Aktuelle Ernährungsmedizin 2004; 29(4): 190-197
DOI: 10.1055/s-2004-828308
Leitlinie Enterale Ernährung - Teil 2
© Georg Thieme Verlag KG Stuttgart · New York

Leitlinie Enterale Ernährung der DGEM und DGG:
Ernährungszustand, Energie- und Substratstoffwechsel im Alter

DGEM and DGG Guidelines Enteral Nutrition: Nutritional Status, Energy and Substrate Metabolism in the ElderlyD.  Volkert1
  • 1Institut für Ernährungswissenschaft, Rheinische Friedrich-Wilhelms-Universität, Bonn
Further Information

Publication History

Publication Date:
12 August 2004 (online)

Literatur

  • 1 MacIntosh C, Morley J E, Chapman I M. The anorexia of aging.  Nutrition. 2000;  16 983-995
  • 2 Morley J E. Anorexia of aging: physiologic and pathologic.  Am J Clin Nutr. 1997;  66 760-773
  • 3 Roberts S B, Fuss P, Heyman M B. et al . Control of food intake in older men.  J Am Med Assoc. 1994;  272 1601-1606
  • 4 Roberts S B. Regulation of energy intake in relation to metabolic state and nutritional status.  Eur J Clin Nutr. 2000;  54, Suppl 3 S64-S69
  • 5 Phillips P A, Rolls B J, Ledingham J GG. et al . Reduced thirst after water deprivation in healthy elderly men.  N Engl J Med. 1984;  311 753-759
  • 6 Phillips P A, Bretherton M, Johnston C I, Gray L. Reduced osmotic thirst in healthy elderly men.  Am J Physiol. 1991;  261 R166-R171
  • 7 Forbes G B. Human body composition. Growth, aging, nutrition and activity. New York, Berlin, Heidelberg; Springer Verlag 1987
  • 8 Roubenoff R. Sarcopenia and its implication for the elderly.  Eur J Clin Nutr. 2000;  54, Suppl 3 S40-S47
  • 9 Schneider S M, Al-Jaouni R, Pivot X, Braulio V B, Rampal P, Hébuterne X. Lack of adaptation to severe malnutrition in elderly patients.  Clin Nutr. 2002;  21 499-504
  • 10 Elia M, Ritz P, Stubbs R J. Total energy expenditure in the elderly.  Eur J Clin Nutr. 2000;  54, Suppl 3 S92-S103
  • 11 World Health Organization .Energy and protein requirements. Report of a Joint FAO/WHO/UNU Expert Consultation. World Health Organization. Techn. Report Ser. No. 74. Geneva; World Health Organisation 1985
  • 12 Department of Health .Report on Health and Social Subjects No. 43. The Nutrition of elderly people. 1993
  • 13 Luhrmann P M, Herbert B M, Krems C, Neuhauser-Berthold M. A new equation especially developed for predicting resting metabolic rate in the elderly for easy use in practice.  Eur J Nutr. 2002;  41 108-113
  • 14 Deutsche Gesellschaft für Ernährung (DGE), Österreichische Gesellschaft für Ernährung (ÖGE), Schweizerische Gesellschaft für Ernährungsforschung (SGE), Schweizerische Vereinigung für Ernährung (SVE) .Referenzwerte für die Nährstoffzufuhr. Frankfurt am Main; Umschau Braus GmbH, Verlagsgesellschaft/DGE 2000
  • 15 Toth M J, Tchernof A. Lipid metabolism in the elderly.  Eur J Clin Nutr . 2000;  54, Suppl 3 S121-S125
  • 16 Beaufrère B, Morio B. Fat and protein redistribution with aging: metabolic considerations.  Eur J Clin Nutr. 2000;  54, Suppl 3 S48-S53
  • 17 Fritsche A, Stumvoll M, Haring H U. Insulin secretion and aging. Implications for insulin therapy in the geriatric patient with diabetes mellitus.  Med Klin. 2003;  98 287-291
  • 18 Elahi D, Muller D C. Carbohydrate metabolism in the elderly.  Eur J Clin Nutr. 2000;  54, Suppl 3 S112-S120
  • 19 Cals M J, Succari M, Meneguzzer E. et al . Markers of oxidative stress in fit, health-conscious elderly people living in the Paris area.  Nutrition. 1997;  13 319-326
  • 20 Beaufrere B, Castaneda C, Groot L de, Kurpad A, Roberts S, Tessari P. Report of the IDECG Working Group on energy and macronutrient metabolism and requirements of the elderly.  Eur J Clin Nutr. 2000;  54, Suppl 3 S162-S163
