6. Geriatric syndromes

Geriatric syndromes are a set of symptoms originated from the combination of a number of diseases that have their expression through pathologies non-framed in common diseases.

The 13 geriatric syndromes were defined by Kane and include:

• Immobility
• Instability
• Incontinence
• Intellectual impairment
• Infection
• Inanition
• Impairment of vision and hearing
• Irritable colon
• Isolation (depression)/insomnia
• Iatrogenesis
• Immune deficiency
• Impotence

They follow a series of features such as: multiple disorders, multifactorial cause, onset and rapid progress, minimal clinical manifestations, sensitive to infection / dehydration / accidents, more severe in intensity of tissue damage, irreversible immobility syndrome, tendency to chronicity processes, mental confusion, acceptance of disability by the patient and family, iatrogenic responses, denial of symptoms and unfavorable prognosis.

The malnutrition 

Then I will focus on a major geriatric syndromes mentioned above, such as is the malnutrition (hunger).

Malnutrition is pathological disorder of nutrition resulting from inadequate intake of one or more essential nutrients resulting in a caloric deficit and protein. 

The causes of malnutrition in the elderly are numerous and can be grouped into: 

• Physiological causes:
• Deterioration of the senses: taste, smell and sight.
• Alterations in the oral cavity: mouth, teeth and gums are damaged, and even wear poorly fitting dentures and they cause mouth sores. Besides this, painful mouth can be caused by stomatitis, glossitis or esophageal candidiasis.
• Digestive disorders: decreased ability to chew and swallow or decreased salivary secretion.
• Psychosocial causes:
• Loneliness, boredom, depression, widowhood..
• Limitation of financial resources.
• Pathological causes:
• Polypharmacy: causes problems such as: changes in appetite, taste, constipation, weakness, drowsiness, diarrhea and nausea (among others).
• Disabilities
• Pluripathology 

Malnutrition worsens the prognosis of life and increases the risk of complications if the patient has a disease.

The Mini Nutritional Assessment (MNA) is a test that nurses make to the assessment of nutritional status in elderly patients. With this test, it is possible to identify people at risk of malnutrition.

The recommendations to develop a diet for the elderly are:

• Diets simple and easy to prepare
• Foods colorful presentation and pleasant
• Diet split into 4-5 meals a day
• The last meal (dinner) must be light
• Liquids and juices between meals were supplied (not during them).
• Moderate consumption of coffee and exciting drinks
• Do not abuse liquor and beverages sweetened
• Keep personal tastes and habits
• The timing of the intake should be an act of coexistence and social relations (where possible).

I believe that malnutrition is one of the most common geriatric problems, because the elderly when they are alone, become depressed and were "away the desire of all" and, I also believe that when a person is alone at home, the first thing that they neglected is the schedule and type of meals.

Bibliography

• Rodríguez, Ávila, N. manual de sociología gerontológica. Barcelona: Publicacions 1 edicions de la Universitat de Barcelona; 2006.
• Pubmed. [Monografía de internet]. [Fecha de consulta 18 de abril de 2013]. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/9990575
• Leturia Arrazola, F. J; Yanguas Lezaun, J. J; Arriola Manchola, E; Uriarte Méndez, A. La valoración de las personas mayores: evaluar para conocer, conocer para intervenir. Manual práctico. Cáritas; 2001.