Nutrition in the age-related disablement process
Open accessAbstract
The transition from independence to disability in older adults is characterized by detectable changes in body composition and physical function. Epidemiologic studies have shown that weight loss, reduced caloric intake and the reduced intake of specific nutrients are associated with such changes. The mechanisms underlying these associations remain unclear, and different hypotheses have been suggested, including the reduction of the antioxidant effects of some nutrients. Changes in muscle mass and quality might play a central role in the pathway linking malnutrition, its biological and molecular consequences, and function. A different approach aims at assessing diets by dietary patterns, which capture intercorrelations of nutrients within a diet, rather than by selective foods or nutrients: epidemiologic evidence suggests that some types of diet, such as the Mediterranean diet, might prevent negative functional outcomes in older adults. However, despite a theoretical and empirical basis, intervention studies using nutritional supplementation have shown inconclusive results in preventing functional impairment and disability. The present work is the result of a review and consensus effort of a European task force on nutrition in the elderly, promoted by the International Association of Gerontology and Geriatrics (IAGG) European Region. After the critical review of different aspects related to the role of nutrition in the transition from independence to disability, we propose future lines for research, including the determination of levels of inadequacy and target doses of supplements, the study of interactions (between nutrients within a diet and with other lifestyle aspects), and the association with functional outcomes.
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Many healthy older adults fail to eat enough dietary protein, and the situation is worsened when they are sick or disabled.
“Many healthy older adults fail to eat enough dietary protein, but the situation is worsened when they are sick or disabled.”
From Evidence-Based Recommendations for Optimal Dietary Protein Intake in Older People: A Position Paper From the PROT-AGE Study Group (2013) · cites this paper as [68]
The sections on dietary adequacy and decreased food intake in older community-dwellers (page unavailable) report widespread nutritional inadequacy and say age-related appetite loss may predispose to protein undernutrition. They also identify acute and chronic disease as risk factors for malnutrition. They do not establish that many specifically healthy older adults eat too little protein, or that protein intake worsens when older adults become disabled. (LLM, conf=0.82)
Experimental — accuracy not yet measuredWhen older adults have acute or chronic diseases, their activities are more limited, they are less likely to consume adequate food, and they fall farther behind in energy and protein intake.
“When older adults have acute or chronic diseases, their activities are more limited, they are less likely to consume adequate food, and they fall farther behind in energy and protein intake.67,68”
From Evidence-Based Recommendations for Optimal Dietary Protein Intake in Older People: A Position Paper From the PROT-AGE Study Group (2013) · cites this paper as [68]
The 'Risk factors and pathophysiology of decreased food intake' section (page unavailable) identifies pain from acute or chronic disease as a risk factor for malnutrition. It also says loss of appetite in ageing may predispose to protein and energy undernutrition. It does not establish that disease itself limits activities or that affected older adults fall progressively farther behind in energy and protein intake; the decline in physical activity is attributed to ageing generally. (LLM, conf=0.84)
Experimental — accuracy not yet measuredMalnourished older people recover from illness more slowly, have more complications, and are more frequently admitted to hospitals for longer stays than healthy older adults.
