. Gastroenterology 1990; 98: 390
  • 193 Tracy JF, Logemann JA, Kahrilas PJ et al. Preliminary observations on the effects of age on oropharyngeal deglutition. Dysphagia 1989; 4: 90-94
  • 194 Germain I, Dufresne T, Gray-Donald K. A novel dysphagia diet improves the nutrient intake of institutionalized elders. J Am Diet Assoc 2006; 106: 1614-1623
  • 195 Gariballa SE, Parker SG, Taub N et al. A randomized, controlled, a single-blind trial of nutritional supplementation after acute stroke. JPEN J Parenter Enteral Nutr 1998; 22: 315-319
  • 196 Aquilani R, Scocchi M, Boschi F et al. Effect of calorie-protein supplementation on the cognitive recovery of patients with subacute stroke. Nutr Neurosci 2008; 11: 235-240
  • 197 Aquilani R, Scocchi M, Iadarola P et al. Protein supplementation may enhance the spontaneous recovery of neurological alterations in patients with ischaemic stroke. Clin Rehabil 2008; 22: 1042-1050
  • 198 Carnaby G, Hankey GJ, Pizzi J. Behavioural intervention for dysphagia in acute stroke: a randomised controlled trial. Lancet Neurol 2006; 5: 31-37
  • 199 Wright L, Cotter D, Hickson M et al. Comparison of energy and protein intakes of older people consuming a texture modified diet with a normal hospital diet. J Hum Nutr Diet 2005; 18: 213-219
  • 200 Vivanti AP, Campbell KL, Suter MS et al. Contribution of thickened drinks, food and enteral and parenteral fluids to fluid intake in hospitalised patients with dysphagia. J Hum Nutr Diet 2009; 22: 148-155
  • 201 Foley N, Finestone H, Woodbury MG et al. Energy and protein intakes of acute stroke patients. J Nutr Health Aging 2006; 10: 171-175
  • 202 Whelan K. Inadequate fluid intakes in dysphagic acute stroke. Clin Nutr 2001; 20: 423-428
  • 203 Bruce D, Laurance I, McGuiness M et al. Nutritional supplements after hip fracture: poor compliance limits effectiveness. Clin Nutr 2003; 22: 497-500
  • 204 Houwing RH, Rozendaal M, Wouters-Wesseling W et al. A randomised, double-blind assessment of the effect of nutritional supplementation on the prevention of pressure ulcers in hip-fracture patients. Clin Nutr 2003; 22: 401-405
  • 205 Brown K, Seabrock N. Nutritional influences on recovery and length of hospital stay in elderly women following femoral fracture. Proceedings of the Nutrition Society 1992; 51: 132A
  • 206 Miller MD, Bannerman E, Daniels LA et al. Lower limb fracture, cognitive impairment and risk of subsequent malnutrition: a prospective evaluation of dietary energy and protein intake on an orthopaedic ward. Eur J Clin Nutr 2006; 60: 853-861
  • 207 Tkatch L, Rapin CH, Rizzoli R et al. Benefits of oral protein supplementation in elderly patients with fracture of the proximal femur. J Am Coll Nutr 1992; 11: 519-525
  • 208 Neumann M, Friedmann J, Roy MA et al. Provision of high-protein supplement for patients recovering from hip fracture. Nutrition 2004; 20: 415-419
  • 209 Schurch MA, Rizzoli R, Slosman D et al. Protein supplements increase serum insulin-like growth factor-I levels and attenuate proximal femur bone loss in patients with recent hip fracture. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 1998; 128: 801-809
  • 210 Espaulella J, Guyer H, Diaz-Escriu F et al. Nutritional supplementation of elderly hip fracture patients. A randomized, double-blind, placebo-controlled trial. Age Ageing 2000; 29: 425-431
  • 211 Bastow MD, Rawlings J, Allison SP. Benefits of supplementary tube feeding after fractured neck of femur: a randomised controlled trial. Br Med J (Clin Res Ed) 1983; 287: 1589-1592
  • 212 Hartgrink HH, Wille J, Konig P et al. Pressure sores and tube feeding in patients with a fracture of the hip: a randomized clinical trial. Clin Nutr 1998; 17: 287-292
  • 213 Sullivan DH, Nelson CL, Bopp MM et al. Nightly enteral nutrition support of elderly hip fracture patients: a phase I trial. J Am Coll Nutr 1998; 17: 155-161
  • 214 Sullivan DH, Nelson CL, Klimberg VS et al. Nightly enteral nutrition support of elderly hip fracture patients: a pilot study. J Am Coll Nutr 2004; 23: 683-691
