Nutrition In Elderly Patients Research Articles

Study on Relieving Symptoms of Oral Pain in the Elderly with Oral Care

Objective: The objective is to investigate the relationship between oral care and dietary nutrition in elderly patients with oral ulcerative pain. Methods: From January 2021 to January 2022, 116 elderly patients with oral ulcer were selected. The two groups of patients were divided into experimental group and control group by random numbering method. The control group received the usual treatment. The control group was given dietary intervention support. The SF-36 questionnaire was used to evaluate the quality of life of the two groups of patients by comparing their satisfaction after nursing intervention, the healing time of oral ulcer, the time when pain disappeared and the normal feeding time. Results: The pain grade of both groups was evaluated by digital pain score. The health knowledge of patients with oral ulcer was compared between the two groups, and the good rate of oral ulcer was compared between the two groups. Results: Compared with the control group, the oral ulcer of the control group healed, the pain disappeared, and the time of normal eating was significantly shortened (P<0.05). After treatment, the scores of general health, mental health, social function, energy and knowledge of the experimental group were higher than those of the control group, but the scores of NRS were lower than those of the control group (P<0.05). The oral healing rate of the experimental group was higher than that of the reference group (P < 0.05). Conclusion: The combination of oral care and dietary intervention in elderly patients with oral ulcer has a significant effect. This can relieve the pain of the patient and speed up the healing of the wound.

Evaluation of Early Postoperative Enteral Nutrition in Elderly Patients with Gastrointestinal Surgery to Improve the Incidence of Complications

Evaluation of Early Postoperative Enteral Nutrition in Elderly Patients with Gastrointestinal Surgery to Improve the Incidence of Complications

The Effect of Complete Denture Rehabilitation on Nutritional Status of Geriatric Patients

Background: Nutrition in elderly patients has been the topic of interest in field of geriatrics. Quality of life is directly correlated with nutritional status in geriatric patients. Aim of the Study: This study was undertaken to evaluate the nutritional status when completely edentulous patients were rehabilitated with conventional complete dentures. Materials and Methods: Hundred edentulous patients, in the age group of 45–65 years, were selected, and biochemical blood analysis was done at three different time periods (0, 3, and 6 months after delivery of complete dentures) for levels of calcium, protein, phosphorus, and hemoglobin in blood. The results at three different time periods were then compared to evaluate the change in the values of these nutrients in the body. Results: Loss of teeth was associated with lower than normal values for calcium, protein, phosphorus, and hemoglobin in blood. There was a significant improvement in the blood calcium and protein levels at the end of 3 months, whereas there was no significant improvement in the blood phosphorus and hemoglobin. Conclusion: Complete denture rehabilitation has a definite positive impact on nutritional status of geriatric patients.

Relationship between enteral nutrition and serum levels of inflammatory factors and cardiac function in elderly patients with heart failure: A protocol for systematic review and meta-analysis.

Background: Published studies investigating enteral nutrition's effect on serum inflammatory factors and the cardiac function of malnourished elderly patients with heart failure (HF) are of poor quality, with small sample sizes, and involve a homogeneous population. Therefore, in order to provide new medical evidence for clinical treatment, we undertook a systematic review and meta-analysis to assess the relationship between enteral nutrition and serum levels of inflammatory factors and cardiac function in elderly patients with HF.Methods: The protocol was written following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement guidelines. Electronic databases including Web of Science, Embase, PubMed, Wanfang, Data, Scopus, Science Direct, Cochrane Library will be searched in April 2021 by 2 independent reviewers. The primary outcome is body mass index, triceps skin fold thickness, upper arm muscle circumference, serum total protein, albumin, and hemoglobin's change in index; secondary outcomes include left ventricular ejection fraction, B-type natriuretic peptide, interleukin-6, C-reactive protein, and tumor necrosis factor-α. The risk of bias assessment of the included studies was performed by 2 authors independently using the tool recommended in the Cochrane Handbook for Systematic Reviews of Interventions (version 5.1.0). We will perform meta-analysis using Review Manager Software.Results: The review will add to the existing literature by showing compelling evidence and improved guidance in clinic settings.Conclusion: Its findings will provide helpful evidence for the application of enteral nutrition in elderly patients with HF.OSF registration number:10.17605/OSF.IO/RTYBP.

Effect of early enteral nutrition in elderly patients with hip fracture during the perioperative period.

