Malnutrition in patients and the elderly needs more attention

– There are very few patients who are diagnosed with malnutrition. In healthcare and elderly care, there is still a problem of underdiagnosis and undertreatment, not only in Sweden but all over the world. But with fairly simple methods, patients and elderly people can feel much better, says Tommy Cederholm, professor of clinical nutrition at Uppsala University.

Together with Ingvar Bosaius, chief physician at Sahlgrenska University Hospital, he wrote a general article on malnutrition in the New England Journal of Medicine. They compiled the state of knowledge in the world over the past 50 years, focusing on what has happened in the last five years, and stated that in the healthcare sector, you need to make more use of experience. Research shows.

acute malnutrition in hospitals

Many elderly people in Sweden suffer from malnutrition. Overall, in society as a whole, between five and ten percent of elderly people suffer from malnutrition. For patients in hospitals, nursing homes or similar, the figure is up to fifty percent. Traditionally, weight loss and malnutrition were seen as a normal manifestation of illness or aging, and nothing could be done about it. It is now known that the most common cause is an underlying disease that makes them eat less and causes the body’s organs and tissues to break down.

A person who is malnourished loses weight, has nutrient deficiencies and has problems with muscle breakdown. This can lead to difficulties coping with daily life. The person may also have an increased susceptibility to infection and a greater need for care, which can lead to longer periods of care and a higher mortality rate.

Knowledge about malnutrition and its treatment has made great strides in recent years. Researchers and doctors around the world have come to agree on how to diagnose malnutrition—a combination of weight loss, underweight, and low muscle mass in individuals with poor appetite, who may or may not have an underlying disease.

Collaboration with nutritionists

Large new clinical trials clearly show that malnutrition can be reversed. Counseling and treatment with dietitians and the use of nutritious drinks can slow weight loss and reduce mortality.

– These are simple measures that are ignored every day. Today we know that it is possible to cure the vast majority of patients, except for those with long-term, fatal diseases, such as metastatic cancer, for example. In Sweden, for example, we have been working on this for many years, but we must become better, says Ingvar Bosaius, chief physician at Sahlgrenska University Hospital.

Researchers propose concrete measures to reduce the suffering of the elderly.

– Recording risk factors for malnutrition early, with attention to weight loss and decreased appetite is crucial. You should also give early advice on nutrient-rich foods and start nutritional therapy in time, for example with nutritional drinks. Knowing this should become a more visible part of both basic education and specialist education for doctors and nurses, says Tommy Cederholm.

Ellen Backstrom