S3-Leitlinie Klinische Ernährung und Hydrierung im Alter

Zusammenfassung

Fragestellung

Mangelernährung, hypertone Dehydratation, Sarkopenie und Adipositas sind weit verbreitete ernährungs (mit)bedingte Gesundheitsprobleme bei älteren Menschen mit weitreichenden negativen Folgen. Ziel dieser Leitlinie sind evidenzbasierte Empfehlungen zu deren Prävention und Therapie.

Methodik

Die bisherige Leitlinie der deutschen Gesellschaft für Ernährungsmedizin (DGEM) zur klinischen Ernährung in der Geriatrie wurde nach den Richtlinien der AWMF aktualisiert und erweitert.

Ergebnisse

Die aktualisierte Leitlinie richtet sich an alle in der Versorgung älterer Menschen tätigen Personen und bezieht sich auf alle Bereiche des Gesundheitswesens (ambulant und stationär). Sie beinhaltet 69 konsentierte Empfehlungen zur Ernährungsversorgung älterer Menschen und gliedert sich in 5 Kapitel: I. Grundprinzipien klinischer Ernährung im Alter mit Empfehlungen zur Energie- und Nährstoffaufnahme und zur Durchführung und Organisation der Ernährungsversorgung älterer Menschen, II. Empfehlungen zur Prävention und Therapie von Mangelernährung – generell, unabhängig von bestimmten Krankheiten sowie bei den häufigen geriatrischen Gesundheitsproblemen Hüftfraktur, Delir, Dekubitus, chronisch obstruktive Lungenerkrankung und Diabetes mellitus, III. Empfehlungen zur Prävention, Erfassung und Therapie einer hypertonen Dehydratation, IV. Empfehlungen zur Therapie der Sarkopenie und V. Empfehlungen zur Therapie von Adipositas im Alter. Generell sollen Ernährungsmaßnahmen bei älteren Menschen ergriffen werden, um eine adäquate Zufuhr von Energie und Nährstoffen einschließlich Flüssigkeit zu ermöglichen und dadurch den Ernährungszustand, Funktionalität und Selbständigkeit möglichst gut zu erhalten oder zu verbessern.

Schlussfolgerung

Zahlreiche Strategien zur Ernährungsversorgung und Unterstützung einer angemessenen Ernährung älterer Menschen stehen zur Verfügung, um ernährungsabhängige Gesundheitsprobleme und ihre Folgen zu vermeiden bzw. zu reduzieren. Eine breite Implementierung der Empfehlungen im Versorgungsalltag soll angestrebt werden.

Abstract

Aim

Malnutrition, low-intake dehydration, sarcopenia and obesity are widespread nutrition-related health problems in older people with serious negative consequences. The aim of this guideline is to provide evidence-based recommendations for their prevention and treatment.

Methods

The previous guideline of the German Society for Nutritional Medicine (DGEM) on nutrition in geriatrics has been updated and expanded in accordance with the principles of the German Association of Scientific Medical Societies (AWMF).

Results

The updated guideline is aimed at all those involved in the care of older persons and applies to all healthcare settings (outpatient and inpatient). It consists of 69 agreed recommendations for the nutritional care of older persons and is divided into 5 chapters: I. Basic principles of clinical nutrition with recommendations on energy and nutrient intake of older people and on the implementation and organisation of nutritional care, II. Recommendations for the prevention and treatment of malnutrition – generally, independent of specific diseases, as well as for the common geriatric health problems of hip fracture, delirium, pressure ulcers, chronic obstructive pulmonary disease and diabetes mellitus, III. Recommendations for the prevention, assessment and treatment of low-intake dehydration, IV. Recommendations for the treatment of sarcopenia and V. Recommendations for the treatment of obesity in old age. In general, nutritional interventions for older people should be used to ensure an adequate supply of energy and nutrients, including fluids, in order to maintain or improve their nutritional status, functionality and independence as much as possible.

Conclusion

Numerous options are available to provide nutritional care and support appropriate nutrition for older people in order to prevent or reduce nutrition-related health problems and their consequences. Broad implementation of the recommendations in everyday care is required.

Schlüsselwörter

Leitlinie - Geriatrie - Ernährungsversorgung - Mangelernährung - Dehydratation

Keywords

Guideline - geriatrics - nutritional care - malnutrition - dehydration

^* Guideline of the German Society for Nutritional Medicine (DGEM) in cooperation with the Austrian Society for Clinical Nutrition (AKE), the Swiss Society for Clinical Nutrition and Metabolism (GESKES), and the German Society for Geriatrics (DGG)

^* Anmerkung zu den Begriffen: Die Osmolalität wird direkt unter Verwendung der Gefrierpunkterniedrigung in mOsm/kg, also bezogen auf eine Masse, gemessen, während die Osmolarität auf die Annäherung an die Osmolalität abzielt und eine Schätzung ist, die auf einer Gleichung mit mehreren Komponenten basiert und in mOsm/L, also volumenbezogen, angegeben wird. Diese beiden Begriffe werden gelegentlich verwechselt.

Publication History

Article published online:
23 June 2025

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