Position Paper: Nutrition and Physical Activity for the Very Old Human under the Aspects of Proper Muscular and Respiratory Functioning

In very old people, especially geriatric patients in clinics or residents in nursing homes, a good adequate diet, which considers the specifics of malabsorption in the very old, decides on the quality of life, cognitive abilities, and muscular fitness, but in principle on life and death. Many nutrients must be increased or given by supplementation. This is especially true for a necessary increased protein intake. Since especially the core, extremities and respiratory muscles are affected by sarcopenia in the very old and there is an increased risk of falls and of pneumonia in malnourished patients, the additional protein intake, if possible by natural means, also applies to the mobilization and pneumological therapy, which of course must be supplemented by respiratory and general muscle training. Furthermore, to reduce malabsorption, attention must be paid to a sufficient acid content in the diet, e.g. through vinegar, and a necessary increase in salt intake, whereby the middle-aged and the very elderly differ fundamentally in this respect. In this position paper, recommendations for the nutrition and the supplemental muscular training to avoid sarcopenia in the very old will be given in a language accessible also for non-physicians based on available scientific literature.