Importance of older age for nutrition management

To review the impact of nutrition on critically ill older adults, focusing on the role of comorbidities such as malnutrition, sarcopenia, and frailty, as well as the importance of nutritional support for outcomes such as mortality, recovery, and long-term disability.

Malnutrition is highly prevalent in the elderly and is strongly associated with adverse outcomes, including increased mortality, longer ICU stays, and higher rates of infection. In addition, frailty, multimorbidity, and cognitive decline significantly contribute to the vulnerability of older patients in the ICU. Evidence suggests that early individualized nutritional management, including adequate protein intake and prevention of the refeeding syndrome, is essential. However, age-specific guidelines are lacking.

Older adults admitted to the ICU face unique challenges owing to physiological decline, chronic diseases, and diminished nutritional reserves. Frailty and malnutrition are key predictors of poor outcomes in older adults. However, nutritional strategies tailored to older adults remain poorly defined. Whether optimized nutritional support through early assessment and age-appropriate interventions improves survival, reduces complications, and enhances quality of life after ICU discharge is a crucial clinical question to be answered by focused research.