Sarcopenia and nutritional support for elderly and senile patients

Demographic aging of the population leads to a significant increase in the proportion of elderly and senile people, both at the outpatient and inpatient stages of treatment. Over the past decade, the average age of the main contingent of patients in intensive care and intensive care units is more than 65 years, with a tendency to increase, which predetermines the strategy for a more thorough assessment of approaches to treatment measures, taking into account polymorbidity and functional capabilities of patients of older age groups, as the period of stay in hospital, and at further stages of recovery and rehabilitation. It is known that, in general, the duration of stay in intensive care units for elderly patients is much longer, and the results of treatment and rehabilitation are significantly lower than that of younger patients. This is due to a combination of a number of factors: comorbidity/polymorbidity of elderly and senile patients, decreased functional reserves of the body, senile asthenia syndrome, the main components of which are sarcopenia, and malnutrition. The relationship of senile asthenia with an increase in the duration of hospitalization, a decrease in physical activity, the development of functional deficits, an increase in the risk of falls, fractures and mortality is well understood, however, in routine clinical practice, assessing nutritional status, diagnosing malnutrition and solving the problem of malnutrition in patients with senile asthenia syndrome and Insufficient attention is paid to sarcopenia, despite the known facts about the relationship of malnutrition, a decrease in skeletal muscle mass, including their strength or function, with unfavorable outcomes of the disease. In the outpatient phase, in addition to a sedentary lifestyle, the development and progression of sarcopenia is often facilitated by the presence of a severe illness accompanied by systemic inflammation, metabolic resistance, nutritional deficiency and depression characteristic of this category of patients. Modern approaches to the treatment of an elderly and senile patient imply a regular assessment of the nutritional status and counseling on rational nutrition with the introduction of nutritional support methods into a comprehensive management program for an elderly patient, along with basic treatment and rehabilitation measures in order to slow the progression of asthenia and sarcopenia syndrome.

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