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nutrition guidelines for geriatrics

Jean-Pierre Droz, Gilles Albrand, Silke Gillessen, Simon Hughes, Nicolas Mottet, Stéphane Oudard, Heather Payne, Martine Puts, Gilbert Zulian, Lodovico Balducci, Matti Aapro
CONTEXT: Prostate cancer is the most frequent male cancer. Since the median age of diagnosis is 66 yr, many patients require both geriatric and urologic evaluation if treatment is to be tailored to individual circumstances including comorbidities and frailty. OBJECTIVE: To update the 2014 International Society of Geriatric Oncology (SIOG) guidelines on prostate cancer in men aged >70 yr. The update includes new material on health status evaluation and the treatment of localised, advanced, and castrate-resistant disease...
January 11, 2017: European Urology
Marine Dupuis, Elisabetta Kuczewski, Laurent Villeneuve, Sylvie Bin-Dorel, Max Haine, Claire Falandry, Thomas Gilbert, Guillaume Passot, Olivier Glehen, Marc Bonnefoy
BACKGROUND: Undernutrition prior to major abdominal surgery is frequent and increases morbidity and mortality, especially in older patients. The management of undernutrition reduces postoperative complications. Nutritional management should be a priority in patient care during the preoperative period. However undernutrition is rarely detected and the guidelines are infrequently followed. Preoperative undernutrition screening should allow a better implementation of the guidelines. METHODS/DESIGN: The ANC ("Age Nutrition Chirurgie") study is an interventional, comparative, prospective, multicenter, randomized protocol based on the stepped wedge trial design...
January 7, 2017: BMC Geriatrics
Robert Battat, Marc Jhonson, Lorne Wiseblatt, Cruff Renard, Laura Habib, Manouchka Normil, Brian Remillard, Timothy F Brewer, Galit Sacajiu
BACKGROUND: Recent calls for reform in healthcare training emphasize using competency-based curricula and information technology-empowered learning. Continuing Medical Education programs are essential in maintaining physician accreditation. Haitian physicians have expressed a lack access to these activities. The Haiti Medical Education Project works in alliance with Haitian medical leadership, faculty and students to support the Country's medical education system. We present the creation, delivery and evaluation of a competency-based continuing medical education curriculum for physicians in rural Haiti...
October 19, 2016: BMC Medical Education
Joseph A Molnar, Lucian G Vlad, Tuna Gumus
There is increasing awareness that chronic wound healing is very dependent on the patient's nutritional status, but there are no clearly established and accepted assessment protocols or interventions in clinical practice. Much of the data used as guidelines for chronic wound patients are extrapolated from acutely wounded trauma patients, but the 2 groups are very different patient populations. While most trauma patients are young, healthy, and well-nourished before injury, the chronic wound patient is usually old, with comorbidities and frequently malnourished...
September 2016: Plastic and Reconstructive Surgery
Liang-Kung Chen, Wei-Ju Lee, Li-Ning Peng, Li-Kuo Liu, Hidenori Arai, Masahiro Akishita
Sarcopenia was recently classified a geriatric syndrome and is a major challenge to healthy aging. Affected patients tend to have worse clinical outcomes and higher mortality than those without sarcopenia. Although there is general agreement on the principal diagnostic characteristics, initial thresholds for muscle mass, strength, and physical performance were based on data from populations of predominantly Europid ancestry and may not apply worldwide. The Asian Working Group for Sarcopenia (AWGS) issued regional consensus guidelines in 2014, and many more research studies from Asia have since been published; this review summarizes recent progress...
August 1, 2016: Journal of the American Medical Directors Association
Anil Chankaramangalam Mathew, Darsana Das, Saranya Sampath, M Vijayakumar, N Ramakrishnan, S L Ravishankar
BACKGROUND: Different studies in India have shown that more than 50% of elderly population of India are suffering from malnutrition and more than 90% have less than recommended intake. OBJECTIVES: The aim of this study is to estimate the prevalence and correlates of malnutrition among elderly aged 60 years and above in an urban area in Coimbatore using Mini Nutritional Assessment (MNA). METHODS: A cross-sectional study was conducted on 154 households and 190 elderly were interviewed...
April 2016: Indian Journal of Public Health
Lina Johansson, Denis Fouque, Vincenzo Bellizzi, Philippe Chauveau, Anne Kolko, Pablo Molina, Siren Sezer, Pieter M Ter Wee, Daniel Teta, Juan J Carrero
The number of older people on dialysis is increasing, along with a need to develop specialized health care to manage their needs. Aging-related changes occur in physiological, psychosocial and medical aspects, all of which present nutritional risk factors ranging from a decline in metabolic rate to assistance with feeding-related activities. In dialysis, these are compounded by the metabolic derangements of chronic kidney disease (CKD) and of dialysis treatment per se, leading to possible aggravation of protein-energy wasting syndrome...
