Department of Geriatrics and Medical Gerontology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13347 Berlin, Germany.
Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbrücke, 14458 Nuthetal, Germany.
Nutrients. 2021 Aug 12;13(8):2764. doi: 10.3390/nu13082764.
Malnutrition in older adults has been recognised as a challenging health concern associated with not only increased mortality and morbidity, but also with physical decline, which has wide ranging acute implications for activities of daily living and quality of life in general. Malnutrition is common and may also contribute to the development of the geriatric syndromes in older adults. Malnutrition in the old is reflected by either involuntary weight loss or low body mass index, but hidden deficiencies such as micronutrient deficiencies are more difficult to assess and therefore frequently overlooked in the community-dwelling old. In developed countries, the most cited cause of malnutrition is disease, as both acute and chronic disorders have the potential to result in or aggravate malnutrition. Therefore, as higher age is one risk factor for developing disease, older adults have the highest risk of being at nutritional risk or becoming malnourished. However, the aetiology of malnutrition is complex and multifactorial, and the development of malnutrition in the old is most likely also facilitated by ageing processes. This comprehensive narrative review summarizes current evidence on the prevalence and determinants of malnutrition in old adults spanning from age-related changes to disease-associated risk factors, and outlines remaining challenges in the understanding, identification as well as treatment of malnutrition, which in some cases may include targeted supplementation of macro- and/or micronutrients, when diet alone is not sufficient to meet age-specific requirements.
老年人营养不良已被认为是一个具有挑战性的健康问题，不仅与死亡率和发病率增加有关，还与身体衰退有关，这对老年人的日常生活活动和整体生活质量都有广泛的急性影响。营养不良很常见，也可能导致老年人老年综合征的发展。老年人的营养不良表现为非自愿性体重减轻或低身体质量指数，但隐藏的缺陷，如微量营养素缺乏，更难评估，因此在社区居住的老年人中经常被忽视。在发达国家，营养不良最常见的原因是疾病，因为急性和慢性疾病都有可能导致或加重营养不良。因此，随着年龄的增长是患疾病的一个风险因素，老年人面临营养风险或营养不良的风险最高。然而，营养不良的病因是复杂的和多因素的，老年人营养不良的发展也很可能是由衰老过程促进的。本综述全面总结了目前关于老年人营养不良的流行率和决定因素的证据，涵盖了与年龄相关的变化到与疾病相关的风险因素，概述了在理解、识别和治疗营养不良方面仍然存在的挑战，在某些情况下，可能包括针对宏量和/或微量营养素的补充，如果仅通过饮食不能满足特定年龄的需求。
