Nutritional problems of the elderly.

Malnutrition is common in elderly persons living in institutions and in the community. In many cases, the problem arises from a highly individual constellation of interacting physiologic, economic, and psychosocial causes that have the common effect of reducing nutrient intake. Protein-calorie and micronutrient undernutrition added to the normal effects of aging can undermine functional independence and diminish the quality of life of the elderly. The spectrum of the elderly is extremely broad, and, consequently, nutritional assessment and support must be highly individualized to be effective. A multidisciplinary approach focusing on prompt identification and treatment of correctable causes of undernutrition is most effective. There is a wide range of support modalities, from simple supplemental foods to total parenteral nutrition, any of which may be used successfully in an elderly patient, provided that the necessary care is taken to define the goals of therapy and to provide patient assessment and monitoring.