Читать книгу Pathy's Principles and Practice of Geriatric Medicine - Группа авторов - Страница 396

The treatment of undernutrition in the elderly begins with a careful differential diagnostic approach aimed at finding reversible medical causes. Medical conditions that may be associated with anorexia, decreased food intake, or increased metabolic requirements should be assessed. Anorexia may be associated with illness, drugs, dementia, or mood disorders. Decreased food intake may result from dysphagia, chewing problems, nausea, vomiting, diarrhoea, pain, or faecal impaction. Increased metabolic requirements may be precipitated by fever, infection, or the presence of chronic skin wounds. Treatment of these conditions may restore appetite and body weight.

Comprehensive gerontological assessment (CGA; see Table 14.3) is therefore a helpful tool for care in complex situations: multiple comorbid conditions or frailty. Starvation and cachexia are frequently associated, and simple interventions such as oral care can improve nutritional status and quality of life. Furthermore, CGA enables providing integrative care, including treatment optimization, assessment of food intake capacities, and improvement in function.