Newsletter

[ Vol. 13 No. 3 ] (September - December 2012 )
Perioperative nutrition support in the elderly: Prevention of post-operative frailty

Hyun Wook Baik
Department of Internal Medicine, Gastroenterology and DMC-MECOX Biomedical Research Center,
Daejin Medical Center, Jesaeng Hospital at Bundang (Republic of Korea)

Elderly patients are at higher risk for malnutrition. The prevalence of malnutrition in the hospitalized elderly is about 38% to 61% in one cross-sectional epidemiologic study in Korea. It is 10% higher compared to younger patients’ group. Another data from one university hospital showed the prevalence evaluated with mini-nutritional assessment was 63% in the elderly. Malnutrition is associated with increased complications including infection, delayed wound healing including decubitus ulcer.

Frailty itself is a clinical phenotype of decreased reserve and resistance to stress. Frail elderly goes to negative energy balance and manifests mutually exacerbating cycle. In the elderly with fairly good health status, a major operation due to femur neck fracture or head trauma is a huge stress which easily leads the elderly to progression of frailty. Peri-operative, especially post-operative intensive nutritional support in the elderly might prevent progression of frailty. Prevention of frailty may reduce morbidity of postoperative infections complications such as pneumonia and even mortality.

To avoid postoperative development of frailty in the elderly, intensive nutritional support including supplementation of trace element especially Zinc, Magnesium and Selenium and trial of oral nutritional supplement might be effective.

The Low plasma level of Zinc and Magnesium is frequently noticed in the elderly with taste alteration, generalized weakness and delayed wound healing. Oral supplement of enteral formula is good for supply of shortage of calorie, protein and micronutrients also good for stimulating appetite.

Intensive Nutrition support in the elderly with major operation might have a beneficial effect on reducing morbidity and mortality. It may improve QOL in the elderly and decrease in enormous medical cost.

Keywords: Frailty, perioperative nutrition support in the elderly, trace element, oral nutritional supplement

From  
The 14^th Congress of Parenteral and Enteral Nutrition Society of Asia
“From Nutrition Support to Nutrition Therapy”
October 14-16, 2011, Taipei, Taiwan 
Page: 12