“Doc, I read on the Internet that probiotics might help me. Is it true?”

Patrick Alexander Wachholz  is a Geriatrician, Research associate at Botucatu Medical School, São Paulo State University (UNESP). His paper Effectiveness of probiotics on the occurrence of infections in older people: systematic review and meta-analysis was recently published in Age and Ageing journal.

In 2001, an international Joint Expert Consultation of sci­entists working on behalf of the Food and Agriculture Organization of the United Nations (FAO) and the World Health Organization (WHO) defined probiotics as “live microorganisms which, when administered in adequate amounts, confer a health benefit on the host”.

Probiotics are intended to have health benefits, and in some countries we can find a huge variety of products sold as probiotics including foods (such as yogurt and fermented milk), dietary supplements, and products that aren’t used orally, such as skin or vaginal creams.

Spring Speakers Series: Why worry about mouthcare?

Sam Shah discusses the HEE supported project exploring hydration, nutrition and mouthcare in hospital and community care settings. The project involves training staff and raising awareness to improve the quality of care, to help avoid admission and to support discharge. The insights from this project will be shared at the  BGS Spring Meeting in Gateshead on the 28th April at 9:30-11:00.

We are all accustomed to brushing our own teeth and cleaning our mouths, it’s entrenched in the daily routines of most people. Most of us are able to eat and drink ourselves and we understand the link between what we eat and our how our bodies respond. A big challenge in the care of frail older people, and those in high needs settings, is ensuring their hydration, nutrition and mouthcare needs are supported.

Oral health; the gateway to hydration, nutrition, and medication

Yasmin Allen @missdiplom and Nikki Patel @NikkiPatel_

Yasmin is currently working as a clinical fellow in leadership and management in the HEE, her work includes promoting collaboration between health care professionals and the dental team, unscheduled dental care and improving oral health for older people in community and hospital settings. Yasmin also works clinically in the out of hours emergency dental care service on weekends.

Nikki is a community dental officer who looks after the oral health of dependant elderly or medically compromised individuals. She is currently pursuing her Fellowship in Clinical Leadership at Health Education England in London, where she is involved with projects and strategies to overall improve the oral health of the population and develop new and improved ways of working.

 

Cast your mind back to when you opened your eyes this morning. Then think of how your mouth felt at that time; I bet it was dry, uncomfortable, had a horrible taste and you most likely felt some plaque roughening the surfaces of your teeth. Now think about how your mouth would feel if you hadn’t brushed your teeth after waking up. Or you didn’t brush them for a week after, or even a few weeks after. Your mouth and teeth will now almost certainly feel dirty, odorous, uncomfortable and in turn it may affect your confidence and well being. This is what happens to dependant elderly people far too regularly than we would like to admit. These are the people whose personal care, including their hair care, foot care, nails care and continence care is being delivered as part of their overall support. Yet there is often one part of personal care which is frequently overlooked- the mouth.

Treating dysphagia: understanding the need for training

Helen Willis is a Dietitian at Wiltshire Farm Foods: in this blog she looks at caring for older people with dysphagia, and the importance of proper training

It is often the case that with such a media and governmental focus on health issues such as obesity, other nutritional issues get pushed aside and given little focus. One example is the very common swallowing condition, dysphagia.

Book review: Manual of Nutritional Therapeutics

Margot Gosney is Professor of Elderly Care Medicine at the University of Reading and Consultant Physician at the Royal Berkshire NHS Foundation Trust. Here she reviews the Manual of Nutritional Therapeutics.

The 6^th edition of this very detailed book has just been published: the fact that it has continued to be relevant and required reading since its first publication in 1983 indicates its usefulness. The American editors have gone out of their way to cover subjects not only in great detail, but also to provide very relevant and up to date references to support the chapters.

One third of care home residents may suffer muscle dysfunction

A new report published in Age & Ageing gives updated figures on the prevalence of sarcopenia (muscle dysfunction), and calls for active screening of older adults along with exercise programs to help manage the condition. The systematic review revealed new details around sarcopenia – an important health condition which is associated with an increased risk of falls and functional dependence.

The report shows that sarcopenia may affect as many as 1 in 20 adults, and up to 1 in 3 care home residents. These findings come from an international collaborative study, which uses a new international consensus definition of sarcopenia to draw together all the results from recent cutting-edge research.

The report also reveals that there are successful treatments available to manage the condition. Exercise interventions, including endurance and resistance training, appear to improve muscle strength and function, as do short term nutritional intervention trials using proteins, essential amino acids, leucine or beta-hydroxy beta-methylbutyrate (although evidence from longer-term trials is sparse).

Frequent consumption of fruit and vegetables inversely associated with sarcopenia

Yunhwan Lee is a professor and Jinhee Kim is a research fellow in the Department of Preventive Medicine and Public Health of Ajou University School of Medicine, and the Institute on Aging of Ajou University Medical Center in the Republic of Korea. His paper was recently published in Age and Ageing journal.

Sarcopenia, the gradual loss of muscle mass with age, is now widely recognised as a major health problem in late life. Older people with sarcopenia are prone to suffering from frailty, falls, and disability that negatively affects their quality of life. Because there is currently no effective treatment for sarcopenia, it is important to identify risk factors that have a modifiable influence on the condition.

Vitamin D and bone health: A practical clinical guideline for patient management – National Osteoporosis Society Guideline

Dr Terence Ong is a Research Fellow at Nottingham University Hospitals NHS Trust.

Professor Opinder Sahota is Professor of Orthogeriatric Medicine and Consultant Physician at Nottingham University Hospitals NHS Trust

image by epSos.de

Vitamin D is not, in the truest sense, a vitamin because it is not exclusively obtained through diet alone. It is a secosteroid, mostly obtained intrinsically by the effect of ultraviolet radiation on previtamin D compounds and subsequent hydroxylation in the liver and kidneys.

Vitamin D plays an important role in calcium and phosphate homeostasis through its effect on gut and bone metabolism. Besides that, it also plays a key role in muscle function. In recent years, our understanding of vitamin D has expanded and we are starting to appreciate its much broader role in areas such as the immune system, cancer and cardiovascular disease.

Practical Guidance to Help Identify and Combat Malnutrition in Frail Older People

Prof Paul Knight is President of the BGS and is Director of Medical Education and Consultant Physician at the Royal Infirmary, Glasgow.

The issue of malnutrition has been brought into sharp focus by the Francis report, where harrowing witness accounts highlighted how patients suffer when patient nutrition and assistance with feeding is not given adequate priority.  However, as geriatricians, we have long recognised the importance that adequate intake of food and fluid plays in gold-standard patient care.