TY  - JOUR
A1  - Volkert, Dorothee
A1  - Beck, Anne Marie
A1  - Cederholm, Tommy
A1  - Cereda, Emanuele
A1  - Cruz-Jentoft, Alfonso J.
A1  - Goisser, Sabine
A1  - de Groot, Lisette
A1  - Grosshauser, Franz
A1  - Kiesswetter, Eva
A1  - Norman, Kristina
A1  - Pourhassan, Maryam
A1  - Reinders, Ilse
A1  - Roberts, Helen C.
A1  - Rolland, Yves
A1  - Schneider, Stéphane M.
A1  - Sieber, Cornel
A1  - Thiem, Ulrich
A1  - Visser, Marjolein
A1  - Wijnhoven, Hanneke
A1  - Wirth, Rainer
T1  - Management of malnutrition in older patients
BT  - Current approaches, evidence and open questions
JF  - Journal of Clinical Medicine : open access journal
N2  - Malnutrition is widespread in older people and represents a major geriatric syndrome with multifactorial etiology and severe consequences for health outcomes and quality of life. The aim of the present paper is to describe current approaches and evidence regarding malnutrition treatment and to highlight relevant knowledge gaps that need to be addressed. Recently published guidelines of the European Society for Clinical Nutrition and Metabolism (ESPEN) provide a summary of the available evidence and highlight the wide range of different measures that can be taken—from the identification and elimination of potential causes to enteral and parenteral nutrition—depending on the patient’s abilities and needs. However, more than half of the recommendations therein are based on expert consensus because of a lack of evidence, and only three are concern patient-centred outcomes. Future research should further clarify the etiology of malnutrition and identify the most relevant causes in order to prevent malnutrition. Based on limited and partly conflicting evidence and the limitations of existing studies, it remains unclear which interventions are most effective in which patient groups, and if specific situations, diseases or etiologies of malnutrition require specific approaches. Patient-relevant outcomes such as functionality and quality of life need more attention, and research methodology should be harmonised to allow for the comparability of studies.
KW  - Geriatric patients
KW  - older persons
KW  - malnutrition
KW  - therapy
KW  - interventions
Y1  - 2019
U6  - https://doi.org/10.3390/jcm8070974
SN  - 2077-0383
VL  - 8
IS  - 7
PB  - MDPI
CY  - Basel
ER  - 
TY  - JOUR
A1  - Volkert, Dorothee
A1  - Kiesswetter, Eva
A1  - Cederholm, Tommy
A1  - Donini, Lorenzo M.
A1  - Egiseer, Doris
A1  - Norman, Kristina
A1  - Schneider, Stephane M.
A1  - Stroebele-Benschop, Nanette
A1  - Torbahn, Gabriel
A1  - Wirth, Rainer
A1  - Visser, Marjolein
T1  - Development of a Model on Determinants of Malnutrition in Aged Persons
BT  - A MaNuEL Project
JF  - Gerontology and Geriatric Medicine
N2  - In older persons, the origin of malnutrition is often multifactorial with a multitude of factors involved. Presently, a common understanding about potential causes and their mode of action is lacking, and a consensus on the theoretical framework on the etiology of malnutrition does not exist. Within the European Knowledge Hub "Malnutrition in the Elderly (MaNuEL)," a model of "Determinants of Malnutrition in Aged Persons" (DoMAP) was developed in a multistage consensus process with live meetings and written feedback (modified Delphi process) by a multiprofessional group of 33 experts in geriatric nutrition. DoMAP consists of three triangle-shaped levels with malnutrition in the center, surrounded by the three principal conditions through which malnutrition develops in the innermost level: low intake, high requirements, and impaired nutrient bioavailability. The middle level consists of factors directly causing one of these conditions, and the outermost level contains factors indirectly causing one of the three conditions through the direct factors. The DoMAP model may contribute to a common understanding about the multitude of factors involved in the etiology of malnutrition, and about potential causative mechanisms. It may serve as basis for future research and may also be helpful in clinical routine to identify persons at increased risk of malnutrition.
KW  - older persons
KW  - malnutrition
KW  - determinants
KW  - etiology
KW  - model
Y1  - 2019
U6  - https://doi.org/10.1177/2333721419858438
SN  - 2333-7214
VL  - 5
PB  - Sage Publ.
CY  - Thousand Oaks
ER  -