Frailty & Disease Related Malnutrition
“I’m Ron, I’m 86 and I have COPD, which affects my breathing, especially if I do any exercise. I used to always be out and about, going for walks – but now sometimes I’ll only have to walk 50 meters and I’ll have to stop to get my breath back. Even eating became difficult, I was so out of breath. This really reduced my appetite.
I have a team of different doctors looking after me at my local hospital. That’s where I found out about nutritional products. Every morning I feel an improvement. The effects that I feel, a little bit more energy – it’s beginning to work.”
Our aging world
There are now more people over 65 than under 5, a trend unlike any in our world history. It is part of a shift toward a greater ratio of older people to young due to the parallel phenomenon of lower global birth rates, medical and technological advances – along with fundamental improvements in sanitation and nutrition.
However, although an increase in life expectancy can be a great thing, healthy lifespans have not kept pace with longevity. Besides the dangers posed by well-known conditions such as cardiovascular disease and diabetes, rising longevity rates bring new risks to the forefront. Some conditions of aging, such as frailty, progress gradually, in ways that can be difficult to identify – slowly robbing people of their mobility, their independence, their dignity and their joy in life over time. These conditions need not be an inevitable part of aging, but age does increase the risk of their development.
The role of nutrition in frailty & disease related malnutrition
Disease related malnutrition can lead to loss of muscle mass, which reduces body strength and walking speed. This is a state known as 'frailty'. This in turn reduces a patient's overall activity and energy levels. The vicious circle of reduced energy leading to more restrictions on physical activity can eventually lead to a loss of independence. Frail patients need extra medical attention in order to reduce the risk of them becoming dependent on others and to stay as independent as possible for as long as possible.
Patients typically enter a spiral of decline in which inadequate nutrition leads to muscle weakness, increasing frailty and risk of costly injury (falls, etc.) and disability.
Frailty is a medical condition that affects both the brain and the body, and that can leave older patients vulnerable, both immediately and in the future. With little strength left in reserve, frail patients often have a low resistance to even the most minor of illnesses, meaning something like a urinary tract infection can result in a greater risk of the onset of disability or even institutionalization.
Conditions of aging, such as weight loss, declining muscle mass (‘sarcopenia’) and frailty, are often viewed as an inevitable part of growing old – not associated with a patient’s nutritional intake. In fact, as we get older, nutrition becomes an even greater factor in terms of its influence on functional ability.
Research suggests that nutritional intervention with medical nutrition products as part of a comprehensive medical strategy has been effective at helping patients return to a healthy aging trajectory.
- Schattner A. QJM, 2018;111:765-767.