[Nutritional support in elderly malnourished patients]

ASSESSMENT OF NUTRITIONAL STATUS: Protein-calorie malnutrition is frequent and often severe in fragile hospitalized or institutionalized elderly subjects. Underdiagnosis and undertreatment is commonplace. Since under- or malnutrition is more difficult to correct in the elderly than in the young subject, a careful assessment of the nutritional status must be made in order to recognize any nutritional disorder early and initiate proper treatment early.

High-protein oral supplementation and complementary enteral nutrition can improve the clinical status of certain under- or malnourished elderly subjects. It is particularly important to initiate nutritional assistance early and provide effective treatment for any recognized surgical or medical cause of malnutrition. Patient cooperation is crucial.

Associated early with rehabilitation therapy, nutritional assistance can be expected to improve the functional independence of the elderly patient. Treatment efficacy and patient tolerance must be evaluated regularly to adapt nutritional assistance to the patient's particular clinical situation. Intensive enteral nutrition is not appropriate for elderly patients with severe malnutrition whose quality of life is compromised by motor, psycho-cognitive, or sensorial handicaps.