“As a result, malnourished older people recover from illness more slowly, have more complications, and are more frequently admitted to hospitals for longer stays than are healthy older adults.67,68”
From Evidence-Based Recommendations for Optimal Dietary Protein Intake in Older People: A Position Paper From the PROT-AGE Study Group (2013) · cites this paper as [68]
The “Nutrition, physical performance, frailty and disability” section links undernutrition to frailty and functional limitations, but does not address recovery from illness, complications, or hospital admission and length of stay. Searches for those specific outcomes found no supporting passage in our copy; page numbers were not available. (LLM, conf=0.75)
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- [31]Semba R.D. Bartali B. Zhou J. Blaum C. Ko C.W. Fried L.P. Low serum micronutrient concentrations predict frailty among older women living in the community J Gerontol A Biol Sci Med Sci 61 6 2006 594 599 PubMed PMID: 16799142 10.1093/gerona/61.6.594 16799142 · DOI
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Effectiveness of probiotics, prebiotics, and prebiotic‐like components in common functional foods
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Dietary Patterns, Skeletal Muscle Health, and Sarcopenia in Older Adults
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Vitamins and Microelement Bioavailability in Different Stages of Chronic Kidney Disease
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Mediterranean diet and depression among older individuals: The multinational MEDIS study
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Macronutrient Intake and Inadequacies of Community-Dwelling Older Adults, a Systematic Review
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Malnutrition among older adults living in Portuguese nursing homes: the PEN-3S study
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Role of Zinc and Copper in Erythropoiesis in Patients on Hemodialysis
Takahashi, A. (2022) · Journal of Renal Nutrition · doi:10.1053/j.jrn.2022.02.007 · Cited by 49 · see citing works
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A Review of Nutritional Requirements of Adults Aged ≥65 Years in the UK
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Sleep complaints are associated with frailty in Mexican older adults in a rural setting
Moreno-Tamayo, K. M., Manrique-Espinoza, B. S., Rosas‐Carrasco, Ó., Alejandro, P.-M., & Salinas‐Rodríguez, A. (2017) · Geriatrics and gerontology international/Geriatrics & gerontology international · doi:10.1111/ggi.13111 · Cited by 48 · see citing works
Motoric Cognitive Risk Syndrome: Symptoms, Pathology, Diagnosis, and Recovery
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Dietary patterns as predictors of successful ageing
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Detecting Frailty in Primary Care: A Major Challenge for Primary Care Physicians
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Dietary Patterns and Their Relationship with Frailty in Functionally Independent Older Adults
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Micronutrient intake and food sources in the very old: analysis of the Newcastle 85+ Study
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Nutrition, frailty, and Alzheimer's disease
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Strategies in traditional Persian medicine to maintain a healthy life in the elderly
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Healthy ageing literature review
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Health Risks and Adverse Reactions to Functional Foods
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Home-Delivered Meals: Characterization of Food Intake in Elderly Beneficiaries
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Dietary Intake, D3Cr Muscle Mass, and Appendicular Lean Mass in a Cohort of Older Men
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LLL 44 – Module 3: Micronutrients in Chronic disease
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Myokines and Biomarkers of Frailty in Older Inpatients with Undernutrition: A Prospective Study
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- Authors
- Inzitari, M., Doets, E., Bartali, B., Benetou, V., Di Bari, M., Visser, M., Volpato, S., Gambassi, G., Topinkova, E., De Groot, L., & Salva, A.
- Affiliations
- Universitat Autònoma de Barcelona (ES)
- Wageningen University & Research (NL)
- Cornell University (US)
- National and Kapodistrian University of Athens (GR)
- Amsterdam Public Health (NL)
- University of Ferrara (IT)
- Università Cattolica del Sacro Cuore (IT)
- Corresponding author
- Inzitari, Marco
- Venue
- The Journal of nutrition, health and aging
- Publisher
- Elsevier BV
- Published
- 2011-10
- Volume
- 15
- Issue
- 8
- Pages
- 599-604
- ISSN
- 1279-7707 (ISSN-L)
- PMC
- PMC12878855
- OpenAlex
- W2058700931
- Cited by
- 148
- References
- 76
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 5 · 2023: 5 · 2022: 10 · 2021: 12 · 2020: 15 · 2019: 10 · 2018: 13 · 2017: 15 · 2016: 13 · 2015: 13 · 2014: 15 · 2013: 10 · 2012: 8
- FWCI
- 7.20
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- The journal of nutrition health & aging (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (acceptedVersion, other-oa)
- Socio-Environmental Systems Modeling (acceptedVersion)
- Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion, other-oa)
- Florence Research (University of Florence) (submittedVersion)
- VU Research Portal (submittedVersion, other-oa)
- Institutional Research Information System University of Ferrara (University of Ferrara) (submittedVersion)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- Universitat de Barcelona
- Universitat Autònoma de Barcelona
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutrition and Health Studies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Keywords
- elderly nutrition, malnutrition, weight loss, energy intake, body composition, muscle mass, physical function, dietary habits, Mediterranean diet, dietary supplementation, functional disability, antioxidant nutrients, nutrient interactions
- MeSH terms
- Activities of Daily Living, Aged, Aging, Energy Intake, Diet, Europe, Persons with Disabilities, Disabled Persons, Humans, Weight Loss, Dietary Supplements, Malnutrition, Sarcopenia, Elder Nutritional Physiological Phenomena
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