Volkert Dorothee, Beck Anne Marie, Cederholm Tommy, Cereda Emanuele, Cruz-Jentoft Alfonso, Goisser Sabine, de Groot Lisette, Großhauser Franz, Kiesswetter Eva, Norman Kristina, Pourhassan Maryam, Reinders Ilse, Roberts Helen C, Rolland Yves, Schneider Stéphane M, Sieber Cornel C, Thiem Ulrich, Visser Marjolein, Wijnhoven Hanneke A H, Wirth Rainer
Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, 90408 Nuremberg, Germany.
Department Nutrition and Health, University College Copenhagen, 2200 Copenhagen, Denmark.
J Clin Med. 2019 Jul 4;8(7):974. doi: 10.3390/jcm8070974.
Malnutrition is widespread in older people and represents a major geriatric syndrome with multifactorial etiology and severe consequences for health outcomes and quality of life. The aim of the present paper is to describe current approaches and evidence regarding malnutrition treatment and to highlight relevant knowledge gaps that need to be addressed. Recently published guidelines of the European Society for Clinical Nutrition and Metabolism (ESPEN) provide a summary of the available evidence and highlight the wide range of different measures that can be taken-from the identification and elimination of potential causes to enteral and parenteral nutrition-depending on the patient's abilities and needs. However, more than half of the recommendations therein are based on expert consensus because of a lack of evidence, and only three are concern patient-centred outcomes. Future research should further clarify the etiology of malnutrition and identify the most relevant causes in order to prevent malnutrition. Based on limited and partly conflicting evidence and the limitations of existing studies, it remains unclear which interventions are most effective in which patient groups, and if specific situations, diseases or etiologies of malnutrition require specific approaches. Patient-relevant outcomes such as functionality and quality of life need more attention, and research methodology should be harmonised to allow for the comparability of studies.
营养不良在老年人中普遍存在，是一种主要的老年综合征，病因多因素，对健康结局和生活质量有严重影响。本文旨在描述当前营养不良治疗的方法和证据，并强调需要解决的相关知识空白。欧洲临床营养与代谢学会（ESPEN）最近发布的指南总结了现有证据，并强调了可以采取的广泛不同措施——从识别和消除潜在原因到肠内和肠外营养——这取决于患者的能力和需求。然而，其中超过一半的建议基于专家共识，因为缺乏证据，只有三项涉及以患者为中心的结局。未来的研究应进一步阐明营养不良的病因，并确定最相关的原因，以预防营养不良。基于有限且部分相互矛盾的证据以及现有研究的局限性，尚不清楚哪些干预措施对哪些患者群体最有效，以及营养不良的特定情况、疾病或病因是否需要特定方法。与患者相关的结局，如功能和生活质量，需要更多关注，并且研究方法应统一，以便研究具有可比性。
