Kırılgan Yaşlılarda Beslenme

Year 2019, Volume: 10 Issue: 2, 184 - 189, 16.06.2019

Şenay Burçin Alkan , Neslişah Rakıcıoğlu

https://doi.org/10.22312/sdusbed.424345

Cited By: 6

Abstract

Kırılganlık yaşa bağlı olarak birden çok sistemde
oluşan fizyolojik değişiklikler nedeniyle ortaya çıkan geriatrik sendromlardan
biridir. Akut ve kronik hastalıklar, kronik inflamasyon, çevresel faktörler,
genetik gibi etmenler kırılganlığın patogenezinde rol oynayabilmektedir. Yaşlı
bireyin ağırlık kaybı, bitkinlik/halsizlik hissi, fiziksel aktivite, yürüme
hızı ve el kavrama gücü değerlendirilerek kırılganlık tespit edilir. Beslenme
ve kırılganlık arasındaki ilişkiyi inceleyen çalışmalarda enerji, protein, D
vitamini, antioksidan besin öğelerinin yeterli alımı ve Akdeniz diyetinin
koruyucu etkisi gösterilmiştir. Kırılganlığın önlenmesi ve tedavisinde;
egzersiz, yeterli protein alımı (1.2-1.5 g/kg/gün) ve gerekli durumlarda oral
beslenme solüsyonlarının kullanılması önerilmektedir. Ayrıca anemi ve
depresyonun tedavi edilmesi, serum düzeyinin izlenip düşük olduğu durumlarda D
vitamini desteği verilmesi gerekliliği vurgulanmaktadır.

