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Nutrition in Geriatrics
Yitshal Berner MD MPH
The rate of elderly is growing with time in the developed as well as in the developing societies in a rate of about 5% a year. This population has higher morbidity then the general population. Elderly are characterized by changes in different physiological activities as well as multiple pathologies. Cellular function is based on Hormones, Cytokines and Neurotransmitters acting through cell?s receptors and altered cellular function. Dietary structure is considered as one of the components of health and well-being. Having high morbidity with slower rate of cure, elderly are major consumer of nutrition support.
It is important to differentiate between the role of nutrition as part of lifestyle, in aging and the role of nutrition in treatment of the sick elderly. Physilogical changes leading to nutrition deficiencies in aging will be discussed.
The recent developments in the technology of nutrition support give us the tools to supply every person with all nutrients compounds in different manners. We can modulate the dietary structure in any way that we think that can benefit the person. There are enriched solutions with different substances, immunological modulating solutions, and many other solutions, that either bypass the swallowing mechanism in different ways supplying enteral nutrition or going parenterally directly to the circulation through different ports. Despite these various opportunities there are many questions about the efficacy of the nutrition support in the elderly in certain opportunities and ethical debate about the indication with different opinions is running now, questioning the medical indications, the techniques and the timing for the implementation of support.
Sarcopenia, the decline in muscle mass is part of the aging process, the differentiation between low muscular mass resulting from starvation secondary to disease and that derived as a consequence of different responses to disease with the background effect of aging is has been recently determined.
The role of the feeding process as part of the needs of the elderly subject, reflecting empathy and psychosocial support is becoming more prominent part of the care of the aged.
The main challenge of clinical nutrition in the aged now, are in the determination of the optimal faster timing for intervention, and with the intervention of the entire geriatric team in the process of proper feeding of aged.
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