The Role of Nutritional Status in Elderly Patients with Heart Failure

Abstract

Evidence indicates that malnutrition very frequently co-occurs with chronic heart failure (HF) and leads to a range of negative consequences. Studies show associations between malnutrition and wound healing disorders, an increased rate of postoperative complications, and mortality. In addition, considering the increasing age of patients with HF, a specific approach to their treatment is required. Guidelines proposed by the European Society of Cardiology (ESC) for treating acute and chronic HF refer to the need to monitor and prevent malnutrition in HF patients. However, the guidelines feature no strict nutritional recommendations for HF patients, who are at high nutritional risk as a group, nor do they offer any such recommendations for the poor nutritional status subgroup, for which high morbidity and mortality rates have been observed. In the context of multidisciplinary healthcare, recommended by the ESC and proven by research to offer multifaceted benefits, nutritional status should be systematically assessed in HF patients. Malnutrition has become a challenge within healthcare systems and day-to-day clinical practice, especially in developed countries, where it affects the course of disease and patients' prognosis.

<p>Cardiac Cachexia: A Well-Known but Challenging Complication of Heart Failure</p>

“…16 Another study reported that 40% of the study participants (patients with chronic HF) were at risk of or already suffered from loss of muscular strength. 8 , 55 Sarcopenia may also develop in obese HF patients, which shows that its pathology is complex. 51 Impaired myocardial relaxation in HFpEF is a reliable and independent predictor of the ability to perform aerobic exercise, and HFpEF patients simultaneously show a high incidence of sarcopenic obesity, 56 which is independently associated with worse outcomes and increased mortality in chronic HF.…”

“…There are associations between malnutrition and impaired wound healing, increased rate of postoperative complications, and mortality. 8 What is important, cardiac cachexia is associated with poor outcomes and unfavorable reactions to pharmacological treatment, and poor quality of life. 9 The overall prevalence of cachexia in the industrialized world increases with a greater incidence of chronic diseases.…”

<p>Psychometric Evaluation Of Appetite Questionnaires In Elderly Polish Patients With Heart Failure</p>

“…Studies confirm that loss of appetite is a predictor of weight loss 9. The reasons for loss of appetite in elderly HF may be multifaceted, and include hormonal changes, pharmacotherapy or psychosocial factors, and coexisting depression 3,10…”

“…According to epidemiological data, malnutrition in patients with heart failure (HF) affects approximately 69% of patients and is a negative prognostic factor, increasing the risk of hospitalization, rehospitalization and death 1,2. In addition, scientific studies have identified a relationship between malnutrition and prolonged hospitalization, increased treatment costs, postoperative complications, the risk of pressure ulcer development, complicated wound healing, increased risk of falls, pneumonia or renal failure 3,4. The European Society of Cardiology (ESC) guidelines for the treatment of acute and chronic HF contain information on the need to monitor and prevent malnutrition 5.…”

Kalp Yetersizliği Olan Yaşlı Bireylerin Kırılganlık Durumunun Belirlenmesi

“…[40] Kanıtlar, yetersiz beslenmenin sıklıkla KY ile birlikte ortaya çıktığını ve bir dizi olumsuz sonuca yol açtığını göstermektedir. [41] Sağlık algısı, bireyin kendi sağlık durumundan referans alan, sağlık alanının farklı boyutlarının olduğunu yansıtan, bireyin biyolojik, mental ve toplumsal durumunu kendisinin değerlendirmesine olanak sağlayan basit ama güçlü bir kavramdır. [42] Sağlık algısı değerlendirmesi kalp yetersizliği olan hastalarda gelişecek olayları tahmin ede- bilmektedir.…”