  • 21 Russell R M. Gastrointestinal function and aging. In: Morley JE, Glick Z, Rubenstein LZ (eds) Geriatric nutrition. A comprehensive review. New York; Raven Press 1990: 231-238
  • 22 Bowman B A, Rosenberg I H, Johnson M A. Gastrointestinal function in the elderly. In: Munro HN, Schlierf G (eds) Nutrition of the elderly. New York; Raven Press 1992: 43-50
  • 23 Pirlich M, Schwenk A, Müller M J, Ockenga J, Schmidt S, Schütz T, Selberg O, Volkert D. DGEM-Leitlinie Enterale Ernährung: Ernährungsstatus.  Aktuel Ernaehr Med. 2003;  28, Suppl 1 S10-S25
  • 24 Nikolaus T, Bach M, Siezen S, Volkert D, Oster P, Schlierf G. Assessment of nutritional risk in the elderly.  Ann Nutr Metab. 1995;  39 340-345
  • 25 Vellas B, Guigoz Y, Garry P J. et al . The Mini Nutritional Assessment (MNA) and its use in grading the nutritional state of elderly patients.  Nutrition. 1999;  15 116-122
  • 26 Agarwal N, Acevedo F, Cayten C G, Pitchumoni C G. Nutritional status of the hospitalized very elderly from nursing homes and private homes (abstr).  Am J Clin Nutr. 1986;  43 659
  • 27 Cederholm T, Hellström K. Nutritional status in recently hospitalized free-living elderly subjects.  Gerontology. 1992;  38 105-110
  • 28 Dormenval V, Budtz-Jorgensen E, Mojon P, Bruyère A, Rapin C-H. Associations between malnutrition, poor general health and oral dryness in hospitalized elderly patients.  Age and Ageing. 1998;  27 123-128
  • 29 Gariballa S E, Parker S G, Taub N, Castleden M. Nutritional status of hospitalized acute stroke patients.  Br J Nutr. 1998;  79 481-487
  • 30 Mowé M, Bohmer T. The prevalence of undiagnosed protein-calorie undernutrition in a population of hospitalized elderly patients.  J Am Geriatr Soc. 1991;  39 1089-1092
  • 31 Mühlethaler R, Stuck A E, Minder C E, Frey B M. The prognostic significance of protein-energy malnutrition in geriatric patients.  Age and Ageing. 1995;  24 193-197
  • 32 Axelsson K, Asplund K, Norberg A, Alafuzoff I. Nutritional status in patients with acute stroke.  Acta Med Scand. 1988;  244 217-224
  • 33 Bienia R, Ratcliff S, Barbour G S, Kummer M. Malnutrition in the hospitalized geriatric patient.  J Am Geriatr Soc. 1982;  30 433-436
  • 34 Cederholm T, Jägren C, Hellström K. Nutritional status and performance capacity in internal medical patients.  Clin Nutr. 1993;  12 8-14
  • 35 Ek A-C, Unosson M, Larsson J, Ganowiak W, Bjurulf P. Interrater variability and validity in subjective nutritional assessment of elderly patients.  Scan J Caring Sci. 1996;  10 163-168
  • 36 Lumbers M, Driver L T, Howland R J, Older M WJ, Williams C M. Nutritional status and clinical outcome in elderly female surgical orthopaedic patients.  Clin Nutr. 1996;  15 101-107
  • 37 Mowé M, Bohmer T, Kindt E. Reduced nutritional status in an elderly population (> 70 y) is probable before disease and possibly contributes to the development of disease.  Am J Clin Nutr. 1994;  59 317-324
  • 38 Detsky A S, McLaughlin J R, Baker J P. et al . What is subjective global assessment of nutritional status.  J Parent Ent Nutr. 1987;  11 8-13
  • 39 Covinsky K E, Martin G E, Beyth R J, Justice A C, Sehgal A R, Landefeld C S. The relationship between clinical assessments of nutritional status and adverse outcomes in older hospitalized medical patients.  J Am Geriatr Soc. 1999;  47 532-538
  • 40 Incalzi R A, Landi F, Cipriani L. et al . Nutritional assessment: A primary component of multidimensional geriatric assessment in the acute care setting.  J Am Geriatr Soc. 1996;  44 166-174
