Cambios gastrointestinales en el envejecimiento: impacto sobre la alimentación y el estado nutricional.

Autores/as

  • David López Centro Latinoamericano de Nutrición (CELAN)
  • Cristina Posada Álvarez Centro Latinoamericano de Nutrición (CELAN)
  • Patricia Savino Lloreda Centro Latinoamericano de Nutrición (CELAN)

DOI:

https://doi.org/10.56050/01205498.2185

Palabras clave:

envejecimiento, tracto gastrointestinal, estado nutricional, enfermedad crónica, dietoterapia

Resumen

Durante el envejecimiento se presentan una serie de cambios biológicos y psicológicos que tienen un impacto social y económico en la población a medida que avanza su edad. Uno de los sistemas con cambios fisiológicos que guarda una estrecha relación con el estado nutricional es el tracto gastrointestinal. Cada una de sus secciones presenta modificaciones que alteran, en una u otra medida, la motilidad, la digestión o la absorción de la energía y nutrientes, con efectos deletéreos como la pérdida de la masa musculoesquelética, la disminución en la funcionalidad y la alteración en la calidad de vida, que finalmente contribuye al aumento de la incidencia de desnutrición proteico calórica y sarcopenia. La vejez es una etapa en la que la presencia de enfermedades crónicas incrementa los problemas nutricionales debido al impacto propio de las patologías, sus efectos gastrointestinales, el uso de medicamentos y la inadecuada indicación de dietas restrictivas, que sin la apropiada orientación de un profesional en nutrición y dietética, pueden favorecer y exacerbar la desnutrición. Esta revisión describe los cambios en la función gastrointestinal que ocurren durante el envejecimiento y los efectos sobre el estado nutricional, y expone las consecuencias de las modificaciones en términos del perfil, contenido de nutrientes y consistencia de la alimentación del adulto mayor.

Biografía del autor/a

David López, Centro Latinoamericano de Nutrición (CELAN)

Nutricionista Dietista, Especialista en epidemiología clínica. Centro Latinoamericano de Nutrición (CELAN).

Cristina Posada Álvarez, Centro Latinoamericano de Nutrición (CELAN)

Nutricionista Dietista, Especialista en bioquímica clínica. Centro Latinoamericano de Nutrición (CELAN).

Patricia Savino Lloreda, Centro Latinoamericano de Nutrición (CELAN)

Nutricionista Dietista, MBA en salud. Centro Latinoamericano de Nutrición (CELAN).

Referencias bibliográficas

Ministerio de Salud y Protección Social. Envejecimiento y Vejez [Internet]. Minsalud.gov.co. 2022 [Consultado 23 de mayo de 2022]. Disponible en: https://www.minsalud.gov.co/proteccionsocial/promocion-social/Paginas/envejecimiento-vejez.aspx

Departamento Administrativo Nacional de Estadística. Adulto mayor en Colombia: características generales [Internet]. Dane.gov.co; 2021 [Consultado 23 de mayo de 2022]9. Disponible en:

https://www.dane.gov.co/files/investigaciones/genero/presentacion-caracteristicas-generales-adulto-mayor-en-colombia.pdf

Chavarro-Carvajal D, Venegas-Sanabria L, Cano C, Cortés Sarmiento D, Saavedra Marín AM. Factores asociados a malnutrición en población adulta mayor colombiana: análisis secundario de la encuesta SABEColombia. [Internet]. ResearchGate.net. 2018. [Consultado 23 de mayo de 2022] Disponible en:

https://www.researchgate.net/publication/342215481-FACTORES-ASOCIADOS-A-MALNUTRICION-EN-POBLACION-ADULTA-MAYOR-COLOMBIANA_ANALISIS_SECUNDARIO_DE_LA_ENCUESTA_SABE-COLOMBIA

Arias Delgado DA, Cepeda Alfonso L, Coca León D, Chavarro-Carvajal D, Heredia Ramírez R, Arias Delgado DA, et al. Factores asociados a caídas en el servicio ambulatorio de geriatría de un hospital universitario en Bogotá (Colombia). Rev Cienc Salud. 2021;19(1):113-23.

Tang S, Liu M, Yang T, Ye C, Gong Y, Yao L, et al. Association between falls in elderly and the number of chronic diseases and health-related behaviors based on CHARLS 2018: health status as a mediating variable. BMC Geriatr. 2022;22(1):374.

Rodríguez MG, Sichacá EG, Rodríguez MG, Sichacá EG. Mortalidad por desnutrición en el adulto mayor, Colombia, 2014-2016. Biomédica. 2019;39(4):663-72.

