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  • Nutrition

The World Health Organization (WHO) has recently published a consensus-led guideline to assist healthcare professionals in clinical settings, to detect declines in physical and mental capacities in older patients, and to deliver effective interventions to prevent and delay progression of symptoms.

The focus of the guideline ‘Integrated care for older people (ICOPE)’ is a comprehensive and community-based care approach which includes assessment, care plans and treatment goals, along with monitoring processes, support for self-management and home-based inventions. The guidelines, designed to support healthcare professionals improve the health and wellbeing of their older patients, make six recommendations:

1. Improve musculoskeletal function, mobility and vitality through a combination of exercise and dietary advice, with oral supplemental nutrition for undernourished older adults
2. Maintain sensory capacity through screening for visual impairment and loss of hearing
3. Prevent severe cognitive impairment and promote psychological well-being through cognitive stimulation and psychological interventions
4. Manage age-associated conditions such as urinary incontinence with prompted visits to the toilet and training of pelvic floor muscles
5. Prevent falls through optimal medication, exercise, hazard control and other tailored interventions following individual assessments
6. Support caregivers through psychological interventions and training

A key factor behind the recommendations is muscle health and the importance of maintaining strength, energy and mobility – elements that can reduce the risk of falls and help improve quality of life. However, a key risk factor to muscle health and mobility is malnutrition, therefore maintaining the right level of nutrition is particularly important in older patients.

It is recommended that older adults over 65 increase their intake of protein and vitamin D to maintain their muscle mass and strength.1-4 High protein oral nutritional supplements (ONS) have been shown to reduce hospital readmissions by 30% and decrease infections.5 In addition, a vitamin D intake of 800-1000 IU per day has been shown to improve skeletal muscle function,6 reduce the risk of falls6 and hip fractures7 and improve mobility.8

With more adults living longer than ever before, the publication of the ICOPE guidelines is a timely reminder of the importance of investing in strategies to keep our ageing population independent for longer - so they can enjoy fuller lives.

References

  1. Kim JS et al. J Nutri Biochem 2010;21(1): 1-13.
  2. English KL and Paddon-Jones D. Curr Opin Clin Nutr Metab Care 2010:13(1):34-39.
  3. de Souza Genaro P and Martini LA. Nutr Rev 2010:68(10):616-623.
  4. Brouwer-Brolsma EM et al. Osteoporosis Int. 2013;24(5):1567-1577.
  5. In: Cawood AL et al. Ageing Res Rev 2012;11(2):278-296.
  6. European Food Safety Authority. EFSA J 2011;9(9):2382.
  7. Bischoff-Ferrari HA et al. NEJM 2012;367(1):40-49.
  8. Zhu K el al. J Am Geriatr Soc 2010;58(11):2063-2068.

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