Nutrition in the Elderly

The elderly population is growing with time in the developed as well as in the developing societies at a rate of about 5% a year. This population has higher morbidity then the general population. The elderly are characterized by changes in different physiological activities as well as multiple pathologies. Cellular function is based on hormones, cytokines and neurotransmitters acting through the cell’s receptors and altered cellular function. Dietary structure is considered as one of the components of health and well-being. Having a high morbidity together with a slower rate of cure, elderly are major consumers of nutrition support. It is important to differentiate between the role of nutrition as part of lifestyle, in aging and the role of nutrition in treatment of the sick elderly. Nutrition has an important role in the process of healthy aging, nevertheless aging has an impact on the nutrition of the person secondary to physiological changes. The recent developments in the technology of nutrition support give us the tools to supply every person with all nutrient compounds in different manners. We can modulate the dietary structure in any way that we think that can benefit the person. There are enriched solutions with different substances, that either bypass the swallowing mechanism in different ways supplying enteral nutrition or going parenterally directly to the circulation through different ports. Despite these various opportunities there are many questions about the efficacy of nutritional support in the elderly in certain conditions and an ethical debate regarding the indication with different opinions is current, questioning the medical indications, together with the techniques and the timing for the implementation of such support. Sarcopenia, a decline in muscle mass, is part of the aging process. The differentiation between low muscular mass resulting from disease-related starvation and that derived from different responses to disease consequent to the background effect of aging has has been recently determined. The role of the feeding process as part of the needs of the old person, reflecting empathy and psychosocial support, is becoming a more prominent part of the care of the elderly. Currently, the main challenge of clinical nutrition in the aged, is in the determination of the optimal time for intervention.