May 21, 2016: Nephrology, Dialysis, Transplantation
Shlomit Strulov Shachar, Arti Hurria, Hyman B Muss
Breast cancer is the most common cancer in women, with an incidence that rises dramatically with age. The average age at diagnosis of breast cancer is 61 years, and the majority of woman who die of breast cancer are age 65 years and older. Major improvements in public health and medical care have resulted in dramatic increases in longevity. The oldest old (those age 80 years and older) are a rapidly expanding group and now comprise 9 million members of the US population. The treatment of individuals who are age 80 years and older is complex and involves clearly defining the goals and value of treatment while also weighing risks, such as the potential effects of treatment on functional loss and quality of life...
February 2016: Journal of Oncology Practice
Junmin Wei, Wei Chen, Mingwei Zhu, Weixin Cao, Xinying Wang, Hanping Shi, Birong Dong, Jianqin Sun, Huaihong Chen, Yeping Zhou, Suming Zhou, Jingyong Xu
The mortality and morbidity of geriatric patients is much higher than for younger patients, especially when critically ill. This may be attributed to a lower reserve capacity in most organs and systems, reduced ability to deal with physical stress and the presence of acute or chronic co-mobidities. Parenteral and enteral nutrition support can improve the clinical condition of the elderly patient and result in better outcomes, such as lower mortality, reduced hospital stay and reduced medical costs. There is a need to standardize nutrition screening and assessment, and the implementation of appropriate evidence based nutritional support of geriatric patients in China...
2015: Asia Pacific Journal of Clinical Nutrition
J Törmä, U Winblad, A Saletti, T Cederholm
OBJECTIVES: Studies on implementation techniques that focus on nutrition in the setting of elderly care are scarce. The aims of this study were to compare two implementation strategies i.e., external facilitation (EF) and educational outreach visits (EOVs), in order to introduce nutritional guidelines (e.g. screening, food quality and mealtime ambience), into a nursing home (NH) setting and to evaluate the clinical outcomes. DESIGN: A controlled study with baseline and follow-up measurements...
January 2015: Journal of Nutrition, Health & Aging
Heather Keller, Anne Marie Beck, Ashwini Namasivayam
Poor food and fluid intake and malnutrition are endemic among older adults in long-term care (LTC), yet feasible and sustainable interventions that target key determinants and improve person-centered outcomes remain elusive. Without a comprehensive study addressing a range of determinants to identify those that are of greatest importance for targeting with interventions, expert consensus can be used to develop a research agenda. International experts and stakeholders convened for a 2-day meeting to participate in a nominal group process to identify and prioritize determinants of food and fluid intake for persons living in LTC...
February 2015: Journal of the American Medical Directors Association
Dominic E Sanford, Angela M Sanford, Ryan C Fields, William G Hawkins, Steven M Strasberg, David C Linehan
BACKGROUND: Weight loss and malnutrition are poorly tolerated by geriatric patients, and pancreaticoduodenectomy (PD) can result in chronic malabsorption and weight loss. We sought to determine how preoperative severe nutritional risk (SNR), as defined by the American College of Surgeons National Surgical Quality Improvement Program/American Geriatric Society Best Practice Guidelines, affects long-term survival after PD for benign disease among geriatric and nongeriatric patients. STUDY DESIGN: All patients undergoing PD for nonmalignant conditions at a single center between 1995 and 2013 were followed for survival, excluding patients who died within 90 days of surgery...
December 2014: Journal of the American College of Surgeons
Antoni Mariusz Szczepanik, Karolina Brzuszkiewicz, Ewa Walewska, Lucyna Scisło, Szymon Pietruszka, Mirosław Szura, Jan Kulig
Proper preparation of the patient for surgery has a crucial impact on the outcome. Due to the continuous increase in life expectancy more and more often the problem of proper perioperative preparation of the patients over 65 years of age burdened with a higher risk of perioperative complications is undertaken. Proper assessment of the health condition and physical capacity allows to optimize treatment and thus minimize the risk of complications. In many countries, the recommended procedure is to perform the Comprehensive Geriatric Assessment (CGA), which, however, due to the need to carry out a number of additional diagnostic tests and consultations is too expensive for the vast majority of hospitals...
