Gallagher-Allred C R, Emley S J
Department of Family Medicine, Ohio State University, Columbus.
Prim Care. 1994 Mar;21(1):175-89.
A dietary treatment plan that considers both quality-of-care and quality-of-life issues is most beneficial for elderly patients. Diabetes can be successfully managed in most elderly patients with a liberalized diet that is low in simple sugars and includes variety and moderation in food choices. Although dietary management in osteoporosis may be most compelling in its preventive capacity, clinicians treating elderly patients with osteoporosis are well advised to consider supplementation of the diet with calcium and vitamin D in amounts equal to the RDAs if patients are unable to consume adequate calcium and vitamin D and if exposure to sunlight is minimal. Encouraging calcium intake, moderate exercise, maintenance of desirable body weight, and avoidance of laxative and antacid abuse with patients throughout the life cycle is appropriate preventive advice. The elderly renal failure patient may benefit from dietary modification of protein, potassium, sodium, fluid, vitamins, and minerals when complications associated with these nutrients are present. Because clinicians treat significant numbers of elderly diabetic, osteoporotic, and renal failure patients, and because many skilled nursing facilities are developing specialty and rehabilitation units for such high-acuity level patients, the clinician is well advised to know how to maximize quality of care and quality of life for these patients through appropriate dietary intervention.
一个兼顾护理质量和生活质量问题的饮食治疗方案对老年患者最为有益。对于大多数老年糖尿病患者而言，采用低糖的宽松饮食方案，且食物选择多样、适度，糖尿病能够得到成功控制。尽管骨质疏松症的饮食管理在预防方面可能最为有效，但对于治疗老年骨质疏松症患者的临床医生而言，如果患者无法摄入足够的钙和维生素D且日照极少，建议考虑按照推荐膳食摄入量补充钙和维生素D。在整个生命周期中鼓励患者摄入钙、适度运动、维持理想体重并避免滥用泻药和抗酸剂，这是合适的预防建议。当出现与蛋白质、钾、钠、液体、维生素和矿物质相关的并发症时，老年肾衰竭患者可能会从这些营养素的饮食调整中获益。由于临床医生治疗大量的老年糖尿病、骨质疏松症和肾衰竭患者，并且许多专业护理机构正在为这类高 acuity 水平的患者设立专科和康复病房，因此建议临床医生了解如何通过适当的饮食干预来最大限度地提高这些患者的护理质量和生活质量。 （注：原文中“acuity”未找到合适释义，可能是特定语境下的专业术语，保留原文）
