The role of nutrition in geriatric rehabilitation :

It is not well recognized that in the elderly weight loss is more common than weight gain. The aim of this analysis was to determine the effect of ageing on appetite (hunger/fullness) and energy intake, after overnight fasting and in a postprandial state, by meta-analyses of trials that included at least two age groups (>18 years). We hypothesized that appetite and energy intake would be less in healthy older compared with younger adults. Following a PubMed-database systematic search up to 30 June 2015, 59 studies were included in the random-effects-model meta-analyses. Energy intake was 16%–20% lower in older (n = 3574/~70 years/~71 kg/~25 kg/m2) than younger (n = 4111/~26 years/~69 kg/~23 kg/m2) adults (standardized mean difference: −0.77 (95% confidence interval −0.90 to −0.64)). Hunger was 25% (after overnight fasting; weighted mean difference (WMD): −17 (−22 to −13) mm) to 39% (in a postprandial state; WMD: −14 (−19 to −9) mm) lower, and fullness 37% (after overnight fasting; WMD: 6 mm (95% CI: 1 to 11 mm)) greater in older than younger adults. In conclusion, appetite and energy intake are less in healthy older than younger adults, suggesting that ageing per se affects food intake.

Hip fractures (HFs) in old age frequently cause severe functional impairment and deteriorating autonomy in everyday life. Many older patients with HFs are malnourished or at risk of malnutrition. In this study, we examined the relationship between nutritional status of geriatric patients before HF and their functional and clinical course up to 6 months after hospital discharge.

Background/Objectives The current Recommended Dietary Allowance (RDA) for protein is based on short-term nitrogen balance studies in young adults and may underestimate the amount needed to optimally preserve physical function in older adults. We examined the association between protein intake and the onset of mobility limitation over six years of follow-up in older adults in the Health ABC study. Design Prospective cohort study Setting Memphis, TN and Pittsburgh, PA Participants Community-dwelling, initially well-functioning adults aged 70–79 years (n=1998). Measurements Protein intake (g/kg body weight/d) was calculated using an interviewer-administered 108-item food frequency questionnaire at baseline. Mobility limitation was assessed semi-annually and defined as reporting any difficulty walking 1/4 mile or climbing 10 steps on two consecutive 6-month contacts. The association between protein intake and incident mobility limitation was examined using Cox proportional hazard regression models adjusting for demographics, behavioral characteristics, chronic conditions, total energy intake, and height. Results Mean (SD) protein intake was 0.91 (0.38) g/kg body weight/d, with 43% reporting intakes less than the RDA (0.8 g/kg body weight/d). During 6 years of follow-up, 705 participants (35.3%) developed mobility limitations. Compared to participants in the upper tertile of protein intake (≥1.0 g/kg body weight/d), participants in the lower two tertiles of protein intake (<0.7 and 0.7 – <1.0 g/kg body weight/d) were at greater risk of developing mobility limitation over 6 years of follow-up (RR (95% CI): 1.86 (1.41– 2.44) and 1.49 (1.20–1.84), respectively). Conclusion Lower protein intake was associated with increased risk of mobility limitation in community-dwelling, initially well-functioning older adults. These results suggest that protein intakes of ≥1.0 g/kg body weight/d may be optimal for maintaining physical function in older adults.