Page 13 - Petelin, Ana, and Šarabon, Nejc. 2018. Eds. Zdravje starostnikov / Health of the Elderly. Znanstvena monografija / Proceedings. Koper: University of Primorska Press
P. 13
n is aged 50 or over, over-fed (45.1 %) and almost a quarter of the obese (23.9 nutrition disorders in the elderly living period 13
%). A survey by Hlastan Ribič and Kranjc (2014) shows the trend of rising fat
and very obese people. The smallest share of overextended and obese is one of
the oldest adults in the group of 80 years or more (Fajdiga et al., 2012).
Development factors of eating disorders
The ability to eat in the elderly is affected by various factors, such as physiolog-
ical: lower energy needs, reduced physical activity, decreased muscle mass and
altered metabolism. The functions of the digestive system are weakened, lead-
ing to a reduction in saliva flow, dysphagia (difficulty swallowing), reduced
gastric secretion, decreased digestion of digestive juices, and weaker taste and
smell of food. Common cause for energy and nutritional malnutrition is ag-
gravated chewing (dental pathology and oral cavity with prosthetics). The abil-
ity to eat is influenced by disease conditions (diarrhea, celiac disease, demen-
tia ...), side effects of drug use, drug interactions and social and psychological
factors (emotional problems, depression, loneliness, anorexia, alcoholism), mo-
bility problems (inaccessibility of foods or Insufficient self-sufficiency), finan-
cial deficits, social isolation, abuse and sometimes even stubbornness (Pečjak,
2007; Cerovič et al., 2008; Smolin and Grosvenor, 2008; Gabrijelčič Blenkuš et
al., 2010; Bernstein, 2016 and Nordqvist, 2016). Malnutrition affects all physical
systems and causes a decrease in the immune system, increased susceptibility
to disease, more complications in treatment, decreased muscle mass and, con-
sequently, increased falls, heart failure, weakened wound healing, social isola-
tion, disturbed thermoregulation, cognitive functions (Smolin, 2008 BAPEN,
2016) and lower quality of life and higher mortality in the elderly (Fielding et
al., 2011; Ribeiro and Kehayias, 2014).
Malnutrition prevention guidelines
A Special Interest Group (SIG) was established in ESPEN, which underlines the
importance of timely detection of malnutrition and proper treatment (Mus-
caritoli, 2010). ESPEN recommends the use of the screening tools Nutrition-
al Risk Screening 2002 (NRS-2002), the Mini Nutritional Assessment-Short
Form (MNA-SF) for Seniors in Homes and the Malnutrition Universal Screen-
ing Tool (MUST) for hospitals (Kondrup et al., 2003; Cederholm et al., 2017).
Research in hospitals, homes for the elderly and residential communi-
ties shows deficiencies such as lack of time intended for eating for the elderly,
not enough varied food and inadequate staff qualifications (Merrell et al., 2012;
Agarwal et al., 2016) and many other factors, related to staff, type and food
preparation, and the environment (Nieuwenhuizen et al., 2010). Similarly, de-
ficiencies have been shown in older people receiving home care, such as limit-
ed time, insufficient knowledge and frequent change of staff (UKHCA, 2012),
and Watkinson-Powell et al. (2014) recommend the social integration of the el-
derly, help with the purchase of foods and the preparation of a meal, and take
%). A survey by Hlastan Ribič and Kranjc (2014) shows the trend of rising fat
and very obese people. The smallest share of overextended and obese is one of
the oldest adults in the group of 80 years or more (Fajdiga et al., 2012).
Development factors of eating disorders
The ability to eat in the elderly is affected by various factors, such as physiolog-
ical: lower energy needs, reduced physical activity, decreased muscle mass and
altered metabolism. The functions of the digestive system are weakened, lead-
ing to a reduction in saliva flow, dysphagia (difficulty swallowing), reduced
gastric secretion, decreased digestion of digestive juices, and weaker taste and
smell of food. Common cause for energy and nutritional malnutrition is ag-
gravated chewing (dental pathology and oral cavity with prosthetics). The abil-
ity to eat is influenced by disease conditions (diarrhea, celiac disease, demen-
tia ...), side effects of drug use, drug interactions and social and psychological
factors (emotional problems, depression, loneliness, anorexia, alcoholism), mo-
bility problems (inaccessibility of foods or Insufficient self-sufficiency), finan-
cial deficits, social isolation, abuse and sometimes even stubbornness (Pečjak,
2007; Cerovič et al., 2008; Smolin and Grosvenor, 2008; Gabrijelčič Blenkuš et
al., 2010; Bernstein, 2016 and Nordqvist, 2016). Malnutrition affects all physical
systems and causes a decrease in the immune system, increased susceptibility
to disease, more complications in treatment, decreased muscle mass and, con-
sequently, increased falls, heart failure, weakened wound healing, social isola-
tion, disturbed thermoregulation, cognitive functions (Smolin, 2008 BAPEN,
2016) and lower quality of life and higher mortality in the elderly (Fielding et
al., 2011; Ribeiro and Kehayias, 2014).
Malnutrition prevention guidelines
A Special Interest Group (SIG) was established in ESPEN, which underlines the
importance of timely detection of malnutrition and proper treatment (Mus-
caritoli, 2010). ESPEN recommends the use of the screening tools Nutrition-
al Risk Screening 2002 (NRS-2002), the Mini Nutritional Assessment-Short
Form (MNA-SF) for Seniors in Homes and the Malnutrition Universal Screen-
ing Tool (MUST) for hospitals (Kondrup et al., 2003; Cederholm et al., 2017).
Research in hospitals, homes for the elderly and residential communi-
ties shows deficiencies such as lack of time intended for eating for the elderly,
not enough varied food and inadequate staff qualifications (Merrell et al., 2012;
Agarwal et al., 2016) and many other factors, related to staff, type and food
preparation, and the environment (Nieuwenhuizen et al., 2010). Similarly, de-
ficiencies have been shown in older people receiving home care, such as limit-
ed time, insufficient knowledge and frequent change of staff (UKHCA, 2012),
and Watkinson-Powell et al. (2014) recommend the social integration of the el-
derly, help with the purchase of foods and the preparation of a meal, and take