  • 215 Gallager J, Schermbeck J, Dixon L et al. Aggressive early management of malnutrition in hip fracture patients (abstract). Journal of Parenteral and Enteral Nutrition 1992; 16: 19S
  • 216 Chevalley T, Hoffmeyer P, Bonjour JP et al. Early serum IGF-I response to oral protein supplements in elderly women with a recent hip fracture. Clin Nutr 2010; 29: 78-83
  • 217 Botella-Carretero JI, Iglesias B, Balsa JA et al. Perioperative oral nutritional supplements in normally or mildly undernourished geriatric patients submitted to surgery for hip fracture: a randomized clinical trial. Clin Nutr 2010; 29: 574-579
  • 218 Lawson RM, Doshi MK, Barton JR et al. The effect of unselected post-operative nutritional supplementation on nutritional status and clinical outcome of orthopaedic patients. Clin Nutr 2003; 22: 39-46
  • 219 Gunnarsson AK, Lonn K, Gunningberg L. Does nutritional intervention for patients with hip fractures reduce postoperative complications and improve rehabilitation?. J Clin Nurs 2009; 18: 1325-1333
  • 220 Eneroth M, Olsson UB, Thorngren KG. Insufficient fluid and energy intake in hospitalised patients with hip fracture. A prospective randomised study of 80 patients. Clin Nutr 2005; 24: 297-303
  • 221 Morley JE, Kraenzle D. Causes of weight loss in a community nursing home. J Am Geriatr Soc 1994; 42: 583-585
  • 222 Brozek J. Effects of generalized malnutrition on personality. Nutrition 1990; 6: 389-395
  • 223 Smoliner C, Norman K, Wagner KH et al. Malnutrition and depression in the institutionalised elderly. Br J Nutr 2009; 102: 1663-1667
  • 224 Yesavage JA, Brink TL, Rose TL et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res 1982; 17: 37-49
  • 225 Sheikh J, Yesavage J. Geriatric Depression Scale (GDS). Recent evidence and development of a shorter version. In: Brink TL, ed. Clinical Gerontology: A Guide to Assessment and Intervention. New York: The Haworth Press; 1986: 165-173
  • 226 Gariballa S, Forster S. Effects of dietary supplements on depressive symptoms in older patients: a randomised double-blind placebo-controlled trial. Clin Nutr 2007; 26: 545-551
  • 227 Reisberg B, Ferris SH, de Leon MJ et al. The Global Deterioration Scale for assessment of primary degenerative dementia. Am J Psychiatry 1982; 139: 1136-1139
  • 228 Sclan SG, Reisberg B. Functional assessment staging (FAST) in Alzheimer’s disease: reliability, validity, and ordinality. Int Psychogeriatr 1992; 4 (Suppl. 01) 55-69
  • 229 Buchman AS, Wilson RS, Bienias JL et al. Change in body mass index and risk of incident Alzheimer disease. Neurology 2005; 65: 892-897
  • 230 Stewart R, Masaki K, Xue QL et al. A 32-year prospective study of change in body weight and incident dementia: the Honolulu-Asia Aging Study. Arch Neurol 2005; 62: 55-60
  • 231 Gillette Guyonnet S, Abellan Van Kan G, Alix E et al. IANA (International Academy on Nutrition and Aging) Expert Group: weight loss and Alzheimer’s disease. J Nutr Health Aging 2007; 11: 38-48
  • 232 Marcus EL, Berry EM. Refusal to eat in the elderly. Nutr Rev 1998; 56: 163-171
  • 233 Mitchell SL, Teno JM, Kiely DK et al. The clinical course of advanced dementia. N Engl J Med 2009; 361: 1529-1538
  • 234 Riviere S, Gillette-Guyonnet S, Voisin T et al. A nutritional education program could prevent weight loss and slow cognitive decline in Alzheimer’s disease. J Nutr Health Aging 2001; 5: 295-299
  • 235 Mathey MF, Vanneste VG, de Graaf C et al. Health effect of improved meal ambiance in a Dutch nursing home: a 1-year intervention study. Prev Med 2001; 32: 416-423
  • 236 Shatenstein B, Ferland G. Absence of nutritional or clinical consequences of decentralized bulk food portioning in elderly nursing home residents with dementia in Montreal. J Am Diet Assoc 2000; 100: 1354-1360
  • 237 Gil Gregorio P, Ramirez Diaz SP, Ribera Casado JM. DEMENU group. Dementia and Nutrition. Intervention study in institutionalized patients with Alzheimer disease. J Nutr Health Aging 2003; 7: 304-308