This study aimed to assess the effects of early enteral nutrition (EN) in elderly patients with hip fracture. The patients were classified into two groups (with and without EN). We compared the pre- and postoperative albumin (ALB) and inflammatory marker levels of each group and the time spent in bed and quality of life 3 months after surgery between the two groups. The pre- and postoperative IL-6 levels of the experimental group (61.68 ± 51.80 pg/L) were lower than those of the control group (233.11 ± 206.31 pg/L) (P< 0.001). The experimental group spent a shorter period of time in bed (38.75 ± 14.26 days) in comparison to the control group (99.71 ± 56.87 days) (P< 0.001). Quality of life was better in the experimental group than in the control group (P< 0.001). Early EN reduced the increment of postoperative IL-6 levels and improved healing postoperatively.

Gastric versus postpyloric enteral nutrition in elderly patients (age \u2265\u200975\xa0years) on mechanical ventilation: a single-center randomized trial

BackgroundThe risk of ventilator-associated pneumonia (VAP) is reduced when postpyloric enteral nutrition (EN) is administered compared to when gastric EN is administered in specific populations. In the present study, we tested the hypothesis that postpyloric EN is superior to gastric EN in reducing the incidence of VAP in elderly patients (age ≥ 75 years) who are admitted to the intensive care unit (ICU) and require mechanical ventilation.MethodsWe performed a single-center randomized clinical trial involving elderly patients (age ≥ 75 years) who were admitted to the ICU and required mechanical ventilation. The patients were randomly assigned to either the postpyloric EN group or the gastric EN group. The primary outcome was the VAP rate.ResultsOf the 836 patients screened, 141 patients were included in the study (70 in the postpyloric EN group and 71 in the gastric EN group). The patients in the postpyloric EN group were 82.0 (75.0–99.0) years old (male 61.4%), and those in the gastric EN group were 82.0 (75.0–92.0) years old (male 63.4%). The Acute Physiology and Chronic Health Evaluation II scores were 28.09 ± 6.75 in the postpyloric EN group and 27.80 ± 7.60 in the gastric EN group (P = 0.43). VAP was observed in 8 of 70 patients (11.4%) in the postpyloric EN group and in 18 of 71 patients (25.4%) in the gastric EN group, which resulted in a significant between-group difference (OR 0.38, 95% CI 0.15–0.94; P = 0.04). In the postpyloric EN group, there were significant reductions in vomiting (12 patients in the postpyloric EN group vs 29 patients in the gastric EN group; OR 0.30, 95% CI 0.14–0.65; P = 0.002) and abdominal distension (18 patients in the postpyloric EN group vs 33 patients in the gastric EN group; OR 0.40, 95% CI 0.20–0.81; P = 0.01). No significant differences were observed between the two groups regarding mortality and other secondary outcomes.ConclusionsOur study demonstrated that, compared with gastric EN, postpyloric EN reduced the VAP rate among elderly patients who were admitted to the ICU and required mechanical ventilation.Trial registrationChinese Clinical Trial Registry, ChiCTR-IPR-16008485. Registered on 17 May 2016.

Risk factors of diarrhea associated with enteral nutrition in elderly patients with severe disease

Objective To study the risk factors of diarrhea associated with enteral nutrition in elderly patients with severe disease. Method One hundred elderly patients with enteral nutrition from July 2015 to May 2016 were divided into two groups. 36 elderly patients were enrolled in the diarrhea group, while 64 elderly patients without diarrhea were allocated in the control group. Body mss index (BMI) , APACHEⅡscore, whether have hypoproteinemia and mechanical ventilation, whether use antibiotics, antiacids and prokinetics, etc. Information of patients were collected, and relevant data of patients in two groups were analyzed by logistic regression. Results The multivariate logistic regression analysis showed that the most dangerous factors of enteral nutrition associated with diarrhea in patients were hypoproteinemia and mechanical ventilation during enteral nutrition (OR=2.528, 4.184; P<0.05) . Conclusions The serum protein should be assessed before carrying out enteral nutrition in elderly patients in case the presence of hypoproteinemia. For elderly patients with mechanical ventilation, the speed of enteral nutrition should slow down, the dose should be reduced with intermittent infusion. Key words: Enteral nutrition; Diarrhea; Intensive care unit (ICU); Elderly patients

Nutrition in elderly patients with cardiovascular diseases

Elderly population is rapidly increasing in Turkey as well as in the world. There are a number of factors that affect the nutritional status of elderly. Factors such as physiological changes that occur with aging, socioeconomic factors, dementia, depression, large number of chronic illnesses and excessive use of drugs, and low intake of food on the grounds of illness affect the feeding of elderly. Cardiovascular diseases such as hypertension, ischemic heart disease and heart failure are more common in elderly and nutrition in these diseases is important in terms of mortality and morbidity.