Corcoran C, Murphy C, Culligan EP, Walton J, Sleator RD. Malnutrition in the elderly. Sci Prog. 2019;102(2):171-80.

Syed Q, Hendler KT, Koncilja K. The Impact of Aging and Medical Status on Dysgeusia. Am J Med. 2016;129(7):753.e1-753.e6.

Correia C, Lopez KJ, Wroblewski KE, Huisingh-Scheetz M, Kern DW, Chen RC, et al. Global Sensory Impairment in Older Adults in the United States. J Am Geriatr Soc. 2016;64(2):306-13.

Ahmed T, Haboubi N. Assessment and management of nutrition in older people and its importance to health. Clin Interv Aging. 2010;5:207-16.

Siddique N, O’Donoghue M, Casey MC, Walsh JB. Malnutrition in the elderly and its effects on bone health - A review. Clin Nutr ESPEN. 2017;21:31-9.

Takehara S, Hirani V, Wright FAC, Naganathan V, Blyth FM, Le Couteur DG, et al. Appetite, oral health and weight loss in community-dwelling older men: an observational study from the Concord Health and Ageing in Men Project (CHAMP). BMC Geriatr. 2021;21(1):255.

Nakamura M, Ojima T, Nakade M, Ohtsuka R, Yamamoto T, Suzuki K, et al. Poor Oral Health and Diet in Relation to Weight Loss, Stable Underweight, and Obesity in Community-Dwelling Older Adults: A Cross-Sectional Study From the JAGES 2010 Project. J Epidemiol. 2016;26(6):322-9.

Kiesswetter E, Keijser BJF, Volkert D, Visser M. Association of oral health with body weight: a prospective study in community-dwelling older adults. Eur J Clin Nutr. 2020;74(6):961-9. 15.

Ohara Y, Hirano H, Yoshida H, Obuchi S, Ihara K, Fujiwara Y, et al. Prevalence and factors associated with xerostomia and hyposalivation among community-dwelling older people in Japan. Gerodontology. 2016;33(1):20-7.

Pérez-González A, Suárez-Quintanilla JA, Otero-Rey E, Blanco-Carrión A, Gómez-García FJ, Gándara-Vila P, et al. Association between xerostomia, oral and general health, and obesity in adults. A cross-sectional pilot study. Med Oral Patol Oral Cirugia Bucal. 2021;26(6):e762- 9.

Fornari CB, Bergonci D, Stein CB, Agostini BA, Rigo L. Prevalence of xerostomia and its association with systemic diseases and medications in the elderly: a cross-sectional study. Sao Paulo Med J Rev Paul Med. 2021;139(4):380-7.

Fernandes MS, Castelo PM, Chaves GN, Fernandes JPS, Fonseca FLA, Zanato LE, et al. Relationship between polypharmacy, xerostomia, gustatory sensitivity, and swallowing complaints in the elderly: A multidisciplinary approach. J Texture Stud. 2021;52(2):187-96.

Lee KA, Park JC, Park YK. Nutrient intakes and medication use in elderly individuals with and without dry mouths. Nutr Res Pract. 2020;14(2):143-51.

Madsen JL, Graff J. Effects of ageing on gastrointestinal motor function. Age Ageing. 2004;33(2):154-9.

Doan TN, Ho WC, Wang LH, Chang FC, Nhu NT, Chou LW. Prevalence and Methods for Assessment of Oropharyngeal Dysphagia in Older Adults: A Systematic Review and Meta-Analysis. J Clin Med. 2022;11(9):2605.

Ravindran N, Moskovitz D, Kim Y. The aging gut. En: Chernoff R, editor. Geriatric nutrition.a4ta ed. Burlington, Massachusetts: Jones & Bartlett Learning; 2014. p. 235- 75.

Kjaersgaard A, Pallesen H. First-Hand Experience of Severe Dysphagia Following Brainstem Stroke: Two Qualitative Cases. Geriatr Basel Switz. 2020;5(1):E15.

Yang C, Pan Y. Risk factors of dysphagia in patients with ischemic stroke: A meta-analysis and systematic review. PloS One. 2022;17(6):e0270096.

Martino R, Foley N, Bhogal S, Diamant N, Speechley M, Teasell R. Dysphagia after stroke: incidence, diagnosis, and pulmonary complications. Stroke. 2005;36(12):2756-63.

Besanko LK, Burgstad CM, Cock C, Heddle R, Fraser A, Fraser RJL. Changes in esophageal and lower esophageal sphincter motility with healthy aging. J Gastrointest Liver Dis JGLD. 2014;23(3):243-8.

