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Nutritional situation of elderly nursing home residents

Ernährungssituation älterer Heimbewohner

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Abstract

Malnutrition in institutionalized elderly is of individual and public concern since it negatively affects health outcome and quality of life and is often preventable. Over the past years several studies have examined the prevalence of malnutrition in institutionalized elderly and reported greatly diverse results. The purpose of the present literature review is to give an overview of the current knowledge about the nutritional situation of institutionalized elderly having specific regard to the prevalence of protein-energy malnutrition and nutrition-related problems. Based on a literature search and additional articles from the files of the authors, observational studies with relatively unselected populations reporting figures for the prevalence of malnutrition and/or the prevalence of nutrition-related problems (e. g. poor appetite, chewing or swallowing problems, eating dependency or poor intake) and published between 1990 and 2006 were considered. Relevant information was extracted and compiled. A total of 42 eligible studies with 41 to 6832 participants were found. BMI was the most frequently used parameter for nutritional assessment with mean values mostly between 21 and 24 kg/m2. Eight studies applied a cut-off value of 20 kg/m2 and reported between 10% and 50% low values. Weight loss was reported in 7 studies with prevalence rates between 5 and 41%, reduced serum albumin (< 35 g/L) in 10 studies with prevalence rates between 0 and 50%. According to the MNA (12 studies) malnutrition was observed in 2 to 38% and a risk of malnutrition in 37 to 62%. Nutritional problems were reported in 17 studies, again with great variability between the studies. In physically and mentally capable study populations malnutrition was relatively unfrequent. Prevalence rates were highest in studies with great proportions of disabled and severely impaired residents.

It can be concluded that malnutrition is generally widespread in institutionalized elderly. Prevalence rates vary according to the parameters and cut-off values used for nutritional assessment and according to the population under study. Future studies should carefully characterize their participants and use standardized nutritional assessment tools in order to achieve better comparability of study results as up to now.

Zusammenfassung

Ältere Heimbewohner haben aufgrund häufiger funktioneller und gesundheitlicher Beeinträchtigungen ein erhöhtes Risiko für Mangelernährung. Studien über die tatsächliche Verbreitung von Mangelernährung kamen in den letzten Jahren zu unterschiedlichen Ergebnissen. Ziel der vorliegenden Übersichtsarbeit war es daher, einen Überblick über die verfügbaren Daten zur Ernährungssituation, speziell zur Häufigkeit von Mangelernährung und von Ernährungsproblemen, bei älteren Heimbewohnern zu geben. Mit Hilfe einer Literaturrecherche mit definierter Suchstrategie wurden Beobachtungsstudien mit gemischten Kollektiven älterer Heimbewohner und Angaben zur Prävalenz von Mangelernährung und/oder zur Prävalenz von Ernährungsproblemen (z. B. Appetitlosigkeit, Kauprobleme, Schluckbeschwerden) gesucht, die seit 1990 in englischer Sprache publiziert worden waren. Zusätzlich wurden relevante Arbeiten aus den Beständen der Autoren berücksichtigt. 42 Studien mit 41 bis 6832 Teilnehmern wurden identifiziert. Zur Beschreibung der Ernährungssituation wurde am häufigsten der BMI herangezogen. In 8 Studien wurde ein Grenzwert von 20 kg/m2 gewählt und zwischen 10 und 50% erniedrigte Werte festgestellt. Ein Gewichtsverlust wurde in 7 Studien mit Häufigkeiten zwischen 5 und 41% beschrieben, erniedrigte Albuminkonzentrationen (< 35 g/L) in 10 Studien mit Häufigkeiten zwischen 0 und 50%. Mittels Mini Nutritional Assessment (MNA; 12 Studien) wurde Mangelernährung bei 2 bis 38% und ein Risiko für Mangelernährung bei 37 bis 62% der Teilnehmer berichtet. Ernährungsprobleme wurden in 17 Studien auf sehr unterschiedliche Weise erfasst, auch hier war eine große Streubreite auffällig. Bei funktionell wenig beeinträchtigten Populationen wurde Mangelernährung relativ selten beobachtet, dagegen waren Bewohnerkollektive mit großen Anteilen funktionell beeinträchtigter Senioren vergleichsweise häufig betroffen. Zusammenfassend lässt sich festhalten, dass Mangelernährung bei älteren Heimbewohnern weit verbreitet ist. Die Häufigkeit variiert je nach Methode und Grenzwert zur Erfassung von Mangelernährung und in Abhängigkeit von der untersuchten Population. Um in Zukunft besser vergleichbare Studienergebnisse zu erhalten, sollten die Teilnehmer weiterer Studien sorgfältig charakterisiert und zur Erfassung der Ernährungssituation einheitliche, standardisierte Methoden verwendet werden.

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  1. Pfrimmer Nutricia GmbH, Am Weichselgarten 23, 91058, Erlangen, Germany

    D. Volkert

  2. Department of Food and Nutrition Sciences, Nutritional Physiology, University of Bonn, Endenicher Allee 11–13, 53115, Bonn, Germany

    L. Pauly, P. Stehle &  D. Volkert

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Pauly, L., Stehle, P. & Volkert, D. Nutritional situation of elderly nursing home residents. Z Gerontol Geriatr 40, 3–12 (2007). https://doi.org/10.1007/s00391-007-0430-x

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