Comparison of nasojejunal tube insertion and percutaneous endoscopic gastrostomy for enteral nutrition in elderly patients

Objective To evaluate the clinical application of enteral nutrition by nasojejunal tube insertion and by percutaneous endoscopic gastrostomy (PEG) in elderly patients. Methods A total of 65 elderly patients with dysphagia recruited at our department from January 2010 to November 2014 were divided into the nasojejunal tube feeding group (35 cases) and the PEG feeding group (30 cases). Differences between these two groups in nutritional indexes, immunological indexes, complications and mortality were analyzed retrospectively. Results Serum total protein, albumin and prealbumin and upper arm circumferences all increased after treatment with nasojejunal tube feeding or percutaneous endoscopic gastrostomy (P>0.05). There was overall improvement in nutritional status, as assessed by Nutritional Risk Screening 2002 (NRS2002). Specifically, the before/one month-after-treatment ratio of scores was 3.72±0.91/1.90±0.61 (t=7.24, P 0.05). Although improvement in CD3+ , CD4+ , CD8+ , CD4+ /CD8+ , IgA, IgG, and IgM was seen in both groups after operation, the differences did not reach statistical significance (P>0.05). The incidence of aspiration pneumonia was notably lower (P<0.05) while the incidence of diarrhea was much higher (P<0.05) in the nasojejunal tube feeding group than in the PEG feeding group at one month and three months. The two groups had similar causes of death and mortality rates. Conclusion Both nasojejunal tube and PEG feeding can improve the nutritional status of elderly patients with dysphagia. However, the choice for the route of nutrition should be individualized. Key words: Jejunostomy; Gastroscopes

Effect of Calcium β-Hydroxy-β-Methylbutyrate (CaHMB), Vitamin D, and Protein Supplementation on Postoperative Immobilization in Malnourished Older Adult Patients With Hip Fracture: A Randomized Controlled Study.

Nutrition support in orthopedic patients with malnutrition shortens the immobilization period. The efficacy of calcium β-hydroxy-β-methylbutyrate (CaHMB), vitamin D, and protein intake on bone structure is studied and well known; however, there is no evidence supporting the effect of combined use in orthopedic conditions. We investigated the effects of CaHMB, vitamin D, and protein supplementation on wound healing, immobilization period, muscle strength, and laboratory parameters. This randomized controlled study included 75 older female patients with a hip fracture admitted to orthopedic clinics. The control group received standard postoperative nutrition. The study group received an enteral product containing 3 g CaHMB, 1000 IU vitamin D, and 36 g protein, in addition to standard postoperative nutrition. Anthropometric, laboratory, wound-healing, immobilization period, and muscle strength assessments were evaluated preoperatively and on postoperative days 15 and 30. Wound-healing period was significantly shorter in the CaHMB/vitamin D/protein group than in the control group ( P < .05). The number of patients in the CaHMB/vitamin D/protein group who were mobile on days 15 and 30 (81.3%) was significantly higher than patients in the control group, who were mobile on days 15 and 30 (26.7%) ( P = .001). Muscle strength on day 30 was significantly higher in the CaHMB/vitamin D/protein group vs the control group. Nutrition of elderly patients with a CaHMB/vitamin D/protein combination led to acceleration of wound healing, shortening of immobilization period, and increased muscle strength without changing body mass index. It also reduced dependence to bed and related complications after an orthopedic operation.

Multidisciplinary coordination to maintain and enhance oral function and improve nutrition in elderly patients living at home

Multidisciplinary coordination to maintain and enhance oral function and improve nutrition in elderly patients living at home

Inappropriate pattern of nutrient consumption and coexistent cardiometabolic disorders in elderly people from Poland.