Keywords

Kırılganlık, beslenme, malnütrisyon

References

• Ko FC, Walston JD. What is frailty? In: Goldstein NE, R. Sean Morrison, editors. Evidence-based practice in palliative medicine. Elsevier; 2013; p. 363–70.
• Bouillon K, Kivimaki M, Hamer M, Sabia S, Fransson EI, Singh-Manoux A, et al. Measures of frailty in population-based studies: An overview. BMC Geriatr 2013;13(1):64.
• Lee PH, Lee YS, Chan DC. Interventions targeting geriatric frailty: A systemic review. J Clin Gerontol Geriatr 2012;3(2):47–52.
• Sternberg SA, Schwartz AW, Karunananthan S, Bergman H, Mark Clarfield A. The identification of frailty: A systematic literature review. J Am Geriatr Soc 2011;59(11):2129–38.
• Morley JE, Vellas B, van Kan GA, Anker SD, Bauer JM, Bernabei R, et al. Frailty consensus: A call to action. J Am Med Dir Assoc 2013;14(6):392–7.
• WHO. [Internet]. Ageing and health. [ Updated 2015; Cited 2018 Jan 25]. Available from: http://www.who.int/mediacentre/factsheets/fs404/en/
• Santos-Eggimann B, Cuenoud P, Spagnoli J, Junod J. Prevalence of frailty in middle-aged and older community-dwelling Europeans living in 10 countries. Journals Gerontol Ser A Biol Sci Med Sci [Internet]. 2009;64A(6):675–81.
• Akın S, Mazıcıoglu MM, Mucuk S, Gocer S, Deniz Şafak E, Arguvanlı S, et al. The prevalence of frailty and related factors in community-dwelling Turkish elderly according to modified Fried Frailty Index and FRAIL scales. Aging Clin Exp Res 2015 27(5):703–9.
• Eyigor S, Kutsal YG, Duran E, Huner B, Paker N, Durmus B, et al. Frailty prevalence and related factors in the older adult—FrailTURK Project. Age (Omaha) 2015;37(3):50.
• Collard RM, Boter H, Schoevers RA, Oude Voshaar RC. Prevalence of frailty in community-dwelling older persons: A systematic review. J Am Geriatr Soc 2012;60(8):1487–92.
• Wilson D, Jackson T, Sapey E, Lord JM. Frailty and sarcopenia: The potential role of an aged immune system. Ageing Res Rev 2017;36:1–10.
• Chen X, Mao G, Leng SX. Frailty syndrome: an overview. Clin Interv Aging 2014;9:433–41.
• Rockwood K, Bergman H. Fraılty: A Report from the 3(rd) Joint Workshop of IAGG/WHO/SFGG, Athens, January 2012. Can Geriatr J 2012;15(2):31–6.
• Cesari M, Landi F, Vellas B, Bernabei R, Marzetti E. Sarcopenia and physical frailty: two sides of the same coin. Front Aging Neurosci 2014;6:192.
• Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 2001 Mar [;56(3):M146-56.
• Yannakoulia M, Ntanasi E, Anastasiou CA, Scarmeas N. Frailty and nutrition: From epidemiological and clinical evidence to potential mechanisms. Metabolism 2017;68:64–76.
• Bollwein J, Volkert D, Diekmann R, Kaiser MJ, Uter W, Vidal K, et al. Nutritional status according to the mini nutritional assessment (MNA®) and frailty in community dwelling older persons: A close relationship. J Nutr Health Aging 2013;17(4):351–6.
• Bonnefoy M, Berrut G, Lesourd B, Ferry M, Gilbert T, Guerin O, et al. Frailty and nutrition: Searching for evidence. J Nutr Health Aging 2015;19(3):250–7.
• Hubbard RE, Lang IA, Llewellyn DJ, Rockwood K. Frailty, Body mass ındex, and abdominal obesity in older people. Journals Gerontol Ser A Biol Sci Med Sci 2010;65A(4):377–81.
• Kurkcu M, Meijer RI, Lonterman S, Muller M, de van der Schueren MAE. The association between nutritional status and frailty characteristics among geriatric outpatients. Clin Nutr ESPEN 2018;23:112–6.
• Normandin E, Houston DK, Nicklas BJ. Caloric restriction for treatment of geriatric obesity: Do the benefits outweigh the risks? Curr Nutr Rep 2015;4(2):143–55.
• Choi J, Joseph L, Pilote L. Obesity and C-reactive protein in various populations: a systematic review and meta-analysis. Obes Rev 2013;14(3):232–44.
• García-Esquinas E, José García-García F, León-Muñoz LM, Carnicero JA, Guallar-Castillón P, Gonzalez-Colaço Harmand M, et al. Obesity, fat distribution, and risk of frailty in two population-based cohorts of older adults in Spain. Obesity 2015;23(4):847–55.
• Wysokiński A, Sobów T, Kłoszewska I, Kostka T. Mechanisms of the anorexia of aging—a review. Age (Omaha) 2015;37(4):81.
• Clegg ME, Williams EA. Optimizing nutrition in older people. Maturitas 2018;112:34–8.
• Santarpia L, Contaldo F, Pasanisi F. Nutritional screening and early treatment of malnutrition in cancer patients. J Cachexia Sarcopenia Muscle 2011;2(1):27–35.
• Kobayashi S, Asakura K, Suga H, Sasaki S. High protein intake is associated with low prevalence of frailty among old Japanese women: a multicenter cross-sectional study. Nutr J 2013;12(1):164.
