Cost-effectiveness of nutritional support in the elderly.

There is clear evidence that nutritional support is effective in elderly patients, reducing mortality, morbidity and in some cases hospital stay. Its effectiveness depends upon its being part of an overall management strategy, including screening for patients at risk and appropriate nutritional policies. The extra cost of meals of high energy density, extra snacks and food supplements is minimal compared with the potential benefit. Artificial feeding by the enteral or parenteral route is extremely effective, especially when carried out by an expert team and in appropriately-selected patients in whom the outcome justifies the additional expenditure.