Nutritional recommendations are aimed at, among others, reducing morbidity and mortality from cardiovascular diseases and metabolic disorders, which are common in the aging population. Adherence to these recommendations allows not only to stop the progression of a disease but also to improve the overall health of elderly patients. The aim of this study was to analyze differences in nutrition of elderly patients, with emphasis on the implementation of nutritional recommendations both for healthy people and for patients with cardiometabolic disorders. Based on a 24-hour recall questionnaire of 239 volunteers (mean age, 72 ±9.34 years) and using the Diet 5.0 software, we analyzed in detail the pattern of consumption of various nutrients. Compared with the recommendations of the World Health Organization and cardiology associations, more than 90% of the population did not cover the demand for calcium, potassium, vitamin D, folic acid, and α-linolenic acid. The intake of polyunsaturated fatty acids, sodium, magnesium, fiber, water, and vitamin C was slightly higher. The appropriate intake was observed only in a diet of 15% to 40% of the subjects. The most significant differences were demonstrated for the coexisting diseases and the intake level of sodium, polyunsaturated fatty acids (particularly docosahexaenoic acid) vitamin C, iron, fiber, lauric acid, and sucrose. The diet of patients with hypercholesterolemia was the least deficient, while deficiencies were the most common in patients with a history of myocardial infarction, ischemic heart disease, and heart failure. Nutrition of geriatric patients is inadequate. Their diet is profoundly deficient in nutrients, and these deficiencies further deteriorate in the presence of cardiovascular or metabolic diseases. Our results indicate the need for education among elderly patients in terms of proper eating habits and, possibly, individual supplementation.

Current clinical aspects of parenteral nutrition in geriatric patients

Advancements in medicine, better diagnostics and zeal for a high quality of life have enabled many geriatric patients seeking medical attention for any type of illness. The elderly population is increasing globally and so does the number of such patients in hospital and critical care units. However, increased incidence of debilitating diseases in elderly makes them more prone to develop malnutrition and thus supplementation of nutrition plays an important role in care of these patients. The parenteral nutrition is usually given if enteral nutrition is inadequate or cannot be given. The causes of malnutrition in elderly can be manifold and may be due to weight loss, loss of fat free mass and due to muscle wasting. The special considerations when formulating parenteral nutrition in elderly population is increased content of lipids, early supplementation of trace elements, minerals and vitamins. The outcomes of parenteral nutrition in elderly population have been found to be similar to that in young patients, however overall prognosis in these patients remain guarded due to more severity and guarded prognosis of the diseases found in these patients. The complications due to parenteral nutrition in elderly patients are similar to that of the young patients and are mainly mechanical (catheter related), infectious and metabolic. It has been recommended that the parenteral nutrition should be started early, if indicated, in geriatric patients and should follow the same guidelines as in younger patients with some modifications.

Enteral nutrition before bowel preparation improves the safety of colonoscopy in the elderly

Adverse events during colonoscopy are more likely to occur in elderly. To avoid the adverse events without decreasing the bowel cleanliness is still an unsolved problem. The aim of this study was to determine the effect of enteral nutrition before colonoscopy in a randomized controlled trail. A total of 108 patients over sixty-five years of age and indicated for colonoscopy were randomized into four groups. Group 1 received a solution of two packages of polyethylene glycol electrolyte powder dissolved in 2000 mL water. Group 2 received 500 mL of enteral nutrition plus polyethylene glycol of the same dosage as in group 1. Group 3 received 200 mL of 25% magnesium sulfate solution. Group 4 received 500 mL of enteral nutrition plus 25% magnesium sulfate solution of the same dosage as in group 3. The intestinal cleaning and various physiological indications were measured before, after bowel preparation, and during colonoscopy. No significant difference in the quality of colon cleansing was found among the four groups. The incidence of adverse effects in groups 2 and 4 was less than in groups 1 and 3. Additional enteral nutrition in elderly patients before bowel preparation did not affect the quality of colon cleansing. However, the process can significantly reduce the incidence of adverse effects.

Home parenteral nutrition in elderly patients with cancer: A French observational study

Home parenteral nutrition in elderly patients with cancer: A French observational study

Impact of fish oil enriched total parenteral nutrition on elderly patients after colorectal cancer surgery.

Polyunsaturated omega-3 fatty acids may beneficially influence healing processes and patient outcomes. The aim of this research was to study the clinical efficacy of fish oil enriched total parenteral nutrition in elderly patients after colorectal cancer surgery. Fifty-seven elderly patients with colorectal cancer were enrolled in this prospective, randomized, double-blind, controlled clinical trial. All patients received isocaloric and isonitrogenous total parenteral nutrition by continuous infusion (20 - 24 hours per day) for seven days after surgery. The control group (n = 28) received 1.2 g/kg soybean oil per day, whereas the treatment group (n = 29) received 0.2 g/kg fish oil and 1.0 g/kg soybean oil per day. Blood samples were taken pre-operatively, and at days one and eight after the operation. The plasma levels of CD4, CD8, CD4/CD8, interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α) were measured. Clinical outcomes were then analysed. Patient characteristics were comparable between the two groups. At day eight post-surgery, IL-6, TNF-α and CD8 titres were lower in the treatment group when compared to the control group; these results reached statistical significance. In the treatment group, there were fewer infectious complications and incidences of systemic inflammatory response syndrome (SIRS), and shorter lengths of hospital stay were observed. The total cost of medical care was comparable for the two groups. No serious adverse events occurred in either group. Fish oil 0.2 g/kg per day administrated to elderly patients after colorectal surgery was safe and may shorten the length of hospital stay and improve clinical outcomes.