  • 238 Lauque S, Arnaud-Battandier F, Gillette S et al. Improvement of weight and fat-free mass with oral nutritional supplementation in patients with Alzheimer’s disease at risk of malnutrition: a prospective randomized study. J Am Geriatr Soc 2004; 52: 1702-1707
  • 239 Young KW, Greenwood CE, van Reekum R et al. Providing nutrition supplements to institutionalized seniors with probable Alzheimer’s disease is least beneficial to those with low body weight status. J Am Geriatr Soc 2004; 52: 1305-1312
  • 240 Parrott MD, Young KW, Greenwood CE. Energy-containing nutritional supplements can affect usual energy intake postsupplementation in institutionalized seniors with probable Alzheimer’s disease. J Am Geriatr Soc 2006; 54: 1382-1387
  • 241 Wouters-Wesseling W, Rozendaal M, Snijder M et al. Effect of a complete nutritional supplement on antibody response to influenza vaccine in elderly people. J Gerontol A Biol Sci Med Sci 2002; 57: M563-566
  • 242 Wouters-Wesseling W, Slump E, Kleijer CN et al. Early nutritional supplementation immediately after diagnosis of infectious disease improves body weight in psychogeriatric nursing home residents. Aging Clin Exp Res 2006; 18: 70-74
  • 243 Carver AD, Dobson AM. Effects of dietary supplementation of elderly demented hospital residents. Journal of Human Nutrition and Dietetics 1995; 8: 389-394
  • 244 Planas M, Conde M, Audivert S et al. Micronutrient supplementation in mild Alzheimer disease patients. Clin Nutr 2004; 23: 265-272
  • 245 Scheltens P, Kamphuis PJ, Verhey FR et al. Efficacy of a medical food in mild Alzheimer’s disease: A randomized, controlled trial. Alzheimers Dement 2010; 6: 1-10, e1
  • 246 Salas-Salvado J, Torres M, Planas M et al. Effect of oral administration of a whole formula diet on nutritional and cognitive status in patients with Alzheimer’s disease. Clin Nutr 2005; 24: 390-397
  • 247 Hanson LC, Ersek M, Gilliam R et al. Oral feeding options for people with dementia: a systematic review. J Am Geriatr Soc 2011; 59: 463-472
  • 248 Ahronheim JC, Mulvihill M, Sieger C et al. State practice variations in the use of tube feeding for nursing home residents with severe cognitive impairment. J Am Geriatr Soc 2001; 49: 148-152
  • 249 Lopez RP, Amella EJ, Strumpf NE et al. The influence of nursing home culture on the use of feeding tubes. Arch Intern Med 2010; 170: 83-88
  • 250 Kuo S, Rhodes RL, Mitchell SL et al. Natural history of feeding-tube use in nursing home residents with advanced dementia. J Am Med Dir Assoc 2009; 10: 264-270
  • 251 Mitchell SL, Teno JM, Roy J et al. Clinical and organizational factors associated with feeding tube use among nursing home residents with advanced cognitive impairment. JAMA 2003; 290: 73-80
  • 252 Teno JM, Mitchell SL, Gozalo PL et al. Hospital characteristics associated with feeding tube placement in nursing home residents with advanced cognitive impairment. JAMA 2010; 303: 544-550
  • 253 Sampson EL, Candy B, Jones L. Enteral tube feeding for older people with advanced dementia. Cochrane Database Syst Rev 2009; Apr 15, (02) CD007209. doi: DOI: 10.1002/14651858. CD007209.pub2
  • 254 Alvarez-Fernandez B, Garcia-Ordonez MA, Martinez-Manzanares C et al. Survival of a cohort of elderly patients with advanced dementia: nasogastric tube feeding as a risk factor for mortality. Int J Geriatr Psychiatry 2005; 20: 363-370
  • 255 Jaul E, Singer P, Calderon-Margalit R. Tube feeding in the demented elderly with severe disabilities. Isr Med Assoc J 2006; 8: 870-874
  • 256 Murphy LM, Lipman TO. Percutaneous endoscopic gastrostomy does not prolong survival in patients with dementia. Arch Intern Med 2003; 163: 1351-1353
  • 257 Meier DE, Ahronheim JC, Morris J et al. High short-term mortality in hospitalized patients with advanced dementia: lack of benefit of tube feeding. Arch Intern Med 2001; 161: 594-599
  • 258 Dwolatzky T, Berezovski S, Friedmann R et al. A prospective comparison of the use of nasogastric and percutaneous endoscopic gastrostomy tubes for long-term enteral feeding in older people. Clin Nutr 2001; 20: 535-540
