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Management of Malnutrition in Older Patients—Current Approaches, Evidence and Open Questions

Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, 90408 Nuremberg, Germany
Department Nutrition and Health, University College Copenhagen, 2200 Copenhagen, Denmark
Herlev and Gentofte University Hospital, 2703 Herlev, Denmark
Clinical Nutrition and Metabolism, Department of Public Health and Caring Sciences, Uppsala University, 701 05 Uppsala, Sweden
Theme Ageing, Karolinska University Hospital, 171 76 Stockholm, Sweden
Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
Servicio de Geriatría, Hospital Universitario Ramón y Cajal (IRYCIS), 28034 Madrid, Spain
Heidelberg University Centre for Geriatric Medicine and Network Aging Research (NAR), University of Heidelberg, 69126 Heidelberg, Germany
Division of Human Nutrition, Wageningen University, 6708 WE Wageningen, The Netherlands
German Institute for Human Nutrition Potsdam-Rehbrücke, Department of Nutrition and Gerontology, 14558 Nuthetal, Germany
Research Group on Geriatrics, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany
Institute of Nutritional Science, University of Potsdam, 14558 Nuthetal, Germany
Department for Geriatric Medicine, Marien Hospital Herne—University Hospital, Ruhr-Universität Bochum, 44625 Herne, Germany
Department of Health Sciences, Faculty of Science, and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
Southampton NIHR Biomedical Research Centre, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK
Gérontopôle, Centre Hospitalo-Universitaire de Toulouse, 31059 Toulouse, France
Nutritional Support Unit, Centre Hospitalier Universitaire de Nice, Université Côte d’Azur, 06200 Nice, France
Department of Medicine, Kantonsspital Winterthur, 8401 Winterthur, Switzerland
Centre of Geriatrics and Gerontology, Albertinen-Haus, Hamburg, and Chair of Geriatrics and Gerontology, University Medical Centre Eppendorf, 20246 Hamburg, Germany
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(7), 974;
Received: 4 June 2019 / Revised: 27 June 2019 / Accepted: 1 July 2019 / Published: 4 July 2019
Malnutrition is widespread in older people and represents a major geriatric syndrome with multifactorial etiology and severe consequences for health outcomes and quality of life. The aim of the present paper is to describe current approaches and evidence regarding malnutrition treatment and to highlight relevant knowledge gaps that need to be addressed. Recently published guidelines of the European Society for Clinical Nutrition and Metabolism (ESPEN) provide a summary of the available evidence and highlight the wide range of different measures that can be taken—from the identification and elimination of potential causes to enteral and parenteral nutrition—depending on the patient’s abilities and needs. However, more than half of the recommendations therein are based on expert consensus because of a lack of evidence, and only three are concern patient-centred outcomes. Future research should further clarify the etiology of malnutrition and identify the most relevant causes in order to prevent malnutrition. Based on limited and partly conflicting evidence and the limitations of existing studies, it remains unclear which interventions are most effective in which patient groups, and if specific situations, diseases or etiologies of malnutrition require specific approaches. Patient-relevant outcomes such as functionality and quality of life need more attention, and research methodology should be harmonised to allow for the comparability of studies. View Full-Text
Keywords: Geriatric patients; older persons; malnutrition; therapy; interventions Geriatric patients; older persons; malnutrition; therapy; interventions
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MDPI and ACS Style

Volkert, D.; Beck, A.M.; Cederholm, T.; Cereda, E.; Cruz-Jentoft, A.; Goisser, S.; de Groot, L.; Großhauser, F.; Kiesswetter, E.; Norman, K.; Pourhassan, M.; Reinders, I.; Roberts, H.C.; Rolland, Y.; Schneider, S.M.; Sieber, C.C.; Thiem, U.; Visser, M.; Wijnhoven, H.A.H.; Wirth, R. Management of Malnutrition in Older Patients—Current Approaches, Evidence and Open Questions. J. Clin. Med. 2019, 8, 974.

AMA Style

Volkert D, Beck AM, Cederholm T, Cereda E, Cruz-Jentoft A, Goisser S, de Groot L, Großhauser F, Kiesswetter E, Norman K, Pourhassan M, Reinders I, Roberts HC, Rolland Y, Schneider SM, Sieber CC, Thiem U, Visser M, Wijnhoven HAH, Wirth R. Management of Malnutrition in Older Patients—Current Approaches, Evidence and Open Questions. Journal of Clinical Medicine. 2019; 8(7):974.

Chicago/Turabian Style

Volkert, Dorothee, Anne M. Beck, Tommy Cederholm, Emanuele Cereda, Alfonso Cruz-Jentoft, Sabine Goisser, Lisette de Groot, Franz Großhauser, Eva Kiesswetter, Kristina Norman, Maryam Pourhassan, Ilse Reinders, Helen C. Roberts, Yves Rolland, Stéphane M. Schneider, Cornel C. Sieber, Ulrich Thiem, Marjolein Visser, Hanneke A.H. Wijnhoven, and Rainer Wirth. 2019. "Management of Malnutrition in Older Patients—Current Approaches, Evidence and Open Questions" Journal of Clinical Medicine 8, no. 7: 974.

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