Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital

ESPEN guideline on clinical nutrition and hydration in geriatrics

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Individual nutritional intervention for prevention of readmission among geriatric patients—a randomized controlled pilot trial

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Narrative Review of Low-Intake Dehydration in Older Adults

    Research output: Contribution to journalReviewResearchpeer-review

  3. Risk of Malnutrition upon Admission and after Discharge in Acutely Admitted Older Medical Patients: A Prospective Observational Study

    Research output: Contribution to journalJournal articleResearchpeer-review

  • Dorothee Volkert
  • Anne Marie Beck
  • Tommy Cederholm
  • Alfonso Cruz-Jentoft
  • Sabine Goisser
  • Lee Hooper
  • Eva Kiesswetter
  • Marcello Maggio
  • Agathe Raynaud-Simon
  • Cornel Sieber
  • Lubos Sobotka
  • Dieneke van Asselt
  • Rainer Wirth
  • Stephan C. Bischoff
View graph of relations

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.

Original languageEnglish
Article number38
JournalClinical Nutrition ESPEN
Issue number1
Pages (from-to)10-47
Number of pages38
Publication statusPublished - Feb 2019

    Research areas

  • Health Sciences - Dehydration, Geriatrics, Guideline, Malnutrition, Nutritional care, Recommendations
  • Dehydration, Geriatrics, Guideline, Malnutrition, Nutritional care, Recommendations

ID: 56117930