PROGRAM - Nestle Health Science · School (1987), he specialized in internal medicine and geriatrics (St. Gallen and Geneva), followed by a postdoctoral fellowship at Emory University,

Best Practice Sharing: Tested nutritional solutions to support mobility and recovery

The 36th ESPEN CongressGeneva, Switzerland

Saturday, September 6, 2014 12:00-13:30Geneva Convention Centre (PALEXPO), Halle 1, Room C

PROGRAM BOOK

Nutrition Screening®

As as

Malnutrition is associated with a 3 times higher infection rate and higher mortality rate1,2

• Most validated tool for the elderly

• Quick, convenient and easy to use

• Identifies patients who need nutrition intervention

• Most commonly used nutrition screening tool by geriatricians3

• The new Self-MNA® is valid for use by older adults4

MNA®: The GOLD standard in nutrition screening for the older adult

1. Sorensen J et al. Clin Nutr 2008; 27(3):340-349. 2. Schneider SM et al. Br J Nutr 2004; 92(1):105-111. 3. Vandewoude M et al. European Geriatric Medicine 2011; vol 2, issue 2:67-70.4. Huhmann et al. J Nutr Health Aging 2013; 17(4):339-344.

Screen and intervene. Nutrition can make a difference.

Visit:

www.mna-elderly.com

Print CMYK | Blue = C 100% / M 72% / B 18% | Green = C 80% / Y 90%

Screening

F2 Calf circumference (CC) in cm 0 = CC less than 31 3 = CC 31 or greater

Last name: First name:

Sex: Age: Weight, kg: Height, cm: Date:

A Has food intake declined over the past 3 months due to loss of appetite, digestive problems, chewing or swallowing difficulties?

0 = severe decrease in food intake 1 = moderate decrease in food intake 2 = no decrease in food intake

B Weight loss during the last 3 months 0 = weight loss greater than 3 kg (6.6 lbs) 1 = does not know 2 = weight loss between 1 and 3 kg (2.2 and 6.6 lbs) 3 = no weight loss

C Mobility 0 = bed or chair bound 1 = able to get out of bed / chair but does not go out 2 = goes out D Has suffered psychological stress or acute disease in the past 3 months? 0 = yes 2 = no

E Neuropsychological problems 0 = severe dementia or depression 1 = mild dementia 2 = no psychological problems

F1 Body Mass Index (BMI) (weight in kg) / (height in m2) 0 = BMI less than 19 1 = BMI 19 to less than 21 2 = BMI 21 to less than 23 3 = BMI 23 or greater

Complete the screen by filling in the boxes with the appropriate numbers. Total the numbers for the final screening score.

12-14 points: Normal nutritional status8-11 points: At risk of malnutrition0-7 points: Malnourished

References1.Vellas B, Villars H, Abellan G, et al. Overview of the MNA® - Its History and Challenges. J Nutr Health Aging. 2006;10:456-465. 2.Rubenstein LZ, Harker JO, Salva A, Guigoz Y, Vellas B. Screening for Undernutrition in Geriatric Practice: Developing the Short-Form Mini Nutritional Assessment (MNA-SF). J. Geront. 2001;56A: M366-377. 3.Guigoz Y. The Mini-Nutritional Assessment (MNA®) Review of the Literature - What does it tell us? J Nutr Health Aging. 2006; 10:466-487.4.Kaiser MJ, Bauer JM, Ramsch C, et al. Validation of the Mini Nutritional Assessment Short-Form (MNA®-SF): A practical tool for identification of nutritional status. J Nutr Health Aging. 2009; 13:782-788. ® Société des Produits Nestlé, S.A., Vevey, Switzerland, Trademark Owners © Nestlé, 1994, Revision 2009. N67200 12/99 10M For more information: www.mna-elderly.com

IF BMI IS NOT AVAILABLE, REPLACE QUESTION F1 WITH QUESTION F2.DO NOT ANSWER QUESTION F2 IF QUESTION F1 IS ALREADY COMPLETED.

