Category Archives: Clinical Conditions

Differentiating Mild Cognitive Impairment from Normal Ageing

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Mild Cognitive Impairment is defined as significant memory loss beyond that which would be expected due to normal ageing without the loss of other cognitive functions and refers to the transitional state between the cognitive changes of normal ageing and very early dementia.1

MCI is a common condition encountered by clinicians and is estimated to occur in 12–18% of people aged ≥60 years.2

MCI is heterogeneous but in approximately 50% of cases represents a transitional state between normal aging and dementia.3

It is estimated that people with MCI have a 3 to 5 times increased risk of developing dementia with about 15% of patients progressing to dementia each year.4

In 2001, the American Academy of Neurology (AAN) set the following criteria for use by medical practitioners in determining if a person has MCI4,5

  • Report of memory problems, preferably confirmed by another person.
  • Measurable, greater-than-normal memory impairment detected with standard memory assessment tests.
  • Normal general thinking and reasoning skills.
  • Ability to perform normal daily activities.

A recent update of these criteria allows the person to be unaware of the memory problems and allows more complex activities, such as managing finances, to be affected.6

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What is Mild Cognitive Impairment and how does it differ from normal aging?

MCI causes cognitive changes that are serious enough to be noticed by the person affected and by family members and friends but may not affect the individual’s ability to carry out everyday activities.2

Presented by Associate Professor Michael Woodward AM, Geriatrician & Director of Aged Care Research, Austin Health

Associate Professor Michael Woodward discusses Mild Cognitive Impairment and how it differs from normal ageing and dementia .

It can be challenging to differentiate MCI from normal ageing.

Normal Ageing MCI
Occasionally losing items in the house. Misplacing/ losing items in the house keys/wallet more regularly so a fix is put in place – eg a hook at the front door.
Forgetting appointments or events occasionally and usually for a reason like fatigue or stress. Having trouble keeping track of dates and appointments so now using a diary all the time/ white board in the kitchen.
Occasional trouble recalling the names of people or places. Having occasional difficulty finding the right word for items usually known e.g. ‘carburettor’ for a car mechanic or ‘the bowers’ for a bridge player.
Going the wrong way in less familiar environments e.g. new city or large shopping centre. Double checking the route even if travelled before. Errors in navigating to familiar places, not taking the most direct route.
Can tire more easily. Unexpected irritability, anxiety, depression or apathy.
Takes more time to learn a new or unfamiliar process e.g. setting up a new appliance. Struggles with more complex processes and needs assistance e.g. eBanking/credit card or smartphone updates.
Clinical examples provided by Associate Professor Mark Yates, Geriatrician. September 2022

What is the trajectory for patients with MCI?

GPs play an essential role in the early detection and management of MCI with the possibility of stabilising and even reversing cognitive decline if treatable causes are identified and managed.

Presented by Associate Professor Mark Yates, Geriatrician, Grampians Health and Deakin University and Associate Professor Michael Woodward AM, Geriatrician & Director of Aged Care Research, Austin Health

Associate Professors Mark Yates and Michael Woodward discuss the possible trajectories for a person with Mild Cognitive Impairment.

Early and accurate diagnosis of Mild Cognitive Impairment provides a window of opportunity to improve patient outcomes using a personalized care plan including lifestyle modifications to reduce the impact of modifiable risk factors (for example, blood pressure control and increased physical activity), cognitive training, dietary advice, and nutritional support.3

Souvenaid® slows the decline of cognition and memory by 60% in MCI (Prodromal AD) when taken daily over 3 years9

Souvenaid® is a once-daily medical drink containing a combination of nutritional precursors and cofactors (long-chain omega-3 fatty acids, uridine, choline, B vitamins, vitamin C, vitamin E, and selenium), and was developed to support the formation and function of neuronal membranes and synapses.10

LipiDiDiet Results

The European Commission-funded LipiDiDiet Clinical trial9 investigated the impact of Souvenaid® on patients with Mild Cognitive Impairment (prodromal AD).