  • 41 Cohendy R, Gros T, Arnaud-Battandier F, Tran G, Plaze J M, Eledjam J-J. Preoperative nutritional evaluation of elderly patients: the Mini Nutritional Assessment as a practical tool.  Clin Nutr. 1999;  18 345-348
  • 42 Compan B, Castri A di, Plaze J M, Arnaud-Battandier F. Epidemiological study of malnutrition in elderly patients in acute, sub-acute and long-term care using the MNA.  J Nutr Health Aging. 1999;  13 146-151
  • 43 Coutaz M, Morisod J, Biselx S, Hermann F, Michel J P. Comparaison de l'état nutritionnel de la personne âgée séjournant á domicile, en institution ou à l'hôpital dans une region semi-rurale.  Rev Med Suisse Romande. 1997;  117 691-695
  • 44 Gazzotti C, Albert A, Pepinster A, Petermans J. Clinical usefulness of the mini nutritional assessment (MNA) scale in geriatric medicine.  J Nutr Health Aging. 2000;  4 176-181
  • 45 Murphy M C, Brooks C N, New S A, Lumbers M L. The use of the Mini-Nutritional Assessment (MNA) tool in elderly orthopaedic patients.  Eur J Clin Nutr. 2000;  54 555-562
  • 46 Nes M C Van, Herrmann F R, Gold G, Michel J P, Rizzoli R. Does the mini nutritional assessment predict hospitalization outcomes in older people?.  Age Ageing. 2001;  30 221-226
  • 47 Constans T, Bacq Y, Breéchot J F, Guilmot J L, Choutet P, Lamisse F. Protein-energy malnutrition in elderly medical patients.  J Am Geriatr Soc. 1992;  40 263-268
  • 48 Davalos A, Ricart W, Gonzalez-Huix F. et al . Effect of malnutrition after acute stroke on clinical outcome.  Stroke. 1996;  27 1028-1032
  • 49 Gariballa S E, Parker S G, Taub N, Castleden C M. Influence of nutritional status on clinical outcome after acute stroke.  Am J Clin Nutr. 1998;  68 275-281
  • 50 Hübsch S, Volkert D, Oster P, Schlierf G. Möglichkeiten und Grenzen der Anwendung flüssiger Nährstoffkonzentrate in der Therapie der Mangelernährung geriatrischer Patienten.  Akt Ernähr-Med. 1994;  19 109-114
  • 51 Klipstein-Grobusch K, Reilly J J, Potter J, Edwards C A, Roberts M A. Energy intake and expenditure in elderly patients admitted to hospital with acute illness.  Br J Nutr. 1995;  73 323-334
  • 52 Larsson J, Unosson M, Ek A-C, Nilsson L, Thorslund S, Bjurulf P. Effects of dietary supplement on nutritional status and clinical outcome in 501 geriatric patients - a randomized study.  Clin Nutr. 1990;  9 179-184
  • 53 Potter J, Klipstein K, Reilly J J, Roberts M. The nutritional status and clinical course of acute admissions to a geriatric unit.  Age and Ageing. 1995;  24 131-136
  • 54 Sullivan D H, Patch G A, Walls C, Lipschitz D A. Impact of nutrition status on morbidity and mortality in a select population of geriatric rehabilitation patients.  Am J Clin Nutr. 1990;  51 749-758
  • 55 Sullivan D H, Walls R C. Impact of nutritional status on morbidity in a population of geriatric rehabilitation patients.  J Am Geriatr Soc. 1994;  42 471-477
  • 56 Sullivan D H, Walls R C. The risk of life-threatening complications in a select population of geriatric patients: The impact of nutritional status.  J Am Coll Nutr. 1995;  14 29-36
  • 57 Tuchschmid Y, Tschantz P. Complications en géronto-chirurgie: rôle de l'état nutritionel et de l'albuminémie.  Helv Chir Acta. 1992;  58 771-774
  • 58 Rich M W, Keller A J, Schechtman K B, Marshall W G. Increased complications and prolonged hospital stay in elderly surgical patients with low serum albumin.  Am J Cardiol. 1989;  63 714-718
  • 59 Linn B S. Outcomes of older and younger malnourished and well-nourished patients one year after hospitalization.  Am J Clin Nutr. 1984;  39 66-73