  • 259 Gaines DI, Durkalski V, Patel A et al. Dementia and cognitive impairment are not associated with earlier mortality after percutaneous endoscopic gastrostomy. JPEN J Parenter Enteral Nutr 2009; 33: 62-66
  • 260 Mitchell SL, Buchanan JL, Littlehale S et al. Tube-feeding versus hand-feeding nursing home residents with advanced dementia: a cost comparison. J Am Med Dir Assoc 2003; 4: 27-33
  • 261 Siddiqi N, House AO, Holmes JD. Occurrence and outcome of delirium in medical in-patients: a systematic literature review. Age Ageing 2006; 35: 350-364
  • 262 Inouye SK. Delirium in older persons. N Engl J Med 2006; 354: 1157-1165
  • 263 Bourdel-Marchasson I, Vincent S, Germain C et al. Delirium symptoms and low dietary intake in older inpatients are independent predictors of institutionalization: a 1-year prospective population-based study. J Gerontol A Biol Sci Med Sci 2004; 59: 350-354
  • 264 Marcantonio ER, Flacker JM, Michaels M et al. Delirium is independently associated with poor functional recovery after hip fracture. J Am Geriatr Soc 2000; 48: 618-624
  • 265 McCusker J, Cole M, Abrahamowicz M et al. Delirium predicts 12-month mortality. Arch Intern Med 2002; 162: 457-463
  • 266 Olofsson B, Lundstrom M, Borssen B et al. Delirium is associated with poor rehabilitation outcome in elderly patients treated for femoral neck fractures. Scand J Caring Sci 2005; 19: 119-127
  • 267 Inouye SK, Charpentier PA. Precipitating factors for delirium in hospitalized elderly persons. Predictive model and interrelationship with baseline vulnerability. JAMA 1996; 275: 852-857
  • 268 Culp KR, Cacchione PZ. Nutritional status and delirium in long-term care elderly individuals. Appl Nurs Res 2008; 21: 66-74
  • 269 Brown S, Fitzgerald M, Walsh K. Delirium dichotomy: a review of recent literature. Contemp Nurse 2007; 26: 238-247
  • 270 Wild T, Rahbarnia A, Kellner M et al. Basics in nutrition and wound healing. Nutrition 2010; 26: 862-866
  • 271 Dorner B, Posthauer ME, Thomas D et al. The role of nutrition in pressure ulcer prevention and treatment: National Pressure Ulcer Advisory Panel white paper. Adv Skin Wound Care 2009; 22: 212-221
  • 272 Jaul E. Assessment and management of pressure ulcers in the elderly: current strategies. Drugs Aging 2010; 27: 311-325
  • 273 Langer G, Schloemer G, Knerr A et al. Nutritional interventions for preventing and treating pressure ulcers. Cochrane Database Syst Rev 2003; (04) CD003216
  • 274 Reddy M, Gill SS, Rochon PA. Preventing pressure ulcers: a systematic review. JAMA 2006; 296: 974-984
  • 275 Reddy M, Gill SS, Kalkar SR et al. Treatment of pressure ulcers: a systematic review. JAMA 2008; 300: 2647-2662
  • 276 Stechmiller JK. Understanding the role of nutrition and wound healing. Nutr Clin Pract 2010; 25: 61-68
  • 277 Bourdel-Marchasson I, Barateau M, Rondeau V et al. A multi-center trial of the effects of oral nutritional supplementation in critically ill older inpatients. GAGE Group. Groupe Aquitain Geriatrique d’Evaluation. Nutrition 2000; 16: 1-5
  • 278 Ek AC, Unosson M, Larsson J et al. The development and healing of pressure sores related to the nutritional state. Clin Nutr 1991; 10: 245-250
  • 279 Stratton RJ, Ek AC, Engfer M et al. Enteral nutritional support in prevention and treatment of pressure ulcers: a systematic review and meta-analysis. Aging Res Rev 2005; 4: 422-450
  • 280 Hommel A, Bjorkelund KB, Thorngren KG et al. Nutritional status among patients with hip fracture in relation to pressure ulcers. Clin Nutr 2007; 26: 589-596
  • 281 Horn SD, Bender SA, Ferguson ML et al. The National Pressure Ulcer Long-Term Care Study: pressure ulcer development in long-term care residents. J Am Geriatr Soc 2004; 52: 359-367
  • 282 Benati G, Delvecchio S, Cilla D et al. Impact on pressure ulcer healing of an arginine-enriched nutritional solution in patients with severe cognitive impairment. Arch Gerontol Geriatr Suppl 2001; 7: 43-47
  • 283 Frias Soriano L, Lage Vazquez MA, Maristany CP et al. The effectiveness of oral nutritional supplementation in the healing of pressure ulcers. J Wound Care 2004; 13: 319-322