The daily consumption of Souvenaid® over a 3-year period significantly slowed decline in cognitive function, thinking skills, memory and brain atrophy compared to placebo9.

The authors conclude that the present study provides evidence for potentially altered disease trajectories supporting the positive effects of long-term multi-nutrient intervention in prodromal AD.9


First Australian MCI Recommendations

Recent Australian recommendations on approaching the Detection, Assessment, and Management of Mild Cognitive Impairment have also supported the role of Souvenaid® for patients with MCI.7

Download MCI recommendation infographic

Recommendation 28

A medical food, Fortasyn® Connect*, has been shown in one 3 year randomised controlled trial to slow the decline in cognition and delay hippocampal atrophy in those with prodromal AD, and patients with MCI should be informed of these results and the availability of Fortasyn® Connect in Australia.7,9

*Souvenaid® contains Fortasyn® Connect.

Please see below link to access the publication

Access the publication here

Souvenaid® is a food for special medical purposes for the dietary management of early Alzheimer’s disease and must be used under medical supervision.

  1. Petersen, R., & Negash, S. (2008). Mild Cognitive Impairment: An Overview. CNS Spectrums, 13(1), 45-53
  2. Alzheimer’s Association. 2022 Alzheimer’s Disease Facts and Figures. Alzheimer’s Dement 2022;18. Available online: (accessed September 2022).
  3. Cummings J et al., Souvenaid in the management of mild cognitive impairment: an expert consensus opinion. Alzheimer’s Res Ther. 2019 Aug 17;11(1):73
  4. Dementia Australia. Mild Cognitive Impairment. Available online: (accessed September 2022).
  5. Petersen RC et al. Practice parameter: early detection of dementia: mild cognitive impairment (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2001 May 8;56(9):1133-42
  6. Ronald C. Petersen et al. Practice guideline update summary: Mild cognitive impairment. Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology Jan 2018, 90 (3) 126-135;
  7. Woodward M, et al. Nationally Informed Recommendations on Approaching the Detection, Assessment, and Management of Mild Cognitive Impairment. Journal of Alzheimer’s Disease, vol. 89, no. 3, pp. 803-809, 2022. Nutricia has no affiliation with the authors of this publication.
  8. Shimada H, et al. Reversible predictors of reversion from mild cognitive impairment to normal cognition: a 4-year longitudinal study. Alzheimer’s Res Ther. 2019;11:24
  9. Soininen H, et al. 36-month LipiDiDiet multinutrient clinical trial in prodromal Alzheimer’s disease. Alzheimer’s Dement. 2021;17:29–40
  10. Sijben J et al. (2011). A multi nutrient concept to enhance synapse formation and function: Science behind a medical food for Alzheimer’s disease. OCL. 18. 267-270. 10.1051/ocl.2011.0410.
  11. Scheltens P et al. Efficacy of a medical food in mild Alzheimer’s disease: A randomized, controlled trial. Alzheimers Dement 2010; 6(1): 1–10.e1.
  12. Scheltens P et al. Efficacy of Souvenaid in mild Alzheimer’s disease: results from a randomized, controlled trial. J Alzheimers Dis 2012; 31(1): 225–36.

Wound Care

Wound Care

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Wounds can be caused by injury, surgery, pressure or friction. The skin acts as a protective barrier so any damage to it increases the chances of infection. There are two types of wounds: acute and chronic. An acute wound is one that usually heals as it should, in an ordered, timely fashion. A chronic wound is one that develops over a longer period of time. Examples of chronic wounds include pressure injuries (also called bed sores or pressure sores/ulcers), leg ulcers, diabetic wounds (including diabetic foot and diabetic ulcers). Wounds which are slow to heal, or which do not heal, can cause both severe emotional and physical stress. Good wound care aims to support the wound healing process through the use of dressings, pressure relief, and correct nutrition.

Wound Care - 1 | Nutricia Adult Healthcare

The role of nutrition

The importance of good nutrition in the healing of wounds is widely accepted by healthcare professionals, but may not be something we automatically think about. Where good nutrition facilitates healing, poor or undernutrition inhibits it.

