Nutrition, energy metabolism and body composition in the frail elderly
Year: 2006
Type: dissertation
Abstract: During aging a reduction of energy metabolism, energy intake and fat free\nmass can be seen. Some elderly patients experience more pronounced body\nweight loss that may lead to malnutrition states. The reasons for the\nunintentional body weight loss, that often accompanies chronic disease,\nare poorly understood. A combination of poor nutritional state and\nimpaired physical function increases the risk for dependency in the daily\nliving and further deterioration of health. Treatment needs to focus on\nthe one hand of optimizing disease management and on the other on\nnutrition and physical function.\n\nThe aim of this thesis was to study several nutrition related parameters\nin frail elderly people and try to gain a deeper understanding of the\nmechanisms contributing to the nutritional problems in elderly patients,\nalso focusing on treatment and follow-up. This was done by analyzing\nenergy intake, body composition and energy metabolism in both nursing\nhome patients and free-living, frail elderly individuals. Individualized\nnutritional treatments were applied and analyzed longitudinally. In the\nfree-living group a three-month randomized controlled trial (RCT) with\nfour arms was performed (nutritional treatment, physical training, both\ncombined or control).\n\nThe results showed that energy intake was low (mean total intake below\n1600 kcal/day, mean relative intake was 25-27 kcal/kg body weight/day).\nIndividual nutritional intervention was difficult to manage and the\neffects difficult to analyze. Nutrient intake was low for about half of\nthe nutrients analyzed. Nutrient density was also low, especially\nconsidering the low level of energy intake. Resting metabolic rate was\nrelated to fat free mass and was in accordance with previous studies.\nMean body weight was stable. At an individual level there was no relation\nbetween changes in energy intake and body weight. In the RCT no evident\ntreatment effects could be seen on any of the nutrition parameters\nanalyzed. Of those in need of an increased energy intake, about one third\nmanaged to actually increase their intake, regardless of intervention.\nThese individuals seemed to be protected against further weight loss.\n\nAs energy metabolism was normal and the physical activity low in these as\nin previous studies in the literature, future research needs to focus on\nthe reasons for the poor energy and nutrient intake in the frail elderly.\nThe relative contribution of diseases and/or injuries, effects of\nmedication, low physical activity, social deprivation and mechanisms\nrelated to ageing are unclear and should be considered. There is a strong\nneed for more treatment trials regarding malnutrition and frailty states.\nThere is a large variety between individuals and therefore attention to\nthe needs of the individual should be emphasized. The importance of\npreventing frailty will increase, as the number of very elderly people\ngrows in society.
Source: Figshare
Author: Eva Lammes
Language: English
Subfield: Physiology (medical)
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2149175748