Influence of an acute disease in geriatric patients – effect of early nutritional support and physiotherapy

Authors: Z. Dědková 1;  P. Andělová 1;  B. Jurašková 1;  V. Tošnerová 2;  L. Sobotka 1
Authors‘ workplace: Univerzita Karlova v Praze ;  Klinika gerontologická a metabolická, FN Hradec Králové Přednosta: prof. MUDr. Luboš Sobotka CSc. 1;  Rehabilitační klinika, FN Hradec Králové Přednosta: doc. MUDr. Vlasta Tošnerová CSc. 2
Published in: Prakt. Lék. 2009; 89(5): 247-249
Category: In diferent


An acute disease in the elderly often results in the loss of self-sufficiency and the need for subsequent admittance to care homes. Muscle mass loss in the course of the acute disease could be the main factor for this, giving rise as it does to a loss of the general condition. The major factors influencing decrease of muscle mass during the acute disease are firstly catabolic reaction, reduced energy intake and inactivity. This article deals with a feasible solution to the problem and formulates the hypothesis that early nutritional support and rehabilitation positively affect the long-term perspective of the seniors. This hypothesis became the basis of the study, which has been under way in the department since 2008.

Key words:
Oral supplements, physiotherapy, sarcopenia, malnutrition, self-sufficiency.


1. Antonelli I.R., Landi, F.., Cipriani, L. et al. Nutritional assessment: a primary komponent of multidimensional geriatric assessment in the acute care setting. J. Am. Geriatr. Soc., 1996, 44, p. 166-174.

2. Dardaine, V., Dequine, P-F., Ripault, H. et al. Outcome of older patients requiring ventilatory support in intensive care: impact of nutritional status. J. Am. Geriatr. Soc., 2001, 49, p. 564-570.

3. De Morton, N.A., Keating, J.L., Jeffs, K. Exercise for acutely hospitalised older medical patients. Cochrane Database Syst. Rev., 2007, 1, CD005955.

4. Edington, J., Barbes, R., Bryan, F. et al. A prospective randomised controlled trial of nutritional supplementation in malnourished elderly in the community: clinical and health economical outcomes. Clin. Nutr., 2004, 23, p. 195-204.

5. Ferrando, A.A., Tipton, K.D., Bamman, M.M., Wolfe, R.R. Resistance exercise maintains skeletal muscle protein synthesis during bed rest. J. Appl. Physiol., 1997, 82, p. 807-810.

6. Gariballa, S., Forester, S., Walters, S., Powers, H. A Randomized, double-blind, placebo-controlled trial of nutritional supplementation during acute illness. Am. J. Med. 2006, 119, p. 693-699.

7. Gariballa, S., Forster, S. Malnutrition is an independent predictor of 1-year mortality following acute illness. Br. J. Nutr. 2007, 98, p. 332-336.

8. Holmerová, I., Jurašková, B., Vaňková, H., Veleta, P. Křehkost vyššího věku a sarkopenie jako její důležitá komponenta. Čes. Ger. Rev., 2007, 5(1), s. 24-32

9. Horowitz, M. Aging and the gastrointestinal tract. The Merck Manual of Geriatrics. [on line] Dostupný na WWW: < mm_geriatrics/sec13/ch102.htm>

10. Hrnčiariková, D., Zadák, Z. Problém sarkopenie ve stáří. Geriatria, 2004, 4, s. 177-183.

11. Jansa P., Kocourek, J., Belmihoubová, J. MKSport a jiné pohybové aktivity v české dospělé populaci. In: Vidušková J, Chrudimský J. Pohybové aktivity jako prostředek ovlivňování člověka. Praha: Fakulta tělesné výchovy a sportu 2003. CD ROM.

12. Janssen, I., Shepard, D.S., Katzmarzyk, P.T., Roumenoff, R. The healthcare costs of sarcopenia in the United States. J. Am. Geriatr. Soc., 2004, 52, p. 80.

13. Kortebein, P., Ferrando, A., Lombeida, J. et al. Effect of 10 days of bed rest on skeletal muscle in healthy older adults. JAMA, 2007, 297(16), p. 1772-1774.

14. Milne, A.C., Potter, J., Avenell, A. Protein and energy supplementation in elderly people at risk from malnutrition. Cochrane Database Syst. Rev. 2002, 3: CD003288.

15. Paddon-Jones, D., Sheffield-Moore, M., Urban, R.J. et al. Essential amino acid and carbohydrate supplementation ameliorates muscle protein loss in humans during 28 days bedrest. J. Clin. Endocrinol. Metab. 2004, 89, p. 4351-4358.

16. Persson, M., Hytter-Landahl, A., Brismar, K., Cederholm, T. Nutritional supplementation and dietary advice in geriatric patients at risk of malnutrition. Clin. Nutr. 2007, 26, p. 216-224.

17. Reuben, D.B., Greendale, G.A., Harrison, G.G. Nutrition screening in older persons. J. Am. Geriatr. Soc., 1995, 43, p. 415-425.

18. Sobotka, L. Vliv malnutrice na průběh akutního onemocnění u gerontologického pacienta. Česká Geriatrická Revue 2003, 1(1), s. 32-35.

19. Sullivan, D.H., Bopp, M.M., Roberson, P.K. Protein-energy undernutrition and life-threatening complications among the hospitalized elderly. J. Gen. Intern. Med. 2002, 17, p. 923-932.

20. Sullivan, D.H., Sun, S., Walls, R.C. Protein-Energy undernutrition among elderly hospitalized patients. JAMA, 1999, 281(21), p. 2013-2019.

21. Tengstrand, B., Cederholm, T., Soderqvist, A., Tiderman, J. Effects of protein-rich supplementation and nandrolone on bone tissue after a hip fracture. Clin. Nutr. 2007, 26, p. 460-465.

22. Tomíška, M. Nutriční podpora formou sippingu. Interní med. 2008, 10(6), s. 285-290.

23. Topinková, E. Využití standardizovaných škál pro hodnocení stavu výživy u starších nemocných. Česká Geriatrická Revue 2003, 1(1), s. 6-11.

24. Wouters-Wesseling, W., Van Hooijdonk, C., Wagenaar, L. et al. The effect of a liquid nutrition suplement on body composition and physical functioning in elderly people. Clin. Nutr. 2003, 22, p. 371-377.

25. Zadák, Z. Výživa v intenzivní péči. Praha: Grada, 2002.

General practitioner for children and adolescents General practitioner for adults
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