Andrews JM, Fraser RJ, Heddle R, Hebbard G, Checklin H. Is esophageal dysphagia in the extreme elderly (>or=80 years) different to dysphagia younger adults? A clinical motility service audit. Dis Esophagus Off J Int Soc Dis Esophagus. 2008;21(7):656-9.

Logemann JA, Larsen K. Oropharyngeal dysphagia: pathophysiology and diagnosis for the anniversary issue of Diseases of the Esophagus. Dis Esophagus Off J Int Soc Dis Esophagus. 2012;25(4):299-304.

Dumic I, Nordin T, Jecmenica M, Stojkovic Lalosevic M, Milosavljevic T, Milovanovic T. Gastrointestinal Tract Disorders in Older Age. Can J Gastroenterol Hepatol. 2019;2019:6757524.

O’Mahony D, O’Leary P, Quigley EMM. Aging and intestinal motility: a review of factors that affect intestinal motility in the aged. Drugs Aging. 2002;19(7):515-27.

International Dysphagia Diet Standardisation Initiative. Complete IDDSI Framework. Detailed definitions 2.0 | 2019. [Internet]. 2019 p. 1-26. Disponible en: https://iddsi.org/IDDSI/media/images/Complete_IDDSI_Framework_Final_31July2019.pdf

Soenen S, Rayner CK, Horowitz M, Jones KL. Gastric Emptying in the Elderly. Clin Geriatr Med. 2015;31(3):339-53.

Watson LE, Xie C, Wang X, Li Z, Phillips LK, Sun Z, et al. Gastric Emptying in Patients With Well-Controlled Type 2 Diabetes Compared With Young and Older Control Subjects Without Diabetes. J Clin Endocrinol Metab. 2019;104(8):3311-9.

Huang HH, Wang TY, Yao SF, Lin PY, Chang JCY, Peng LN, et al. Gastric Mobility and Gastrointestinal Hormones in Older Patients with Sarcopenia. Nutrients. 2022;14(9):1897.

Serra-Prat M, Mans E, Palomera E, Clavé P. Gastrointestinal peptides, gastrointestinal motility, and anorexia of aging in frail elderly persons. Neurogastroenterol Motil Off J Eur Gastrointest Motil Soc. 2013;25(4):291-e245.

Wysokiński A, Sobów T, Kłoszewska I, Kostka T. Mechanisms of the anorexia of aging-a review. Age Dordr Neth. 2015;37(4):9821.

Feldman M, Cryer B, McArthur KE, Huet BA, Lee E. Effects of aging and gastritis on gastric acid and pepsin secretion in humans: a prospective study. Gastroenterology. 1996;110(4):1043-52.

Porter KM, Hoey L, Hughes CF, Ward M, Clements M, Strain J, et al. Associations of atrophic gastritis and proton-pump inhibitor drug use with vitamin B-12 status, and the impact of fortified foods, in older adults. Am J Clin Nutr. 2021;114(4):1286-94.

Ducker T, Truong-Leikauf M. Nutritional implications of gastrointestinal disorders. En: Bernstein M, Munoz N, editores. Nutrition for the older adult.e3ra en. Burlington, Massachusetts: Jones & Bartlett Learning; 2020. p. 217-51.

Schiller LR. Maldigestion Versus Malabsorption in the Elderly. Curr Gastroenterol Rep. 2020;22(7):33.

Parlesak A, Klein B, Schecher K, Bode JC, Bode C. Prevalence of small bowel bacterial overgrowth and its association with nutrition intake in nonhospitalized older adults. J Am Geriatr Soc. 2003;51(6):768-73.

Dewiasty E, Setiati S, Agustina R, Istanti R, Roosheroe AG, Abdullah M, et al. Comparisons of Characteristics and Nutritional Inadequacies in Indonesian Older Adults Consuming or Refraining from Dairy Products. Acta Medica Indones. 2022;54(2):255-65.

Dewiasty E, Setiati S, Agustina R, Roosheroe AG, Abdullah M, Istanti R, et al. Prevalence of lactose intolerance and nutrients intake in an older population regarded as lactase non-persistent. Clin Nutr ESPEN. 2021;43:317- 21.

Smith NW, Dave AC, Hill JP, McNabb WC. Nutritional assessment of plant-based beverages in comparison to bovine milk. Front Nutr. 2022;9:957486.

Islam N, Shafiee M, Vatanparast H. Trends in the consumption of conventional dairy milk and plant-based beverages and their contribution to nutrient intake among Canadians. J Hum Nutr Diet Off J Br Diet Assoc. 2021;34(6):1022-34.