Mini Nutritional Assessment MNA®

Screening score (max. 14 points)



SATELLITE SYMPOSIUM

Saturday, September 6, 2014 12:00-13:30Geneva Convention Centre (PALEXPO), Halle 1, Room C

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Speakers:

• New evidence for combined nutrition and exercise to improve physical function in pre-frail seniors

RetoW.Kressig,MD(Switzerland)

• Caregiver tips to optimize adherence to prescribed nutritional supplements SandraSimmons,PhD(USA)

• Effects of combined nutrition and exercise programs in frail institutionalized older adults: The ACTIVNES study

PedroAbizanda,MD,PhD(Spain)

Chair:MatteoCesari,MD,PhD(France)

PROGRAM SPEAKERS

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Reto W. Kressig, born in Zurich (Switzerland), is professor and chief of Geriatrics at the University of Basel, where he is directing the Acute Geriatrics Department, including the acute geriatrics division, the Memory Clinic, and the Basel Mobility Center. After graduation and dissertation at the Zurich University Medical School (1987), he specialized in internal medicine and geriatrics (St. Gallen and Geneva), followed by a postdoctoral fellowship at Emory University, Georgia Institute of Technology, and VA Rehab R&D in Atlanta, USA. In 2005, he obtained the academic degree of Private Docent at the University of Geneva, Switzerland, and in 2006 he was appointed Professor at the Medical Faculty of Basel University.

His scientific work and interests include older adults’ gait biomechanics, physical activity, functional autonomy, and cognition in relation to principles of geriatric rehabilitation, nutrition and fall prevention. He is author of numerous original articles, reviews, letters and book chapters. Professor Kressig is Editorial-Member of several international geriatric journals, Associate Professor of Gerontology at the University of Luxemburg and former Secretary of the European Academy for Medicine of Aging.

SPEAKERBIOGRAPHY

KEYMESSAGES

Theagingprocessisassociatedwithprogressivelossofmusclemasswithloweredstrengthandphysicalendurance(“sarcoepenia”).Regularaerobicandresistanceexerciseprogramshavebeenshowntocounteractmostaspectsofsarcopenia.

However,onlyaroundhalfofEuropeanseniorsareconsideredphysicallyactiveandengagedintoregularexerciseprograms.Further,simpleresistanceexercisealoneandthereforeincreasedmusclemassandmusclestrengtharenotaguaranteeforfunctionalimprovementandlessfallsinseniors.

Whendesigningandofferingexerciseprogramsforseniors,compliancefactorssuchasfunandsocializing,butalsocognitivecomponentsforbodycoordinationandbalancecontrolimperativelyneedtobeconsidered.Proteinnutritionincombinationwithexerciseisconsideredoptimalformaintainingmusclefunction.Using“fastproteins”suchaswheyindirectcombinationwithphysicaltraininginterventionsseemstobefeasibleandpracticalinregardtocomplianceandmostpromisinginregardtoincreasingmusclestrengthandmusclefunctionality.

Adequatedietaryproteinintake(1.0–1.2gprotein/kgbodyweight/dayforhealthyolderpeople;1.2–1.5gprotein/kgbodyweight/dayformalnourishedandsarcopenicolderpeople)andcontinuingexercise/physicalactivityareimportanttohealthyagingandshouldbeundertakenbyallolderpeople,foraslongaspossible.

Reto W. Kressig, MD

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Sandra F. Simmons, PhD, is an Associate Professor of Medicine in the Division of General Internal Medicine and Public Health at Vanderbilt University. Her educational background is in clinical psychology and gerontology. Her current clinical appointments include staff member at the Vanderbilt Center for Quality Aging and the Geriatric Research, Education and Clinical Center (GRECC), Veterans Administration.

Active in research as a Principal Investigator or Co-investigator, Dr. Simmons has been the recipient of numerous grants and fellowships to examine issues in gerontology from the National Institutes of Health and Aging, Agency for Healthcare Research & Quality, Veterans Health Administration and the National Alzheimer’s Association. Specifically, her research foci include clinical interventions to improve quality of care and quality of life for older adults in a variety of care settings, in particular long term care.