September 2014: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
Pooja Baijal, Vyjeyanthi Periyakoil
As population ages, the number of older adults with cancer is increasing rapidly. Chronological age per se is a poor guide for an oncologist to determine tolerance to cancer treatment. Older adults have been underrepresented in cancer clinical trials, leading to paucity of guidelines to meet the treatment challenges in this population. To evaluate an older adult with cancer, oncologists must understand age-related changes and identify the subset of population who is vulnerable and at risk of cancer treatment toxicity...
September 2014: Cancer Journal
Alfonso J Cruz-Jentoft, Francesco Landi, Stéphane M Schneider, Clemente Zúñiga, Hidenori Arai, Yves Boirie, Liang-Kung Chen, Roger A Fielding, Finbarr C Martin, Jean-Pierre Michel, Cornel Sieber, Jeffrey R Stout, Stephanie A Studenski, Bruno Vellas, Jean Woo, Mauro Zamboni, Tommy Cederholm
OBJECTIVE: to examine the clinical evidence reporting the prevalence of sarcopenia and the effect of nutrition and exercise interventions from studies using the consensus definition of sarcopenia proposed by the European Working Group on Sarcopenia in Older People (EWGSOP). METHODS: PubMed and Dialog databases were searched (January 2000-October 2013) using pre-defined search terms. Prevalence studies and intervention studies investigating muscle mass plus strength or function outcome measures using the EWGSOP definition of sarcopenia, in well-defined populations of adults aged ≥50 years were selected...
November 2014: Age and Ageing
S Allepaerts, J De Flines, N Paquot
Ageing of the body predisposes to a high incidence of undernutrition in the elderly person wherever he or she is living, but the prevalence of malnutrition is particularly high in hospitalized or instutionalized patients. Early detection of malnutrition is important because malnutrition may have significant consequences and evaluation of nutritional status has to be a routine screening in the elderly. There is no single parameter which supplies a full assessment of the patient's nutritional status. It is then necessary to use screening tools for the identification of patients at nutritional risk, based on anamnestic, antropometric and biological data...
May 2014: Revue Médicale de Liège
Morteza Emami, Mohammad Ali Nazarinia, Hussein Rezaeizadeh, Mohammad M Zarshenas
The present article aimed to compile information on the nutritional management for geriatric people. Popular textbooks of Persian medicine from 10th to 18th century were studied to derive relative viewpoints and considerations. The temperament, which is defined as the combination of 4 main elements (fire, air, water, and soil) and 4 humors made subsequently (black bile, yellow bile, phlegm, and blood), changes during age periods. Imbalance in proportional amounts of humors in elderly should be corrected with food and medicaments having opposite nature to the current condition...
October 2014: Journal of Evidence-based Complementary & Alternative Medicine
R Rizzoli, J Branco, M-L Brandi, S Boonen, O Bruyère, P Cacoub, C Cooper, A Diez-Perez, J Duder, R A Fielding, N C Harvey, M Hiligsmann, J A Kanis, J Petermans, J D Ringe, Y Tsouderos, J Weinman, J-Y Reginster
UNLABELLED: This consensus article reviews the diagnosis and treatment of osteoporosis in geriatric populations. Specifically, it reviews the risk assessment and intervention thresholds, the impact of nutritional deficiencies, fall prevention strategies, pharmacological treatments and their safety considerations, the risks of sub-optimal treatment adherence and strategies for its improvement. INTRODUCTION: This consensus article reviews the therapeutic strategies and management options for the treatment of osteoporosis of the oldest old...
November 2014: Osteoporosis International
Hiroshi Takahashi
The Japan Geriatrics Society (JGS) published the JGS Guidelines for Decision-making in the Care of the Elderly Focusing on Indications for Artificial Hydration and Nutrition (AHN) in June 2012. While these guidelines have been implemented in medical practice, they have not pervaded the awareness of the common public, especially in the countryside. Therefore, we developed a set of guidelines and a support tool for the use of AHN in older adults in our community, northern Iwate Prefecture, Japan in accordance with the original guidelines...
2014: Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
Dottie Laflamme, Danièlle Gunn-Moore
At least one-third of cats seen by veterinarians are mature, defined as 7 years of age or older, and approximately 13% of cats are geriatric, defined as 12 years of age or older. The article reviews physiologic differences between these life stages and relates the changes to nutritional needs. Geriatric cats have increased requirements for dietary energy and protein. Feeding management addresses what, when, how, and where food is provided. This article provides an update on diet-sensitive conditions, including cognitive dysfunction, diabetes mellitus, chronic kidney disease, osteoarthritis, and hyperthyroidism...
July 2014: Veterinary Clinics of North America. Small Animal Practice
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