  • 284 Desneves KJ, Todorovic BE, Cassar A et al. Treatment with supplementary arginine, vitamin C and zinc in patients with pressure ulcers: a randomised controlled trial. Clin Nutr 2005; 24: 979-987
  • 285 Cereda E, Gini A, Pedrolli C et al. Disease-specific, versus standard, nutritional support for the treatment of pressure ulcers in institutionalized older adults: a randomized controlled trial. J Am Geriatr Soc 2009; 57: 1395-1402
  • 286 Heyman H, Van De Looverbosch DE, Meijer EP et al. Benefits of an oral nutritional supplement on pressure ulcer healing in long-term care residents. J Wound Care 2008; 17: 476-478, 480
  • 287 Raffoul W, Far MS, Cayeux MC et al. Nutritional status and food intake in nine patients with chronic low-limb ulcers and pressure ulcers: importance of oral supplements. Nutrition 2006; 22: 82-88
  • 288 Henderson CT, Trumbore LS, Mobarhan S et al. Prolonged tube feeding in long-term care: nutritional status and clinical outcomes. J Am Coll Nutr 1992; 11: 309-325
  • 289 Teno JM, Gozalo P, Mitchell SL et al. Feeding tubes and the prevention or healing of pressure ulcers. Arch Intern Med 2012; 172: 697-701
  • 290 Ohura T, Nakajo T, Okada S et al. Evaluation of effects of nutrition intervention on healing of pressure ulcers and nutritional states (randomized controlled trial). Wound Repair Regen 2011; 19: 330-336
  • 291 Breslow RA, Hallfrisch J, Guy DG et al. The importance of dietary protein in healing pressure ulcers. J Am Geriatr Soc 1993; 41: 357-362
  • 292 Ellinger S, Stehle P. Efficacy of vitamin supplementation in situations with wound healing disorders: results from clinical intervention studies. Curr Opin Clin Nutr Metab Care 2009; 12: 588-595
  • 293 Thomas DR. Prevention and treatment of pressure ulcers. J Am Med Dir Assoc 2006; 7: 46-59
  • 294 Meaume S, Kerihuel JC, Constans T et al. Efficacy and safety of ornithine alpha-ketoglutarate in heel pressure ulcers in elderly patients: results of a randomized controlled trial. J Nutr Health Aging 2009; 13: 623-630
  • 295 Doley J. Nutrition management of pressure ulcers. Nutr Clin Pract 2010; 25: 50-60
  • 296 Nijs KA, de Graaf C, Kok FJ et al. Effect of family style mealtimes on quality of life, physical performance, and body weight of nursing home residents: cluster randomised controlled trial. BMJ 2006; 332: 1180-1184
  • 297 Mamhidir AG, Karlsson I, Norberg A et al. Weight increase in patients with dementia, and alteration in meal routines and meal environment after integrity promoting care. J Clin Nurs 2007; 16: 987-996
  • 298 Desai J, Winter A, Young KW et al. Changes in type of foodservice and dining room environment preferentially benefit institutionalized seniors with low body mass indexes. J Am Diet Assoc 2007; 107: 808-814
  • 299 Remsburg RE, Luking A, Bara P et al. Impact of a buffet-style dining program on weight and biochemical indicators of nutritional status in nursing home residents: a pilot study. J Am Diet Assoc 2001; 101: 1460-1463
  • 300 Elmstahl S, Blabolil V, Fex G et al. Hospital nutrition in geriatric long-term care medicine. I. Effects of a changed meal environment. Compr Gerontol A 1987; 1: 29-33
  • 301 Wright L, Hickson M, Frost G. Eating together is important: using a dining room in an acute elderly medical ward increases energy intake. J Hum Nutr Diet 2006; 19: 23-26
  • 302 Gaskill D, Isenring EA, Black LJ et al. Maintaining nutrition in aged care residents with a train-the-trainer intervention and Nutrition Coordinator. J Nutr Health Aging 2009; 13: 913-917
  • 303 Simmons SF, Schnelle JF. Feeding assistance needs of long-stay nursing home residents and staff time to provide care. J Am Geriatr Soc 2006; 54: 919-924
  • 304 Suominen MH, Kivisto SM, Pitkala KH. The effects of nutrition education on professionals’ practice and on the nutrition of aged residents in dementia wards. Eur J Clin Nutr 2007; 61: 1226-1232
  • 305 Wikby K, Ek AC, Christensson L. Implementation of a nutritional programme in elderly people admitted to resident homes. Scand J Caring Sci 2009; 23: 421-430
