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Ongoing population ageing is one of the factors influencing the increase in the prevalence of undernutrition, because elderly people are a vulnerable group due to their biological, psychological and social characteristics. Despite its high prevalence, undernutrition is underdiagnosed in the geriatric sphere. For this reason, the aim of this consensus document is to devise a protocol for geriatric nutritional assessment. A multidisciplinary team has been set up within the Spanish Society of Geriatrics and Gerontology (in Spanish Sociedad Española de Geriatría y Gerontología, SEGG) in order to address undernutrition and risk of undernutrition so that they can be diagnosed and treated in an effective manner. The MNA-SF is a practical tool amongst the many validated methods for nutritional screening. Following suspicion of undernutrition or after establishing the presence of undernutrition, a full assessment will include a detailed nutritional history of the patient. The compilation of clinical-nutritional and dietetic histories seeks to aid in identifying the possible risk factors at the root of a patient's undernutrition. Following this, an anthropometric assessment associated to laboratory data, will describe the patient's physical and metabolic changes associated to undernutrition. Currently, the tendency is to further nutritional assessment through the use of non-invasive techniques to study body composition in association with functional status. The latter is an indirect index for nutritional status which is very interesting from a geriatrician's point of view. To conclude, correct nutritional screening is the fundamental basis for an early undernutrition diagnosis and to assess the need for nutritional treatment. In order to achieve this, it is fundamental to foster research in the field of nutritional geriatrics, in order to expand our knowledge base and to increasingly practice evidence-based geriatrics., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)

The physiological processes of ageing and factors prevalent in the elderly such as comorbidities and polypharmacy often cause loss of appetite in the elderly, which we call anorexia of ageing. Social factors, together with changes in the sensory organs, can be important causes of a reduction in both appetite and ingestion. This review assesses the regulation of appetite in the elderly and the development of anorexia of ageing. It also examines the prevalence of this type of anorexia, its associated comorbidities and mortality rates. We have reviewed 27 studies, with a total of 6208 patients. These reported changes in the secretion and response of both central and peripheral hormones that regulate appetite. Anorexia, very prevalent among hospitalized and institutionalized elderly people, is associated with comorbidity and represents a predictive factor for mortality. No treatment for it has been proved to be effective. The mechanism regulating ingestion in elderly people is complex and difficult to resolve. Comorbidity as a cause or a consequence of anorexia of ageing has become a research field of great interest in geriatrics. A correct nutritional evaluation is a fundamental part of an integrated geriatric assessment., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)

Sarcopenia, defined as a syndrome rather than as a pathology, is the loss of muscle mass and function associated with age. Sarcopenia is an enigma for medicine, and despite the numerous publications available in the literature and the number of papers currently being published, there is no agreement about its definition, and even less about its root causes. One salient aspect that proves the lack of consensus is the fact that different working groups are still debating about the right name for this syndrome (which is associated with the loss of muscle mass and strength in the elderly). In hospitalized patients, sarcopenia has been shown to raise the risk of complications such as infections, pressure ulcers, loss of autonomy, institutionalization and poor quality of life, as well as to increase mortality. The factors that contribute to the development of sarcopenia in the elderly are: the state of chronic inflammation, atrophy of motoneurons, reduced protein intake (secondary among others to the condition defined as geriatric anorexia), and immobility. There is ongoing debate about the causes of sarcopenia, but the aspect that generates most interest today is the quest to achieve repeatable and clinically useful diagnostic criteria for its diagnosis, prevention and treatment. The aim of this narrative review is to summarise the abundant information available in the literature and to draw useful conclusions., (Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.)