Soenen S, Rayner CK, Jones KL, Horowitz M. The ageing gastrointestinal tract. Curr Opin Clin Nutr Metab Care. 2016;19(1):12-8.

Jeong E, Kim JA, Kim BS, Lee CK, Kim M, Won CW. Functional Constipation and Anorexia in CommunityDwelling Older Adults: Korean Frailty and Aging Cohort Study (KFACS). Int J Environ Res Public Health. 2021;18(11):5754.

Arco S, Saldaña E, Serra-Prat M, Palomera E, Ribas Y, Font S, et al. Functional Constipation in Older Adults: Prevalence, Clinical Symptoms and Subtypes, Association with Frailty, and Impact on Quality of Life. Gerontology. 2022;68(4):397-406.

Guo M, Yao J, Yang F, Liu W, Bai H, Ma J, et al. The composition of intestinal microbiota and its association with functional constipation of the elderly patients. Future Microbiol. 2020;15:163-75.

FitzHenry F, Eden SK, Denton J, Cao H, Cao A, Reeves R, et al. Prevalence and Risk Factors for Opioid-Induced Constipation in an Older National Veteran Cohort. Pain Res Manag. 2020;2020:5165682.

Park H, Lim J, Baek JY, Lee E, Jung HW, Jang IY. Status of Constipation and Its Association with Sarcopenia in Older Adults: A Population-Based Cohort Study. Int J Environ Res Public Health. 2021;18(21):11083.

van der Schoot A, Drysdale C, Whelan K, Dimidi E. The effect of fiber supplementation on chronic constipation in adults: an updated systematic review and metaanalysis of randomized controlled trials. Am J Clin Nutr. 2022;nqac184.

Dorner B, Friedrich EK. Position of the Academy of Nutrition and Dietetics: Individualized Nutrition Approaches for Older Adults: Long-Term Care, Post-Acute Care, and Other Settings. J Acad Nutr Diet. 2018;118(4):724-35.

Landi F, Liperoti R, Lattanzio F, Russo A, Tosato M, Barillaro C, et al. Effects of anorexia on mortality among older adults receiving home care: an observation study. J Nutr Health Aging. 2012;16(1):79-83.

Moss C, Dhillo WS, Frost G, Hickson M. Gastrointestinal hormones: the regulation of appetite and the anorexia of ageing. J Hum Nutr Diet Off J Br Diet Assoc. 2012;25(1):3-15.

Besora-Moreno M, Llauradó E, Tarro L, Solà R. Social and Economic Factors and Malnutrition or the Risk of Malnutrition in the Elderly: A Systematic Review and Meta-Analysis of Observational Studies. Nutrients. 2020;12(3).

Hengeveld LM, Boer JMA, Gaudreau P, Heymans MW, Jagger C, Mendonça N, et al. Prevalence of protein intake below recommended in community-dwelling older adults: a meta-analysis across cohorts from the PROMISS consortium. J Cachexia Sarcopenia Muscle. 2020;11(5):1212-22.

Deutz NEP, Bauer JM, Barazzoni R, Biolo G, Boirie Y, Bosy-Westphal A, et al. Protein intake and exercise for optimal muscle function with aging: recommendations from the ESPEN Expert Group. Clin Nutr Edinb Scotl. 2014;33(6):929-36.

Liu X, Hu Z, Xu X, Li Z, Chen Y, Dong J. The associations of plant-based protein intake with all-cause and cardiovascular mortality in patients on peritoneal dialysis. Nutr Metab Cardiovasc Dis NMCD. 2020;30(6):967-76.

Huang J, Liao LM, Weinstein SJ, Sinha R, Graubard BI, Albanes D. Association Between Plant and Animal Protein Intake and Overall and Cause-Specific Mortality. JAMA Intern Med. 2020;180(9):1173-84.

Naghshi S, Sadeghi O, Willett WC, Esmaillzadeh A. Dietary intake of total, animal, and plant proteins and risk of all cause, cardiovascular, and cancer mortality: systematic review and dose-response meta-analysis of prospective cohort studies. BMJ. 2020;370:m2412.

van Asselt D, de Groot LCPGM. Aging and Changes in Body Composition. En: Raats MM, de Groot LCPGM, van Asselt D, es. Food for the Aging Population [Internet]. 2da ed. Woodhead Publishing; 2017 [consuitado 4 de abril de 2022]. p. 171-84.. Disponible en: https://www.sciencedirect.com/science/article/pii/ B9780081003480000081

Cruz-Jentoft A, Bahat G, Bauer J, Boirie Y, Bruyere O, Cederholm T. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(4):16- 31.