  • 306 Koulentaki M, Reynolds N, Steinke D et al. Eight years’ experience of gastrostomy tube management. Endoscopy 2002; 34: 941-945
  • 307 Babineau J, Villalon L, Laporte M et al. Outcomes of screening and nutritional intervention among older adults in healthcare facilities. Can J Diet Pract Res 2008; 69: 89-94
  • 308 Volkert D. Practical guideline for nutritional care in geriatric institutions. Z Gerontol Geriatr 2009; 42: 77-87
  • 309 Vellas B, Guigoz Y, Garry PJ et al. The Mini Nutritional Assessment (MNA) and its use in grading the nutritional state of elderly patients. Nutrition 1999; 15: 116-122
  • 310 Kondrup J, Allison SP, Elia M et al. ESPEN guidelines for nutrition screening 2002. Clin Nutr 2003; 22: 415-421
  • 311 Keller HH, Gibbs-Ward A, Randall-Simpson J et al. Meal rounds: an essential aspect of quality nutrition services in long-term care. J Am Med Dir Assoc 2006; 7: 40-45
  • 312 Bundeskonferenz zur Qualitätssicherung im Gesundheits- und Pflegewesen e.V. (BUKO-QS). Qualitätsniveau II: Orale Nahrungs- und Flüssigkeitsversorgung von Menschen in Einrichtungen der Pflege und Betreuung. Heidelberg: Economica Verlag; 2008
  • 313 Durfee SM, Gallagher-Allred C, Pasquale JA et al. Standards for specialized nutrition support for adult residents of long-term care facilities. Nutr Clin Pract 2006; 21: 96-104
  • 314 Salva A, Coll-Planas L, Bruce S et al. Nutritional assessment of residents in long-term care facilities (LTCFs): recommendations of the task force on nutrition and ageing of the IAGG European region and the IANA. J Nutr Health Aging 2009; 13: 475-483
  • 315 Thomas DR, Ashmen W, Morley JE et al. Nutritional management in long-term care: development of a clinical guideline. Council for Nutritional Strategies in Long-Term Care. J Gerontol A Biol Sci Med Sci 2000; 55: M725-734
  • 316 Gaillard C, Alix E, Salle A et al. Energy requirements in frail elderly people: a review of the literature. Clin Nutr 2007; 26: 16-24
  • 317 Alix E, Berrut G, Bore M et al. Energy requirements in hospitalized elderly people. J Am Geriatr Soc 2007; 55: 1085-1089
  • 318 Gaillard C, Alix E, Salle A et al. A practical approach to estimate resting energy expenditure in frail elderly people. J Nutr Health Aging 2008; 12: 277-280
  • 319 Lammes E, Akner G. Resting metabolic rate in elderly nursing home patients with multiple diagnoses. J Nutr Health Aging 2006; 10: 263-270
  • 320 Luhrmann PM, Neuhaeuser Berthold M. Are the equations published in literature for predicting resting metabolic rate accurate for use in the elderly?. J Nutr Health Aging 2004; 8: 144-149
  • 321 Weiss CO, Cappola AR, Varadhan R et al. Resting metabolic rate in old-old women with and without frailty: variability and estimation of energy requirements. J Am Geriatr Soc 2012; 60: 1695-1700
  • 322 Deutsche Gesellschaft für Ernährung, Österreichische Gesellschaft für Ernährung, Schweizerische Gesellschaft für Ernährungsforschung, Schweizerische Vereinigung für Ernährung ed. Referenzwerte für die Nährstoffzufuhr. 1.. Auflage, 4., korrigierter Nachdruck. Bonn: 2012
  • 323 Paddon-Jones D, Rasmussen BB. Dietary protein recommendations and the prevention of sarcopenia. Curr Opin Clin Nutr Metab Care 2009; 12: 86-90
  • 324 Wolfe RR, Miller SL, Miller KB. Optimal protein intake in the elderly. Clin Nutr 2008; 27: 675-684
  • 325 Morais JA, Chevalier S, Gougeon R. Protein turnover and requirements in the healthy and frail elderly. J Nutr Health Aging 2006; 10: 272-283
  • 326 Gaffney-Stomberg E, Insogna KL, Rodriguez NR et al. Increasing dietary protein requirements in elderly people for optimal muscle and bone health. J Am Geriatr Soc 2009; 57: 1073-1079
  • 327 Zarling EJ, Edison T, Berger S et al. Effect of dietary oat and soy fiber on bowel function and clinical tolerance in a tube feeding dependent population. J Am Coll Nutr 1994; 13: 565-568
  • 328 Shankardass K, Chuchmach S, Chelswick K et al. Bowel function of long-term tube-fed patients consuming formulae with and without dietary fiber. JPEN J Parenter Enteral Nutr 1990; 14: 508-512
