Many older adults don’t eat enough to meet their nutritional needs, and this can impact their healing and recovery from injury.
In support of this, a 2-year pilot study has shown that giving one extra meal a day to older adults who were hospitalised with hip fractures halved their risk of dying.
The study, conducted by the NHS in the UK, was instigated after staff noticed that patients with hip fractures struggled to get enough nutrients. In the program, nutrition advisors across six sites brought food from the hospital’s canteen and sat with patients as they ate their extra meal.
As a result, mortality rates fell from 11 to 5.5 percent, and medical authorities are considering whether it should be introduced countrywide.
Often, busy staff overlook patients’ food intake, noted chief orthopaedic surgeon Dominic Inman. Commenting on the findings to The Telegraph, he said, “If you look upon food as a very, very cheap drug, that’s extremely powerful.”
Hip fractures are the most common, and most serious type of fracture in Australia, with new fractures resulting in 50,900 hospitalisations and 579,000 bed days throughout 2015-16.
The health of adults over 50 often rapidly declines after a hip fracture, exacerbating poor outcomes. For three months after fracturing a hip, older adults are at five to eight times greater risk of dying, and one in three adults over 50 dies within 12 months.
Aside from that, a hip fracture can sorely impact mobility, independence and quality of life, and many patients are transferred to another facility for ongoing care.
Falls can be prevented by maintaining good muscle mass and strength. Failing that, patient outcomes after a fall can be improved with rehabilitation aimed at getting them moving as soon as possible, and with good nutrition.
Malnutrition, although widespread, is often overlooked, so it is important to be aware of the signs.
Addressing this, Queensland researchers have tested a patient-centred food service model in a public hospital setting and showed that it increased patients’ energy and protein intake – key requirements for healing and preventing malnourishment.
The model has been used in private acute care settings for 15 years. It revolves around providing room service to patients on demand – so they get to choose what they eat and when. (Who wants dinner at 5pm if you’re not ready for it?)
This food revolution was led by Sally McCray, who says, “This innovate model demonstrates the importance of patients being able to order flexibly, both in terms of the type of food items that patients feel like eating, as well as ordering food at a time of day that they feel like eating.”
The researchers showed that, not only can it improve nutrition intake, it also results in happier patients and reduced food waste.
It affects about one in three older adults, it’s debilitating, it fast-tracks mortality, and finally it is gaining greater recognition.
Sarcopenia Australia Day was officially launched just last year in July 2018 by the Australian Institute for Musculoskeletal Science, the University of Melbourne and Western Health to increase awareness, detection and treatment of this muscle wasting disease.
In November 2016, Sarcopenia was dubbed the “‘new’ disease on the block” by SBS news, shortly after it was recognised by the World Health Organisation and given its own ICD-10 (International Classification of Diseases) code in October that year.
Its label as a disease may be new, but the condition certainly isn’t.
Irving Rosenberg first devised the term sarcopenia (sarx = flesh; penia = loss) in 1988 to describe the disease, saying, “no single feature of age-related decline (is) more striking than the decline in lean body mass.”
Despite this, the disease didn’t gain traction until more recent years. Professor Gustavo Duque from the University of Melbourne is pushing for greater recognition of the condition.
He told SBS news that “People progressively lose the capacity to do the things that they usually do and they don’t know why.”
The disease is “to muscles what osteoporosis is to bones”, but doctors are often unaware of the condition, he said.
It can be particularly tricky to detect if patients are not visually wasting away; low muscle mass can even coexist with obesity.
Some muscle wasting is normal with ageing, but thousands of older Australians have accelerated muscle loss, leading to increased risk of falls, fractures, and hospitalisation.
And it affects more than just muscles. Muscle mass makes up more than half of overall body tissue, and so far research suggests its degradation has widespread ramifications including poor wound healing, increased risk of insulin resistance, type 2 diabetes, poor lung function and even breast cancer.
Diet and exercise become increasingly important as we age, and our body’s ability to repair and regenerate muscle is not what it used to be.
Physical activity helps to maintain muscle mass and strength – especially resistance training. But any activity can help, even small, regular movements or 15 minutes of cardiovascular exercise can promote muscle growth.
The importance of protein cannot be underestimated. Protein has numerous functions for maintaining the body’s metabolic processes and is important for maintaining lean muscle mass and healthy bone density.
Other nutrients can also help, including Vitamin D, creatinine supplementation (combined with resistance training), and minerals such as magnesium, selenium and zinc.
Importantly, the best results come from combining movement with good nutrition for stronger muscles and better, longer quality of life.