ESPEN guideline on clinical nutrition and hydration in geriatrics

Beitrag in einer Fachzeitschrift

Details zur Publikation

Autor(en): Volkert D, Beck AM, Cederholm T, Cruz-Jentoft A, Goisser S, Hooper L, Kießwetter E, Maggio M, Raynaud-Simon A, Sieber C, Sobotka L, van Asselt D, Wirth R, Bischoff SC
Zeitschrift: Clinical Nutrition
Jahr der Veröffentlichung: 2018
ISSN: 0261-5614


BACKGROUND: Malnutrition and dehydration are widespread in older people, and obesity is an increasing problem. In clinical practice, it is often unclear which strategies are suitable and effective in counteracting these key health threats.
AIM: To provide evidence-based recommendations for clinical nutrition and hydration in older persons in order to prevent and/or treat malnutrition and dehydration. Further, to address whether weight-reducing interventions are appropriate for overweight or obese older persons.
METHODS: This guideline was developed according to the standard operating procedure for ESPEN guidelines and consensus papers. A systematic literature search for systematic reviews and primary studies was performed based on 33 clinical questions in PICO format. Existing evidence was graded according to the SIGN grading system. Recommendations were developed and agreed in a multistage consensus process.
RESULTS: We provide eighty-two evidence-based recommendations for nutritional care in older persons, covering four main topics: Basic questions and general principles, recommendations for older persons with malnutrition or at risk of malnutrition, recommendations for older patients with specific diseases, and recommendations to prevent, identify and treat dehydration. Overall, we recommend that all older persons shall routinely be screened for malnutrition in order to identify an existing risk early. Oral nutrition can be supported by nursing interventions, education, nutritional counseling, food modification and oral nutritional supplements. Enteral nutrition should be initiated if oral, and parenteral if enteral nutrition is insufficient or impossible and the general prognosis is altogether favorable. Dietary restrictions should generally be avoided, and weight-reducing diets shall only be considered in obese older persons with weight-related health problems and combined with physical exercise. All older persons should be considered to be at risk of low-intake dehydration and encouraged to consume adequate amounts of drinks. Generally, interventions shall be individualized, comprehensive and part of a multimodal and multidisciplinary team approach.
CONCLUSION: A range of effective interventions is available to support adequate nutrition and hydration in older persons in order to maintain or improve nutritional status and improve clinical course and quality of life. These interventions should be implemented in clinical practice and routinely used.

FAU-Autoren / FAU-Herausgeber

Kießwetter, Eva Dr.
Professur für Klinische Ernährung im Alter
Sieber, Cornel Prof. Dr.
Lehrstuhl für Innere Medizin (Geriatrie)
Volkert, Dorothee Prof. Dr. rer. nat.
Professur für Klinische Ernährung im Alter

Autor(en) der externen Einrichtung(en)
Herlev Hospital
Hôpital Bichat-Claude-Bernard (CHU, APHP)
Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS)
Radboud university medical center / Radboudumc of voluit Radboud Universitair Medisch Centrum (UMC)
Ruprecht-Karls-Universität Heidelberg
St. Elisabeth Gruppe GmbH - Katholische Kliniken Rhein-Ruhr
Universität Hohenheim
University of East Anglia
University of Parma / Università degli Studi di Parma
Univerzita Karlova v Praze / Charles University in Prague
Uppsala University


Volkert, D., Beck, A.M., Cederholm, T., Cruz-Jentoft, A., Goisser, S., Hooper, L.,... Bischoff, S.C. (2018). ESPEN guideline on clinical nutrition and hydration in geriatrics. Clinical Nutrition.

Volkert, Dorothee, et al. "ESPEN guideline on clinical nutrition and hydration in geriatrics." Clinical Nutrition (2018).


Zuletzt aktualisiert 2019-08-03 um 13:08