ESPEN Guidelines on Enteral Nutrition: Geriatrics.
Nutritional intake is often compromised in elderly, multimorbid patients. Enteral nutrition (EN) by means of oral nutritional supplements (ONS) and tube feeding (TF) offers the possibility to increase or to insure nutrient intake in case of insufficient oral food intake. The present guideline is intended to give evidence-based recommendations for the use of ONS and TF in geriatric patients. It was developed by an interdisciplinary expert group in accordance with officially accepted standards and is based on all relevant publications since 1985. The guideline was discussed and accepted in a consensus conference. EN by means of ONS is recommended for geriatric patients at nutritional risk, in case of multimorbidity and frailty, and following orthopaedic-surgical procedures. In elderly people at risk of undernutrition ONS improve nutritional status and reduce mortality. After orthopaedic-surgery ONS reduce unfavourable outcome. TF is clearly indicated in patients with neurologic dysphagia. In contrast, TF is not indicated in final disease states, including final dementia, and in order to facilitate patient care. Altogether, it is strongly recommended not to wait until severe undernutrition has developed, but to start EN therapy early, as soon as a nutritional risk becomes apparent.
Volkert
D
D
Head Medical Science Division, Pfrimmer-Nutricia, Erlangen, Germany. d.volkert@nutricia.com
Berner
Y N
YN
Berry
E
E
Cederholm
T
T
Coti Bertrand
P
P
Milne
A
A
Palmblad
J
J
Schneider
St
S
Sobotka
L
L
Stanga
Z
Z
Lenzen-Grossimlinghaus
R
R
Krys
U
U
Pirlich
M
M
Herbst
B
B
Schütz
T
T
Schröer
W
W
Weinrebe
W
W
Ockenga
J
J
Lochs
H
H
D000368:Aged; D000369:Aged, 80 and over; D004750:Enteral Nutrition / Q000592:standards*; D005060:Europe; D005853:Geriatrics / Q000592:standards*; D006801:Humans; D044342:Malnutrition / Q000628:therapy*; D010818:Practice Patterns, Physicians'; D011788:Quality of Life