5．高齢者の経腸栄養の問題点と対策

5．高齢者の経腸栄養の問題点と対策

Comparision of nutritional status of hemodialysis patients with different ages and its nursing strategy

Objective To explore the nutritional status of hemodialysis patients with different ages, and analyze the reasons of differences of nutritional status. Methods 109 hemodialysis patients were divided into the young-age group (n=26), the middle-age group (n=49) and the old-age group (n=34). The body indices, blood biochemical parameters, dietary assessment, handgrip strength and subjective global assessment were measured. The nutritional indices and relationship were compared among patients in the three groups. Results Leg circumstance, prealbumin, creatinine, handgrip strength and SGA scores were different among the three groups (P<0.05 or P<0.01). And those five factors were all statistically associated with age (P<0.05). Conclusions With the increase of age, the hemodialysis patients' nutritional status has a descending trend. It's necessary for nursing staff to timely monitor and intervene the nutrition of elderly patients so as to prevent the incidence of malnutrition. Key words: Renal dialysis; Nutritional status; Nutrition assessment; Age factors; Nursing care

Syndrome de basse T3 chez des patients âgés présentant une dénutrition modérée ou sévère

Under nutrition causes alterations in serum thyroid function tests referred as “non-thyroidal illness syndrome” (NTIS). We determined serum thyroid hormones in elderly patients (≥ 70 years) with mild (25 ≤ albuminemia < 35 g/l, N = 64) or severe (albuminemia < 25 g/l, N = 67) under nutrition, compared to well-nourished patients (albuminemia ≥ 35 g/l, N = 78). Patients with under nutrition had lower (32%) free T3 (FT3) and higher (21%) free T4 (FT4) concentrations than in controls. TSH level was similar in the three groups of patients. Therefore, malnourished elderly patients showed euthyroidism profile, whatever the severity of under nutrition. The decrease in FT3 level was more marked in patients with severe under nutrition. In addition, there was a positive correlation between FT3 and albumin, transthyretin and transferrin and a negative correlation with PINI (“prognostic inflammatory and nutritional index”). These data showed that FT3 is a good marker of severity of under nutrition in elderly patients.

Fat oxidation and plasma removal capacity of an intravenous fat emulsion in elderly and young men

Objective We explored metabolic and thermogenic responses to exogenous fat in relation to age as a basis for a rational design of parenteral nutrition in elderly patients. Methods Ten healthy elderly men (70–78 y of age, body mass index 21–27 kg/m 2) and 10 healthy young men (19–45 y of age, body mass index 19–26 kg/m 2) were studied with a hypertriglyceridemic clamp (primed infusion of a long-chain triacylglycerol emulsion to reach and stabilize at a triacylglycerol concentration of 4 mmol/L for 180 min). Continuous indirect calorimetry was carried out in the basal state and throughout the study period. Results The infusion rates required to maintain plasma triacylglycerol levels at 4 mmol/L were similar in elderly and young individuals (mean ± SEM 0.201 ± 0.027 versus 0.203 ± 0.014 mmol/min, not significant). Plasma concentrations of free fatty acids and β-OH-butyrate were higher in the elderly before the infusion and increased in a similar manner in both groups during infusion. Energy expenditure at baseline was higher in the young than in the elderly (79 ± 2 versus 64 ± 3 kcal/h; P < 0.001), although the respiratory quotient was similar in the two groups (0.80 ± 0.01 versus 0.78 ± 0.01, not significant). During lipid administration there was a similar increase in energy expenditure in the old and young individuals (+9.0 ± 1.3% versus +6.0 ± 1.8%, not significant). Lipid infusion resulted in similar increments in fat oxidation in the young and elderly (23.9 ± 7.0% versus 15.1 ± 4.9%, respectively, not significant). Plasma lipoprotein lipase activity was almost three times higher in the young than in the elderly subjects (0.23 ± 0.02 versus 0.65 ± 0.09 mU/mL, respectively, P < 0.001). During lipid infusion, a similar increment (four- to five-fold) in plasma lipoprotein lipase activity was noted in the two groups. Conclusions Elderly healthy men have a similar capacity as young healthy men to clear and oxidize a high triacylglycerol load administered as a hypertriglyceridemic clamp.