Stratégie de prise en charge en cas de dénutrition protéino-énergétique chez la personne âgée - Nutritional support strategy for protein-energy malnutrition in the elderly 1

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Posted on Jun 26 2007 To provide a guide for health professionals to assist management of elderly subjects who are malnourished or at risk of malnutrition. Posted on Jun 26 2007

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CLINICAL PRACTICE GUIDELINES

Nutritional support strategy for protein-energy malnutrition in the elderly

GUIDELINES April 2007

Nutrional support strategy for protein-energy malnutrition in the elderly

The full report (in French) can be downloaded fromwww.has-sante.fr Haute Autorité de Santé Communications Department 2 avenue du Stade de France - F 93218 Saint-Denis La Plaine CEDEX Phone:+33 (0)1 55 93 70 00 - Fax:+33 (0)1 55 93 74 00

This document was validated by the Haute Autorité de Santé Board in April 2007 © Haute Autorité de Santé 2007

HAS / SRP / April 2007 2

Nutrional support strategy for protein-energy malnutrition in the elderly

Sommaire

1. 1.1 1.2 1.3 1.4 1.5

3. 3.1 3.2

Introduction...........................................................................................5 Subject and aims of the guidelines.........................................................5 Patients concerned.................................................................................5 Health professionals concerned.............................................................6 Assessment method...............................................................................6 Grading of the guidelines.......................................................................6

Protein-energy malnutrition : definition, epidemiology ................... 6

What are the risk factors for malnutrition in elderly persons? ....... 7 Risk factors unrelated to age..................................................................7 Risk factors more specific to the elderly.................................................7

4. What tools may be used to screen for and diagnose malnutrition in the elderly? How is severe malnutrition diagnosed? ............................. 7 4.1 ittrn.io mornualineef gnrcS.....................................................................7 4.2 Dgniasiso fo nlamirtution....................................................................9.... 4.3 Diagnosis of severe malnutrition ............................................................ 10

5. 5.1 5.2 5.3

Nutritional support strategy................................................................11 Objective of nutritional support in malnourished elderly subjects .......... 11 Methods of nutritional support................................................................11 Choice of methods of nutritional support................................................11

6. 12 5.4 .................12................................ant medication..................R eloa fovujd 5.5 cripPres................................rcimtunonoit fo ........enri..ts3......1................. 5.6 Monitoring of malnourished elderly subjects, periodicity of nutritional assessment and tools.......................................................................................13 5.7 ts oLimi salonti..rtpoupnimret firtun la....................................................1.4

6 6.1 6.2

7. 7.1 7.2 7.3 7.4 7.5

Practical methods of nutritional support...........................................14 Oral nutritional support...........................................................................14 Prescription of enteral nutrition...............................................................16

Special situations.................................................................................17 Alzheimer’s disease................................................................................17 Pressure sores.......................................................................................18 Swallowing disorders..............................................................................19 Convalescence after an acute disease or surgery ................................. 19 Depression.............................................................................................20

HAS / SRP / April 2007 3

8. inte 8.1 8.2 8.3

Nutrional support strategy for protein-energy malnutrition in the elderly

Coordination among health professionals and among rvention sites............................................................................................20 At home..................................................................................................20 In institutions...........................................................................................21 In hospitals.............................................................................................21

Appendix 1. Assessmentmethod used to produce the clinicalpractice guidelines .......... 22

Appendix 2. Mini Nutritional Assessment (MNA®)

......................................25

Appendix 3. Food fortification methods.......................................................27

Participants.....................................................................................................28

Summary data sheet.......................................................................................30

HAS / SRP / April 2007 4

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