  • 329 Homann HH, Kemen M, Fuessenich C et al. Reduction in diarrhea incidence by soluble fiber in patients receiving total or supplemental enteral nutrition. JPEN J Parenter Enteral Nutr 1994; 18: 486-490
  • 330 Shimoni Z, Averbuch Y, Shir E et al. The addition of fiber and the use of continuous infusion decrease the incidence of diarrhea in elderly tube-fed patients in medical wards of a general regional hospital: a controlled clinical trial. J Clin Gastroenterol 2007; 41: 901-905
  • 331 Grant LP, Wanger LI, Neill KM. Fiber-fortified feedings in immobile patients. Clin Nurs Res 1994; 3: 166-172
  • 332 Nakao M, Ogura Y, Satake S et al. Usefulness of soluble dietary fiber for the treatment of diarrhea during enteral nutrition in elderly patients. Nutrition 2002; 18: 35-39
  • 333 Bass DJ, Forman LP, Abrams SE et al. The effect of dietary fiber in tube-fed elderly patients. J Gerontol Nurs 1996; 22: 37-44
  • 334 Jafri NS, Mahid SS, Minor KS et al. Meta-analysis: antibiotic prophylaxis to prevent peristomal infection following percutaneous endoscopic gastrostomy. Aliment Pharmacol Ther 2007; 25: 647-656
  • 335 Lipp A, Lusardi G. Systemic antimicrobial prophylaxis for percutaneous endoscopic gastrostomy. Cochrane Database Syst Rev 2006; (04) CD005571
  • 336 Best C. Enteral tube feeding and infection control: how safe is our practice?. Br J Nurs 2008; 17: 1036, 1038-1041
  • 337 Elia M, Engfer MB, Green CJ et al. Systematic review and meta-analysis: the clinical and physiological effects of fibre-containing enteral formulae. Aliment Pharmacol Ther 2008; 27: 120-145
  • 338 Luft VC, Beghetto MG, de Mello ED et al. Role of enteral nutrition in the incidence of diarrhea among hospitalized adult patients. Nutrition 2008; 24: 528-535
  • 339 Mathus-Vliegen EM, Bredius MW, Binnekade JM. Analysis of sites of bacterial contamination in an enteral feeding system. JPEN J Parenter Enteral Nutr 2006; 30: 519-525
  • 340 Scott F, Beech R, Smedley F et al. Prospective, randomized, controlled, single-blind trial of the costs and consequences of systematic nutrition team follow-up over 12 mo after percutaneous endoscopic gastrostomy. Nutrition 2005; 21: 1071-1077
  • 341 Leff B, Cheuvront N, Russell W. Discontinuing feeding tubes in a community nursing home. Gerontologist 1994; 34: 130-133
  • 342 Oto T, Kandori Y, Ohta T et al. Predicting the chance of weaning dysphagic stroke patients from enteral nutrition: a multivariate logistic modelling study. Eur J Phys Rehabil Med 2009; 45: 355-362
  • 343 Krieger RP, Brady S, Stewart RJ et al. Predictors of returning to oral feedings after feeding tube placement for patients poststroke during inpatient rehabilitation. Top Stroke Rehabil 2010; 17: 197-203
  • 344 American Diabetes Association. Standards of medical care in diabetes – 2013. Diabetes Care 2013; 36 (Suppl. 01) S11-66
  • 345 Sinclair A, Morley JE, Rodriguez-Manas L et al. Diabetes mellitus in older people: position statement on behalf of the International Association of Gerontology and Geriatrics (IAGG), the European Diabetes Working Party for Older People (EDWPOP), and the International Task Force of Experts in Diabetes. J Am Med Dir Assoc 2012; 13: 497-502
  • 346 Vischer UM, Perrenoud L, Genet C et al. The high prevalence of malnutrition in elderly diabetic patients: implications for anti-diabetic drug treatments. Diabet Med 2010; 27: 918-924
  • 347 Montagnani A, Gonnelli S, Alessandri M et al. Osteoporosis and risk of fracture in patients with diabetes: an update. Aging Clin Exp Res 2011; 23: 84-90
  • 348 Boucher BJ. The problems of vitamin d insufficiency in older people. Aging Dis 2012; 3: 313-329
  • 349 Reinstatler L, Qi YP, Williamson RS et al. Association of biochemical B12 deficiency with metformin therapy and vitamin B12 supplements: the National Health and Nutrition Examination Survey, 1999–2006. Diabetes Care 2012; 35: 327-333
  • 350 Mathus-Vliegen EM. Obesity Management Task Force of the European Association for the Study of Obesity. Prevalence, pathophysiology, health consequences and treatment options of obesity in the elderly: a guideline. Obes Facts 2012; 5: 460-483
