Causes of malnutrition.

• Causes of malnutrition include undereating calories and protein, having very small meals and missing meals.

• Becoming immobile is in fact a very high risk for becoming malnourised.

• Severe malnutrition leads to cachexia, a complex metabolic syndrome associated with multiple underlying medical illness and inflammation which contributes to increased catabolism and increased muscle protein breakdown.

• inflammatory cytokines which are signalling protein molecules secreted by specific cells of immune system that mediate, regulate and alter the immune system response, cause inflammation and play a direct role in the development of sarcopenia (loss of muscle mass, strength, and function in older people), anaemia, and cognitive decline, particularly in immobile frail older people. These cytokines include Interleukins which act as chemical signals between white blood cells and Interferons which help the body resist viral infections and cancers. They become very active in infections and immobility in the elderly, and contribute to muscle breakdown and malnutrition.

  Interferons are chemicals that help the body resist viral infections and cancers.

• Muscles just start to melt down and disappear in older people immobile in bed.

• This is why frail, older, acutely unwell, immobile older people need to eat a lot more, not less!

• Older people at particular risk of malnutrition include those with-

  ·       Alzheimer's dementia.

  ·       Parkinson's disease.

  ·       stroke.

  ·       fractured hip.

  ·       chronic lung disease.

  ·       heart failure.

  ·       the disabled housebound older person.

  ·       those with chewing and swallowing problems.

• Malnutrition in the elderly is commonly associated with multiple chronic medical problems, leading to an early and unnecessary preventable hospital admission.

• Acute causes of malnutrition include-

  • delirium

  • falls

  • infections

  • adverse drug reactions

  • new onset immobility

  • deteriorating walking and balance

  • enforced starvation in hospitals and nursing homes with poor food services and poor nutritional support.

  • suddenly not coping at home alone.

For more information read Dr Peter Lipski’s book “Your Elderly Parents Failing Health. Is It Ageing Or A Treatable Condition”.