  • 60 Kemm J R, Allcock J. The distribution of supposed indicators of nutritional status in elderly patients.  Age and Ageing. 1984;  13 21-28
  • 61 Nogues R, Sitges-Serra A, Sancho J J. et al . Influence of nutrition, thyroid hormones and rectal temperature on in-hospital mortality of elderly patients with acute illness.  Am J Clin Nutr. 1995;  61 597-602
  • 62 Phillips P. Grip strength, mental performance and nutritional status as indicators of mortality risk among female geriatric patients.  Age and Ageing. 1986;  15 53-56
  • 63 Alarcón T, Bárcena A, González-Montalvo J I, Peñalosa C, Salgado A. Factors predictive of outcome on admission to an acute geriatric ward.  Age Ageing. 1999;  28 429-432
  • 64 Cederholm T, Jägren C, Hellström K. Outcome of protein-energy malnutrition in elderly medical patients.  Am J Med. 1995;  98 67-74
  • 65 Flodin L, Svensson S, Cederholm T. Body mass index as a predictor of 1 year mortality in geriatric patients.  Clin Nutr. 2000;  19 121-125
  • 66 Foster M R, Heppenstall R B, Friedenberg Z B, Hozack W J. A prospective assessment of nutritional status and complications in patients with fractures of the hip.  J Orthopedic Trauma. 1990;  4 49-57
  • 67 Sullivan D H, Walls R C, Lipschitz D A. Protein-energy undernutrition and the risk of mortality within 1 y of hospital discharge in a select population of geriatric rehabilitation patients.  Am J Clin Nutr. 1991;  53 599-605
  • 68 Sullivan D H, Walls R C, Bopp M M. Protein-energy undernutrition and the risk of mortality within one year of hospital discharge: A follow-up study.  J Am Geriatr Soc. 1995;  43 507-512
  • 69 Sullivan D H, Walls R. Protein-energy undernutrition and the risk of mortality within six years of hospital discharge.  J Am Coll Nutr. 1998;  17 571-578
  • 70 Kaw M, Sekas G. Long-term follow-up of consequences of percutaneous endoscopic gastrostomy (PEG) tubes in nursing home patients.  Dig Dis Sci. 1994;  39 738-743
  • 71 Nair S, Hertan H, Pitchumoni C G. Hypoalbuminemia is a poor predictor of survival after percutaneous endoscopic gastrostomy in elderly patients with dementia.  Am J Gastroenterol. 2000;  95 133-136
  • 72 Henderson C T, Trumbore L S, Mobarhan S, Benya R, Miles T P. Prolonged tube feeding in long-term care: Nutritional status and clinical outcome.  J Am Coll Nutr. 1992;  11 309-325
  • 73 Friedenberg F, Jensen G, Gujral N, Braitman L E, Levine G M. Serum albumin is predictive of 30-day survival after percutaneous endoscopic gastrostomy.  J Parent Ent Nutr. 1997;  21 72-74
  • 74 Morgan D B, Newton H MV, Schorah C J, Jewitt M A, Hancock M R, Hullin R P. Abnormal indices of nutrition in the elderly: a study of different clinical groups.  Age and Ageing. 1986;  15 65-76
  • 75 Hancock M R, Hullin R P, Aylard P R. et al . Nutritional state of elderly women on admission to mental hospital.  Br J Psychiatry. 1985;  147 404-407
  • 76 Maffulli N, Dougall T W, Brown M T, Golden M H. Nutritional differences in patients with proximal femoral fractures.  Age Ageing. 1999;  28 458-462
  • 77 Volkert D, Frauenrath C, Kruse W, Oster P, Schlierf G. Malnutrition in geriatric patients - Diagnostic and prognostic significance of nutritional parameters.  Ann Nutr Metab. 1992;  36 97-112
  • 78 Cunha D F, Cunha S F, Unamuno M R, Vannucchi H. Serum levels assessment of vitamin A, E, C, B2 and carotenoids in malnourished and non-malnourished hospitalized elderly patients.  Clin Nutr. 2001;  20 167-170