  • 351 Sorkin JD, Muller DC, Andres R. Longitudinal change in height of men and women: implications for interpretation of the body mass index: the Baltimore Longitudinal Study of Aging. Am J Epidemiol 1999; 150: 969-977
  • 352 Zamboni M, Mazzali G, Zoico E et al. Health consequences of obesity in the elderly: a review of four unresolved questions. Int J Obes (Lond) 2005; 29: 1011-1029
  • 353 Stevens J, Cai J, Pamuk ER et al. The effect of age on the association between body-mass index and mortality. N Engl J Med 1998; 338: 1-7
  • 354 Freedman DM, Ron E, Ballard-Barbash R et al. Body mass index and all-cause mortality in a nationwide US cohort. Int J Obes (Lond) 2006; 30: 822-829
  • 355 Thinggaard M, Jacobsen R, Jeune B et al. Is the relationship between BMI and mortality increasingly U-shaped with advancing age? A 10-year follow-up of persons aged 70-95 years. J Gerontol A Biol Sci Med Sci 2010; 65: 526-531
  • 356 Villareal DT, Banks MR, Patterson BW et al. Weight loss therapy improves pancreatic endocrine function in obese older adults. Obesity (Silver Spring) 2008; 16: 1349-1354
  • 357 Weinheimer EM, Sands LP, Campbell WW. A systematic review of the separate and combined effects of energy restriction and exercise on fat-free mass in middle-aged and older adults: implications for sarcopenic obesity. Nutr Rev 2010; 68: 375-388
  • 358 Villareal DT, Chode S, Parimi N et al. Weight loss, exercise, or both and physical function in obese older adults. N Engl J Med 2011; 364: 1218-1229
  • 359 Han TS, Tajar A, Lean ME. Obesity and weight management in the elderly. Br Med Bull 2011; 97: 169-196
  • 360 Anton SD, Manini TM, Milsom VA et al. Effects of a weight loss plus exercise program on physical function in overweight, older women: a randomized controlled trial. Clin Interv Aging 2011; 6: 141-149
  • 361 Foy CG, Lewis CE, Hairston KG et al. Intensive lifestyle intervention improves physical function among obese adults with knee pain: findings from the Look AHEAD trial. Obesity (Silver Spring) 2011; 19: 83-93
  • 362 Gariballa S, Forster S, Walters S et al. A randomized, double-blind, placebo-controlled trial of nutritional supplementation during acute illness. Am J Med 2006; 119: 693-699
  • 363 Gazzotti C, Arnaud-Battandier F, Parello M et al. Prevention of malnutrition in older people during and after hospitalisation: results from a randomised controlled clinical trial. Age Ageing 2003; 32: 321-325
  • 364 Langkamp-Henken B, Wood SM, Herlinger-Garcia KA et al. Nutritional formula improved immune profiles of seniors living in nursing homes. J Am Geriatr Soc 2006; 54: 1861-1870
  • 365 Manders M, de Groot CP, Blauw YH et al. Effect of a nutrient-enriched drink on dietary intake and nutritional status in institutionalised elderly. Eur J Clin Nutr 2009; 63: 1241-1250
  • 366 Manders M, De Groot LC, Hoefnagels WH et al. The effect of a nutrient dense drink on mental and physical function in institutionalized elderly people. J Nutr Health Aging 2009; 13: 760-767
  • 367 Price R, Daly F, Pennington CR et al. Nutritional supplementation of very old people at hospital discharge increases muscle strength: a randomised controlled trial. Gerontology 2005; 51: 179-185
  • 368 Wouters-Wesseling W, Vos AP, Van Hal M et al. The effect of supplementation with an enriched drink on indices of immune function in frail elderly. J Nutr Health Aging 2005; 9: 281-286
  • 369 Wouters-Wesseling W, Wagenaar LW, Rozendaal M et al. Effect of an enriched drink on cognitive function in frail elderly persons. J Gerontol A Biol Sci Med Sci 2005; 60: 265-270
  • 370 Rabadi MH, Coar PL, Lukin M et al. Intensive nutritional supplements can improve outcomes in stroke rehabilitation. Neurology 2008; 71: 1856-1861
  • 371 Dennis MS, Lewis SC, Warlow C et al. Effect of timing and method of enteral tube feeding for dysphagic stroke patients (FOOD): a multicentre randomised controlled trial. Lancet 2005; 365: 764-772