Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia.
National Research Council, Neuroscience Institute, Aging Branch.
Curr Opin Clin Nutr Metab Care. 2018 Jan;21(1):24-29. doi: 10.1097/MCO.0000000000000431.
To provide an updated perspective of how nutritional screening and assessment in older persons should be performed and reasonably implemented in the near future.
Although nutritional screening and assessment should be fast and easy procedures, there is increasing evidence that more time should be dedicated to them. This is probably an answer to the claim to a medicine being more preventive than curative. Increasing interest is currently given to healthy aging and nutritional status is more likely to be addressed for its implications on functional status and disability. Important prognostic conditions, such as frailty, sarcopenia, and cachexia, which are closely linked to the nutritional domain, are at the top of the agenda. Therefore, body composition is a key issue and functional status is suggested as primary endpoint of nutrition trials. In this scenario, there is also a rationale for systematic assessment of inflammation, protein intake, and vitamin D status as potential contributing factors to reduced muscle mass and function.
A 'second-generation' multidimensional nutritional screening and assessment including the evaluation of body composition, frailty, sarcopenia, and cachexia could be hypothesized. Nutritional assessment should be also completed by the systematic evaluation of inflammation, protein intake, and vitamin D status.
提供关于老年人营养筛查和评估的最新观点,以及在不久的将来如何合理地实施。
尽管营养筛查和评估应该是快速而简单的程序,但越来越多的证据表明,应该为其分配更多的时间。这可能是对医学更具预防性而非治疗性的主张的回应。目前人们对健康老龄化越来越感兴趣,并且更有可能关注营养状况对功能状态和残疾的影响。与营养领域密切相关的重要预后情况,如虚弱、肌少症和恶液质,处于议程的首位。因此,身体成分是一个关键问题,功能状态被建议作为营养试验的主要终点。在这种情况下,系统评估炎症、蛋白质摄入和维生素 D 状况作为导致肌肉减少和功能下降的潜在因素也是合理的。
可以假设包括身体成分、虚弱、肌少症和恶液质评估的“第二代”多维营养筛查和评估。营养评估还应通过系统评估炎症、蛋白质摄入和维生素 D 状况来完成。