Han A, Bokshan SL, Marcaccio SE, DePasse JM, Daniels AH. Diagnostic Criteria and Clinical Outcomes in Sarcopenia Research: A Literature Review. J Clin Med. 2018;7(4).

Xia L, Zhao R, Wan Q, Wu Y, Zhou Y, Wang Y, et al. Sarcopenia and adverse health-related outcomes: An umbrella review of meta-analyses of observational studies. Cancer Med. 2020;9(21):7964-78.

Melo LA de, Lima KC de. Prevalence and factors associated with multimorbidities in Brazilian older adults. Cienc Saude Coletiva. 2020;25(10):3869-77.

Vetrano DL, Damiano C, Tazzeo C, Zucchelli A, Marengoni A, Luo H, et al. Multimorbidity Patterns and 5-Year Mortality in Institutionalized Older Adults. J Am Med Dir Assoc. 2022;S1525-8610(22)00107-4.

Gutiérrez-Valencia M, Aldaz Herce P, Lacalle-Fabo E, Contreras Escámez B, Cedeno-Veloz B, Martínez-Velilla N. Prevalence of polypharmacy and associated factors in older adults in Spain: Data from the National Health Survey 2017. Med Clin (Barc). 2019;153(4):141-50.

Eyigor S, Kutsal YG, Toraman F, Durmus B, Gokkaya KO, Aydeniz A, et al. Polypharmacy, Physical and Nutritional Status, and Depression in the Elderly: Do Polypharmacy Deserve Some Credits in These Problems? Exp Aging Res. 2021;47(1):79-91.

Darmon P, Kaiser MJ, Bauer JM, Sieber CC, Pichard C. Restrictive diets in the elderly: never say never again? Clin Nutr Edinb Scotl. 2010;29(2):170-4.

Thibault R, Abbasoglu O, Ioannou E, Meija L, OttensOussoren K, Pichard C, et al. ESPEN guideline on hospital nutrition. Clin Nutr Edinb Scotl. 2021;40(12):5684- 709.

Ministerio de Proteccion Social. SABE Colombia 2015: Estudio Nacional de Salud, Bienestar y Envejecimiento. Resumen ejecutivo. Bogotá, Colombia: Ministerio de Salud y Proteccion Social; 2015 p. 6.

Lactose content of different foods [Internet].Uptodate.com. 2022 [Consuitado 31 de mayo de 2022]. Disponible en:

https://www.uptodate.com/contents/image?imageKey=PI%2F55938

Calvo M. Nutrición en el paciente polimedicado. Nutr Hosp. 2012;5(1):64-76.

Reyes-Torres CA, Castillo-Martínez L, Reyes-Guerrero R, Ramos-Vázquez AG, Zavala-Solares M, CassisNosthas L, et al. Design and implementation of modified-texture diet in older adults with oropharyngeal dysphagia: a randomized controlled trial. Eur J Clin Nutr. 2019;73(7):989-96.

Shimizu A, Fujishima I, Maeda K, Murotani K, Kayashita J, Ohno T, et al. Texture-Modified Diets are Associated with Poor Appetite in Older Adults who are Admitted to a Post-Acute Rehabilitation Hospital. J Am Med Dir Assoc. 2021;S1525-8610(21)00484-9.

Jastaniah N, Sagim RA, Sanyour RM, Alamri DM, Bajandouh RH, Shaheen EA, et al. A Retrospective Chart Review: The Prevalence of Hyponatremia Among Elderly Inpatients in a Tertiary Care Centre in Saudi Arabia. Cureus. 2022;14(3):e22960.

Borkhanova EG, Khalfina TN, Maksudova AN. ¿Should we prescribe low-protein diet for geriatric patient with chronic kidney disease? Vopr Pitan. 2022;91(2):21-30.

Norman K, Haß U, Pirlich M. Malnutrition in Older AdultsRecent Advances and Remaining Challenges. Nutrients. 2021;13(8):2764.

Cómo citar

[1]
López, D. et al. 2022. Cambios gastrointestinales en el envejecimiento: impacto sobre la alimentación y el estado nutricional . Medicina. 44, 3 (nov. 2022), 396–414. DOI:https://doi.org/10.56050/01205498.2185.

Descargas

Los datos de descargas todavía no están disponibles.

Descargas

Publicado

2022-11-17

Número

Sección

Artículos de Revisión
Crossref Cited-by logo