Handbook of Clinical Nutrition and Stroke by Mandy L. Corrigan Arlene A. Escuro & Donald F. Kirby

Author:Mandy L. Corrigan, Arlene A. Escuro & Donald F. Kirby
Language: eng
Format: epub
Publisher: Humana Press, Totowa, NJ

Risk Factors for the Development of Malnutrition Following Stroke

Premorbid risk factors associated with the development of malnutrition following stroke include a history of smoking [53], advanced age [10], female sex [13], and residential care [10]. The consequences of stroke can further increase a patient’s risk for poor energy and protein intake and subsequent nutritional decline post-stroke. Fatigue, depression, and anxiety may result in decreased appetite and intake [49]. Patients who are unable to communicate food preferences due to aphasia may also be at risk for decreased intake [50]. Decreased or inability to self-feed related to upper paresis, apraxia, or visual deficits may result in an inability to open containers at meals and reluctance to ask staff for help. Lack of access to between-meal snacks placed within easy reach may also contribute to inadequate intake. Half of patients surveyed in acute care hospitals in London, UK, identified barriers outside of the food itself such as organizational (meal timing and lack of assistance), physical (inappropriate eating utensils and seating), and environmental (unpleasant smells, interruptions) as impacting negatively on food intake [51]. Visual field losses such as homonymous hemianopsia (the loss of half the field of view on the same side in both eyes) may prevent a patient from seeing food on one side of the plate and potentially reduce intake unless the patient is cued to scan the affected side.

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