Complementing her research endeavors, Dr. Simmons writes for the medical literature and has more than 80 peer-reviewed articles to her credit, as well as numerous review articles, editorials and book chapters. Additionally, Dr. Simmons frequently speaks nationally and internationally on long-term care quality issues at professional and provider-oriented meetings.

SPEAKERBIOGRAPHY

KEYMESSAGES

• Manyolderadultsareatriskforunder-nutritionanddehydration.

• Caregiveroffersofavarietyofsupplementsandsnacksmultipletimesperdaybetweenregularly-scheduledmealsisaneffectivewaytoincreasecaloricintake.

• Professionalcaregiversinthelong-termcaresettingoftendonotprovideconsistentoffersoradequateassistance.

• Bothprofessionalandlaycaregiverscanbetrainedtoprovidebetterqualityassistancetoenhanceindependenceineatingandintakeforolderadults.

Sandra F. Simmons, PhD

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Pedro Abizanda Soler, MD, PhD, is Chief of the Geriatrics Department at the Complejo Hospitalario Universitario de Albacete. He is Associate Professor in Geriatrics at the Medicine Faculty from Castilla-La Mancha University.

His PhD degree was granted by the Universidad Autónoma de Madrid. He serves as President of the Ethics Research Committee from Albacete, and member of the Geriatrics Specialty National Commission. He is the author of books and publications in international journals covering issues among older persons in community and hospital settings. Focus areas include cognitive and physical function, frailty, and disability; validated clinical methods of assessment, and therapeutic interventions for rehabilitation.

SPEAKERBIOGRAPHY

KEYMESSAGES

TheESPENGuidelinesonEnteralNutritionstatethatinfrailelderly,oralnutritionalsupplementsarerecommendedtoimproveormaintainnutritionalstatus.Ithasalsobeendemonstratedthatphysicalexerciseinfrailolderadultsisassociatedwithmultiplebenefits.WiththesepremisesweconductedtheACTIVNESStudy.Ourhypothesiswasthatacombinedinterventionofahyperproteic,hypercaloric(HP/HC)oralnutritionalsupplement(ONS)(Resource®SeniorActiv,NestléHealthScience)plusstandardizedphysicalexercisetraininginfrailinstitutionalizedolderadultsinSpain,wouldincreasestrength,functionalstatus,andqualityoflifeunderususalclinicalpracticeconditions.

Thedesignwasamulticentricprospectiveobservationalstudyin4institutionsfromSpain(n=97).Theinclusioncriteriawere:Patients≥ 70yearsold,with3ormoreofFried´sfrailtycriteria,abletowalk50meters,andalreadytakingorwhostartedtotakeaHP/HCnutritionalformulawithprebioticfiber,vitaminDandcalcium.

Themainconclusionsofthestudywere:Thestudyintervention(ONS+exercise)revealsanimprovementinfunctionalcapacities,especiallyat6weeks.50%ofparticipantsimprovedoneormorepointsinSPPBatweeks6and12.Thisimprovementismoreimportantinparticipantswithmorefrailtycriteria,lowerfunctionallevel,lowerVitaminDlevelsandwithpoorernutritionalstatus.Participantsalsoimprovednutritionalstatus,especiallythosewithmalnutrition,andtheirqualityoflifeatweeks6and12.Itisimportanttohighlightthatover90%ofresidentsaccomplisheddailyexercises,andover80%accomplishedanoralintakeofmorethan60%ofONS.Thegoodresultsobtainedafter6weeksandthepositivetrendofmanyresultsat12weeksopenanewresearchfieldinmedicalassistance.

Pedro Abizanda Soler, MD,PhD

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NOTES


Documents

PROGRAM - Nestle Health Science · School (1987), he specialized in internal medicine and geriatrics (St. Gallen and Geneva), followed by a postdoctoral fellowship at Emory University,