In France, more than 2 million elderly people suffer from undernutrition , particularly the elderly who represent 60% of cases in health establishments. Indeed, according to INSEE, nearly one in five senior citizens is concerned. Any involuntary weight loss in an elderly person should lead to a consultation with the general practitioner. Depending on the severity of the malnutrition, the doctor has several options: increased energy intake (richer and more frequent meals, oral nutritional supplements), enteral or parenteral nutrition. To treat the malnutrition of seniors, oral intake will always be preferred first.
The malnutrition is defined by the HAS as “an imbalance between nutrient intake and requirements of the body resulting in tissue loss, including muscle, which have deleterious functional consequences.” This nutritional state is characterized by a lack of energy and a deficiency of proteins and nutrients. Several risks can result: muscle weakness, infections, delayed recovery, or even death.
In the elderly, undernutrition corresponds to a decrease in their food intake that can cause various deficiencies and weakened health. A state of undernutrition can develop gradually or rapidly.
Official recommendations assess the nutritional intake of seniors at around 35kcal / kg / day, or 1,800 kcal, including 1g / kg / day of protein.
Several behaviors can alert loved ones and the healthcare team:
The social, psychological or pathological situation of a senior can lead to or worsen undernutrition. Thus, several situations can be at risk in an elderly person:
One of the main warning signs of undernutrition is weight loss:
The other symptoms are diverse and can include fatigue, listlessness, a sunken face, dull hair, dry skin, a limp handshake, decreased social interactions, loss of interest in hobbies. , etc.
Indeed, it is not essential to be a doctor or a caregiver to detect the signs of undernutrition. They are easily identified by:
The consequences of undernutrition in the elderly can be dramatic. Weak people can contract all kinds of infections and pathologies. It is therefore essential to quickly detect the first signs of this nutritional state.
Weight loss is the symptom that should alert health professionals or not. Indeed, an involuntary weight loss of more than 5% in 1 month should lead to a consultation, or at least to corrective measures.
The doctor can refer the patient to a dietitian in addition to his care.
The earlier the treatment, the more effective it will be. It will depend on several parameters such as the nutritional status of the person, the associated pathologies and disabilities and the opinion of the patient and his family.
Three types of therapy can be considered:
There are several stages of undernutrition. The doctor adapts his treatment according to the severity of it.
We speak of moderate undernutrition when the patient can still eat. An increase in energy intake, whether or not associated with a prescription for oral nutritional supplements, is sufficient.
We speak of severe undernutrition when the patient no longer eats alone. In this case, the doctor may prescribe oral nutritional supplements, and possibly enteral nutrition.
To prevent undernutrition, it is important to eat properly, and to enjoy eating. First of all, you should know that the elderly have greater food needs than the rest of the population. Indeed, contrary to popular belief, food requirements do not decrease with age. Thus, after 70 years, it is advisable to avoid fasting by eating three meals a day and if possible two snacks.
Some tips for a good diet:
To note ! It is important to maintain physical activity (gardening, walking, etc.) for at least 30 minutes a day, consecutive or not, in order to maintain sufficient muscle mass. The practice of a physical activity also makes it possible to avoid situations of isolation, even of depression.