Dwyer J
Department of Medicine and Community Health, School of Medicine, Tufts University, Boston, Massachusetts.
Aging (Milano). 1993 Apr;5(2 Suppl 1):13-21.
The population of older Americans over 65, and particularly over 75 and 85 years of age, when daily activities affecting eating and food-getting are often compromised, is growing rapidly. Screening to identify risk factors to nutritional and general health, and further assessment and intervention for those who are found to be at risk is essential. The Nutrition Screening Initiative is a voluntary effort of several major health professional organizations focused on promoting better nutrition screening and nutritional care for our nation's elderly. This article describes some of the nutrition-related problems faced by older Americans. The progress of the Nutrition Screening Initiative is reviewed, and some simple steps to implement the Initiative's recommendations in physician offices and other health care settings serving older Americans are provided. By adopting and using the simple screening and assessment tools that are provided, or by developing individualized tools, the practicing physician can incorporate these essential components of comprehensive geriatric assessment into office practice. This will do much to alleviate remediable problems early, and to control or ameliorate those that cannot be prevented. Some useful supportive continuing medical education efforts, resources available, and measures that are being taken at the community level are summarized. A case study of some potential problems and how they might be alleviated is provided. Finally, some potential avenues in both the health and social services system for more effective interventions to deal with problems are identified.
65岁及以上的美国老年人数量，尤其是75岁及85岁以上的老年人数量正在迅速增长，这些老年人在影响饮食和获取食物的日常活动中往往受到影响。进行筛查以确定营养和总体健康的风险因素，并对那些被发现有风险的人进行进一步评估和干预至关重要。营养筛查倡议是几个主要健康专业组织的一项自愿行动，重点是为我国老年人促进更好的营养筛查和营养护理。本文描述了美国老年人面临的一些与营养相关的问题。回顾了营养筛查倡议的进展情况，并提供了在为美国老年人服务的医生办公室和其他医疗保健场所实施该倡议建议的一些简单步骤。通过采用和使用所提供的简单筛查和评估工具，或开发个性化工具，执业医生可以将这些综合老年评估的基本组成部分纳入门诊实践。这将大大有助于早期缓解可补救的问题，并控制或改善那些无法预防的问题。总结了一些有用的支持性继续医学教育工作、可用资源以及社区层面正在采取的措施。提供了一个关于一些潜在问题及其如何得到缓解的案例研究。最后，确定了健康和社会服务系统中一些更有效的干预措施来解决问题的潜在途径。
