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Geriatric Nutritional Assessment and Treatment Frameworks

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Geriatric Gastroenterology

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Abstract

Malnutrition is common in older adults in the community, nursing home, and hospital. Deficiencies in caloric and vitamin intake increase with age, functional impairment, and institutionalization, with resultant added risk of skin breakdown, illness, and death. Common contributory factors to undernutrition include polypharmacy, dementia, depression, oral health problems, and socioeconomic factors. Unintentional weight loss always warrants evaluation. Nutritional assessment includes a focused medical and social history, anthropometrics, selected biochemical and hematological parameters, and tools such as the Mini Nutritional Assessment and Simplified Nutritional Appetite Questionnaire. In addition to addressing the cause of malnutrition, management includes meeting patient food preferences, providing oral supplements, and rarely using orexigenic medications. Overnutrition as well has become increasingly common and should be addressed through a healthy diet such as one based on US Dietary Guidelines, including DASH and Mediterranean-like diets. Dietary changes should be made in conjunction with increased physical activity wherever possible. Behavioral counseling to improve lifestyle has been shown to reduce cardiovascular events in persons with cardiovascular risk factors such as hypertension and hyperlipidemia; benefits may also be present for some cancers, depression, and cognitive health. Importantly, adverse events are rare from lifestyle approaches. Treatment plans should respect patient preferences in the context of overall prognosis.

Since the original publication of the chapter in the first edition of Geriatric Gastroenterology (Springer), Kenneth Lloyd Minaker MD, co-author, has passed away; his contributions to the original chapter and the field of geriatrics have been invaluable

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Authors and Affiliations

  1. Clover Health, Jersey City, NJ, USA

    Kumar Dharmarajan

  2. Yale School of Medicine, New Haven, CT, USA

    Kumar Dharmarajan

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  1. Kumar Dharmarajan
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Correspondence to Kumar Dharmarajan .

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Editors and Affiliations

  1. Department of Medicine, Robert Wood Johnson School of Medicine, Rutgers University, New Brunswick, NJ, USA

    C. S. Pitchumoni

  2. Department of Medicine, Division of Geriatrics, Montefiore Medical Center, Wakefield Campus, Bronx, NY, USA

    T.S. Dharmarajan

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Dharmarajan, K. (2021). Geriatric Nutritional Assessment and Treatment Frameworks. In: Pitchumoni, C.S., Dharmarajan, T. (eds) Geriatric Gastroenterology. Springer, Cham. https://doi.org/10.1007/978-3-030-30192-7_15

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