Pressure sores in geriatric medicine: The role of nutrition

Malnutrition is frequent in geriatric patients: it effects 30 to 600% of elderly residents of institutions and 30 to 700% of patients admitted for short-term hospitalization. Malnutrition is a risk factor for developing pressure sores, and patients with them ore more often and more severely malnourished than patients without them. In elderly subjects, multiple end interlinked factors may trigger or aggravate malnutrition; they may be physical, psychological or social and may be worsened by drugs and some diets. Malnutrition has been recognized as a risk factor for the onset and perpetuation of pressure sores. of the dietary factors, protein intake seems most important. A low body moss index (BMI), low serum albumin, and weight loss ore associated with an increased risk of pressure sores. A physician observing pressure sores must conduct a nutritional assessment, using clinical and laboratory screening tools. The criteria for malnutrition in elderly subjects are weight loss >= 5016 in 3 months or >= 100% in 6 months, BMI < 21 kg/m(2) serum albumin < 35g/L or a MNA (Mini Nutritional Assessment) score < 17. Any one of these criteria is a sufficient basis for a diagnosis of malnutrition. Nutritional management is port of the prevention and treatment of pressure sores in geriatric medicine. It must be adapted for each patient. The recommended calorie intake in malnourished patients at risk of or with pressure sores is 30-40 kcol/kg/d, with 1.2-1.5 g of proteins/kg/d.