• Kobayashi S, Suga H, Sasaki S. Diet with a combination of high protein and high total antioxidant capacity is strongly associated with low prevalence of frailty among old Japanese women: a multicenter cross-sectional study. Nutr J BioMed Central; 2017;16(1):29.
• Beasley JM, LaCroix AZ, Neuhouser ML, Huang Y, Tinker L, Woods N, et al. Protein ıntake and ıncident frailty in the Women’s Health Initiative Observational Study. J Am Geriatr Soc 2010;58(6):1063–71.
• Bollwein J, Diekmann R, Kaiser MJ, Bauer JM, Uter W, Sieber CC, et al. Distribution but not amount of protein intake is associated with frailty: a cross-sectional investigation in the region of Nürnberg. Nutr J 2013;12(1):109.
• Wilhelm-Leen ER, Hall YN, DeBoer IH, Chertow GM. Vitamin D deficiency and frailty in older Americans. J Intern Med 2010;268(2):171–80.
• Zhou J, Huang P, Liu P, Hao Q, Chen S, Dong B, et al. Association of vitamin D deficiency and frailty: A systematic review and meta-analysis. Maturitas 2016;94:70–6.
• Artaza-Artabe I, Sáez-López P, Sánchez-Hernández N, Fernández-Gutierrez N, Malafarina V. The relationship between nutrition and frailty: Effects of protein intake, nutritional supplementation, vitamin D and exercise on muscle metabolism in the elderly. A systematic review. Maturitas 2016;93:89–99.
• Brieger K, Schiavone S, Miller J, Krause K. Reactive oxygen species: from health to disease. Swiss Med Wkly 2012;142:w13659.
• Meng S-J, Yu L-J. Oxidative stress, molecular inflammation and sarcopenia. Int J Mol Sci 2010;11(4):1509–26.
• Bartali B, Frongillo EA, Bandinelli S, Lauretani F, Semba RD, Fried LP, et al. Low nutrient intake is an essential component of frailty in older persons. J Gerontol A Biol Sci Med Sci 2006;61(6):589–93.
• Semba RD, Ferrucci L, Sun K, Walston J, Varadhan R, Guralnik JM, et al. Oxidative stress and severe walking disability among older women. Am J Med 2007;120(12):1084–9.
• Kobayashi S, Asakura K, Suga H, Sasaki S. Inverse association between dietary habits with high total antioxidant capacity and prevalence of frailty among elderly Japanese women: A multicenter cross-sectional study. J Nutr Health Aging 2014;18(9):827–39.
• Urpi-Sarda M, Andres-Lacueva C, Rabassa M, Ruggiero C, Zamora-Ros R, Bandinelli S, et al. The relationship between urinary total polyphenols and the frailty phenotype in a community-dwelling older population: The InCHIANTI Study. Journals Gerontol Ser A Biol Sci Med Sci 2015;70(9):1141–7.
• Bach-Faig A, Berry EM, Lairon D, Reguant J, Trichopoulou A, Dernini S, et al. Mediterranean diet pyramid today. Science and cultural updates. Public Health Nutr 2011;14(12A):2274–84.
• Trichopoulou A, Martínez-González MA, Tong TYN, Forouhi NG, Khandelwal S, Prabhakaran D, et al. Definitions and potential health benefits of the Mediterranean diet: Views from experts around the world. BMC Med. 2014; 24;12:112.
• Bollwein J, Diekmann R, Kaiser MJ, Bauer JM, Uter W, Sieber CC, et al. Dietary quality ıs related to frailty in community-dwelling older adults. Journals Gerontol Ser A Biol Sci Med Sci 2013;68(4):483–9.
• Kojima G, Avgerinou C, Iliffe S, Walters K. Adherence to Mediterranean Diet reduces ıncident frailty risk: Systematic review and meta-analysis. J Am Geriatr Soc. 2018;2–7.
• León-Muñoz LM, Guallar-Castillón P, López-García E, Rodríguez-Artalejo F. Mediterranean Diet and risk of frailty in community-dwelling older adults. J Am Med Dir Assoc 2014;15(12):899–903.
• Kim C-O, Lee K-R. Preventive effect of protein-energy supplementation on the functional decline of frail older adults with low socioeconomic status: a community-based randomized controlled study. J Gerontol A Biol Sci Med Sci. United States 2013;68(3):309–16.
• Abizanda P, López MD, García VP, Estrella J de D, da Silva González Á, Vilardell NB, et al. Effects of an oral nutritional supplementation plus physical exercise ıntervention on the physical function, nutritional status, and quality of life in frail ınstitutionalized older adults: The ACTIVNES Study. J Am Med Dir Assoc 2015;16(5):439.e9-439.e16.
• Morley JE. Frailty: Diagnosis and management [Internet]. J Nutr Health Aging 2011;667–70
• Heuberger RA. The frailty syndrome: A comprehensive review. J Nutr Gerontol Geriatr 2011;30(4):315–68.
• Volkert D1, Berner YN, Berry E, Cederholm T, Coti Bertrand P, Milne A, Palmblad J, Schneider S, Sobotka L, Stanga Z; DGEM (German Society for Nutritional Medicine), Lenzen-Grossimlinghaus R, Krys U, Pirlich M, Herbst B, Schütz T, Schröer W, Weinrebe W, Oc LHE (European S for P and EN, Volkert D, Berner YN, Berry E, Cederholm T, Coti Bertrand P, et al. ESPEN Guidelines on Enteral Nutrition: Geriatrics. Clin Nutr 2006;25 (2)(2):330–60.