ABSTRACT
Aging is associated with a decline in immune competence and an increased risk of infection (see Chapter 4). Nutritional factors have been shown to playa significant role in age-associated immune dysfunction (1-4), and the prevalence ofmalnutrition among older adults is greatest in residents of long-term care facilities (LTCFs) (5,6). Reversal of underlying nutritional deficits is an attractive and inexpensive option for reducing morbidity and mortality in elderly residents of LTCFs; however, there are few randomized, controlled trials of sufficient power to clearly define the utility of such interventions for clinical endpoints. Most frequently, surrogate markers of nutrition or immune function (i.e., reversal of previously documented vitamin deficiency, increases in serum albumin, vaccine responses, or delayed-type hypersensitivity reactions) have been the outcomes measured in clinical trials. With this limitation clearly stated, this chapter will review the prevalence, causes, methods of detection, and clinical relevance of malnutrition in residents of LTCFs, and provide evidence-based suggestions for practical interventions to boost immune response and reduce the risk of infection in this at-risk population.
