| Abstract | Starenje je sastavni dio ljudskog života koje obuhvaća čitav niz fizioloških promjena organizma povezanih sa smanjenjem životnih funkcija, a samo razdoblje starenja završava smrću. S povećanjem životne dobi dolazi do brojnih tjelesnih i psiholoških promjena koje mogu utjecati na prehranu i nutritivni status starijih osoba. Zbog procesa progresivnog slabljenja i oštećenja funkcija organa i organskih sustava otežava se adekvatna apsorpcija, transport, metabolizam i izlučivanje prehrambenih tvari što dovodi do rizika pojave nutritivnog deficita. Starenjem dolazi do smanjenja mišićne mase te povećanja masnog tkiva čime se mijenja sastav tijela i metaboličke potrebe starije osobe. S obzirom na čestu prisutnost kroničnih bolesti u starijoj dobi, dolazi do neadekvatne prehrane i neravnoteže između potrebe za nutrijentima i prehrambenog unosa što za posljedicu ima nastanak malnutricije ili lošeg statusa uhranjenosti. Brojna istraživanja pokazuju da je malnutricija učestali problem među osobama starije dobi, a da bi se ona uspješno spriječila, potrebno je redovito provoditi procjenu nutritivnog statusa starijih osoba što uključuje intervencije stručnjaka kroz primjenu standardiziranih obrazaca, edukaciju starije populacije, pravilnu prehranu i adekvatan unos hranjivih tvari. Nutritivni status bolesnika važan je čimbenik koji utječe na ishod i oporavak od bolesti ili ozljede i preporuka je da se procjena nutritivnog statusa provodi prilikom dolaska pacijenta u bolnicu i tijekom liječenja. No ipak, unatoč tim saznanjima u današnjem moderniziranom zdravstvu, procjena nutritivnog statusa uglavnom se ne provodi. Metode za procjenu pojedinih sastavnica nutritivnog statusa dijele se na dijetetičke, antropometrijske, biokemijske metode te klinički pregled te su neke od njih opisane u ovom radu. Danas postoje jednostavni i brzi upitnici za procjenu nutritivnog statusa koje su razvili stručnjaci Britanskog društva za parenteralnu i enteralnu prehranu i Europskog društva za kliničku prehranu i metabolizam, a u kliničkoj praksi se razvijaju već tridesetak godina. Na temelju uputa validiranih obrazaca izrađen je individualizirani upitnik za potrebe istraživanja provedenog u domovima za starije i nemoćne osobe, a rezultati provedenog istraživanja potvrđuju činjenicu kako je nutritivni status u staračkim domovima često nekontroliran te predstavlja značajan, ali još uvijek neadekvatno rješavan problem. Od ukupnog broja ispitanika u ovom istraživanju samo dvoje (4%) korisnika staračkih domova nalaze se u nutritivnom deficitu dok ih samo 14 (28%) ima normalnu tjelesnu masu. Čak 18 (36%) korisnika ima prekomjernu tjelesnu masu, a 13 (26%) njih ulazi već u prvi stupanj pretilosti. Udio pretilih starijih osoba u ukupnoj populaciji u stalnom je porastu, a rizični čimbenici koji utječu na porast pretilosti kod starije populacije su smanjena razina fizičke aktivnosti i porast sjedilačkog načina života. Ovim radom ukazan je značaj probira nutritivnog statusa u skrbi starijih i uloga zdravstvenih radnika u prepoznavanju nutritivnog rizika kojeg je potrebno ispravno identificirati i tumačiti. |
| Abstract (english) | Aging is an integral part of human life that encompasses a variety of physiological changes in the body associated with diminishing life functions, and only the aging period ends with death. With increasing age, numerous physical and psychological changes can occur that can affect the nutrition and nutritional status of the elderly. Due to the process of progressive weakening and damage to organ and organ system functions, adequate absorption, transport, metabolism and secretion of nutrients is hampered, leading to a risk of nutritional deficiency. Aging reduces muscle mass and increases fatty tissue, which changes body composition and metabolic needs of the elderly. Given the frequent presence of chronic diseases at an earlier age, inadequate nutrition and imbalance between nutrition and nutritional intake result, resulting in malnutrition or poor nutrition status. Numerous studies show that malnutrition is a frequent problem among the elderly, and to prevent it, it is necessary to regularly assess the nutritional status of the elderly, including expert interventions through standardized methods, older population education, proper nutrition and adequate intake of nutrients. Nutritional status of the patient is an important factor influencing the outcome and recovery from illness or injury and it is recommended that the nutritional status assessment be carried out upon arrival of the patient in the hospital and during treatment. But despite these findings in today's modernized health care, nutritional status estimates are largely unsuccessful. Methods for the evaluation of certain constituents of nutritional status are divided into diet, anthropometric, biochemical and clinical examinations, and some of them are described in this paper. Today there are simple and fast nutrition assessment questionnaires developed by British Society for Parenteral and Enteral Nutrition and the European Society for Clinical Nutrition and Metabolism, and have been developing in clinical practice for some thirty years. Based on the guidelines of the validated methods, a questionnaire was developed for the needs of research conducted in homes for the elderly and infirm, and the results of the survey were concerned. Today there are simple and fast nutrition assessment questionnaires developed by British Society for Parenteral and Enteral Nutrition and the European Society for Clinical Nutrition and Metabolism, and have been developing in clinical practice for some thirty years. Based on the guidelines of the validated forms, an individualized questionnaire was developed for the research conducted in homes for the elderly and infirm, and the results of the research carried out confirm the fact that the nutritional status of nursing homes is often uncontrollable and represents a significant but still inadequate problem. Of the total number of respondents in this study, only two (4%) of nursing home users are found in a nutritional deficit, while only 14 (28%) have normal body mass. Even 18 (36%) of users have excessive body mass, and 13 (26%) are entering the first stage of obesity. The share of obese elderly people in the total population is steadily increasing, and the risk factors
that increase obesity in the elderly population have been reduced in terms of physical activity and rising sedentary lifestyle. This paper emphasizes the importance of the screening of nutritional status in the care of the elderly and the role of health workers in recognizing the nutritional risk that needs to be properly identified and interpreted. |