  • 79 Markus H S, Tomkins A M, Stern G M. Increased prevalence of undernutrition in Parkinson's disease and its relationship to clinical disease parameters.  J Neural Transm. 1993;  5 117-125
  • 80 Ponzer S, Tidermark J, Brismar K, Söderqvist A, Cederholm T. Nutritional status, insulin-like growth factor-1 and quality of life in elderly women with hip fractures.  Clin Nutr. 1999;  18 241-246
  • 81 Dardaine V, Dequin P F, Ripault H, Constans T, Ginies G. Outcome of older patients requiring ventilatory support in intensive care: impact of nutritional status.  J Am Geriatr Soc. 2001;  49 564-570
  • 82 Doshi M K, Lawson R, Ingoe L E, Colligan J M, Barton J R, Cobden I. Effect of nutritional supplementation on clinical outcome in post-operative orthopaedic patients (abstract).  Clin Nutr. 1998;  17, Suppl 1 30
  • 83 Guenter P, Malyszek R, Bliss D Z. et al . Survey of nutritional status in newly hospitalized patients with stage III or stage IV pressure ulcers.  Adv Skin Wound Care. 2000;  13 164-168
  • 84 Chiari M M, Bagnoli R, Luca P De, Monti M, Rampoli E, Cunietti E. Influence of acute inflammation on iron and nutritional status indexes in older inpatients.  J Am Geriatr Soc. 1996;  43 767-771
  • 85 Finucane P, Rudra T, Hsu R. et al . Markers of the nutritional status in acutely ill elderly patients.  Gerontology. 1988;  34 304-310
  • 86 Lansey S, Waslien C, Mulvihill M, Fillit H. The role of anthropometry in the assessment of malnutrition in the hospitalized frail elderly.  Gerontology. 1993;  39 346-353
  • 87 Wilson M MG, Vaswani S, Liu D, Morley J E, Miller D K. Prevalence and causes of undernutrition in medical outpatients.  Am J Med. 1998;  104 56-63
  • 88 McWhirter J P, Pennington C R. Incidence and recognition of malnutrition in hospital.  Br Med J. 1994;  308 945-948
  • 89 Asplund K, Normark M, Petterson V. Nutritional assessment of psychogeriatric patients.  Age and Ageing. 1981;  10 87-94
  • 90 Greer A, McBride D H, Shenkin A. Comparison of the nutritional state of new and long-term patients in a psychogeriatric unit.  Br J Psychiatry. 1986;  149 738-741
  • 91 Hanger H C, Smart E J, Merrilees M J, Frampton C M. The prevalence of malnutrition in elderly hip fracture patients.  N Z Med J. 1999;  112 88-90
  • 92 Paillaud E, Bories P N, Parco J C Le, Campillo B. Nutritional status and energy expenditure in elderly patients with recent hip fracture during a 2-month follow-up.  Br J Nutr. 2000;  83 97-103
  • 93 Schols A, Mostert R, Soeters P, Greve L H, Wouters E FM. Inventory of nutritional status in patients with COPD.  Chest. 1989;  96 247-249
  • 94 Thomas D R, Verdery R B, Gardner L, Kant A, Lindsay J. A prospective study of outcome from protein-energy malnutrition in nursing home residents.  J Parent Ent Nutr. 1991;  15 400-404
  • 95 Joosten E, Vanderelst B, Pelemans W. The effect of different diagnostic criteria on the prevalence of malnutrition in a hospitalized geriatric population.  Aging (Milano). 1999;  11 390-394
  • 96 Quadri P, Fragiacomo C, Pertoldi W, Guigoz Y, Hermann F, Rapin C H. MNA and cost of care. In: Vellas B, Garry PJ, Guigoz Y (eds) Mini Nutritional Assessment (MNA): Research and practice in the elderly. Nestlé Nutrition Workshop Series, Clinical u. Performance Programme. Vol. 1. Basel; Karger 1999: 141-148
  • 97 Donini L M, Felice M R de, Tassi L. et al . A „proportional and objective score” for the mini nutritional assessment in long-term geriatric care.  J Nutr Health Aging. 2002;  6 141-146

PD Dr. Dorothee Volkert

Institut für Ernährungswissenschaft · Rheinische Friedrich-Wilhelms-Universität

Endenicher Allee 11 - 13

53115 Bonn

Email: d.volkert@uni-bonn.de