There are certain nutrients that have a key role to play in the wound healing process. Protein is the building block of all the major organs in the body including skin and muscle. It is essential in making sure that the infection fighting cells of the body function properly and helps repair damaged tissue from the wound. Other essential nutrients include arginine, vitamin C, E, Selenium and Zinc, which all play key roles in the wound healing process.

Adequate energy intake in the form of carbohydrates and fat is also important as the body has an increased demand to support the healing process. Dehydration can also impair the wound healing process, so it’s essential to ensure plenty of fluids are taken throughout the day.

Wound Care - 2 | Nutricia Adult Healthcare

Future based research

At Nutricia we are committed to improving quality of life for patients and providing healthcare providers with nutritional solutions to help them in their everyday practice. That’s why scientists at our world-class research facilities in Utrecht, develop products through pioneering research into the effective management of wound care through nutrition.

Wound Care - 3 | Nutricia Adult Healthcare

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Cancer diagnosis is a life-changing event for both patients and the people around them. For many reasons, the incidence of cancer is expected to rise over the coming years. An aging population, urbanisation, decrease in exercise, obesity and smoking are all contributing to the increasing numbers.

One of the most common physical changes experienced is weight loss; in fact one in three patients with cancer are likely to lose weight at some point during their illness. There are lots of reasons for this, from reduced food intake due to psychological factors, or physical limitations and metabolic changes caused by the disease and/or its treatment.

Oncology - 1 | Nutricia Adult Healthcare

The role of nutrition

Patients with cancer can experience a range of nutritional problems, including poor appetite, weight loss and/or swallowing problems. Some of these issues can be caused by the cancer itself, while some are due to the effects of treatment. The links between undernutrition and recovery (‘clinical outcomes’) are well known and include a reduced response to chemotherapy, higher hospital readmission rates and a lower quality of life.

At Nutricia we strive to make a positive and proven difference in patients’ lives, by supporting patients, carers and societies throughout the journey and helping to deliver a better quality of life.

Oncology - 2 | Nutricia Adult Healthcare

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Frailty & Malnutrition

Frailty & Malnutrition

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A healthy, nutritionally balanced diet is important throughout our lives, but as we age or become unwell it can be difficult to achieve the optimal nutrition we need.  When the body doesn’t get enough energy, protein and other nutrients it can become malnourished. Common consequences of malnutrition include a greater chance of infection, weakness/fatigue, decreased bone strength, slower wound healing and even impaired functioning of the heart, lungs and gastrointestinal (GI) system.

The role of nutrition in frailty

Disease-related malnutrition can lead to loss of muscle mass, which reduces body strength and walking speed. This is a state known as ‘frailty’. This in turn reduces a patient’s overall activity and energy levels. The vicious circle of reduced energy leading to more restrictions of physical activity can eventually lead to a loss of independence. Frail patients need extra medical attention in order to reduce the risk of them becoming dependent on others and to stay as independent as possible for as long as possible. Patients typically enter a spiral of decline in which inadequate nutrition leads to muscle weakness, increasing frailty and risk of costly injury (falls, etc.) and disability.

Frailty is a medical condition that affects both the brain and the body, and can leave older patients vulnerable, both immediately and in the future. With little strength left in reserve, frail patients often have a low resistance to even the most minor of illnesses, meaning something like a urinary tract infection can result in a greater risk of the onset of disability or even institutionalisation. Providing healthy and balanced nutrition to patients is key for their overall care.

Patient stories

Learn more about how nutritional supplementation has affected the lives of one couple in the UK.

Physical frailty

As mentioned, physical frailty can be induced by disease-related malnutrition. We can split frail older patients in two groups: the first is the group that have involuntary weight loss and show physical frailty. The second is the group that do not show involuntary weight loss (yet) but do show signs of physical frailty. Older patients with physical frailty may benefit from preventative interventions against disability.
In a consensus paper a group of geriatricians and gerontologists discuss screening and treatment for older patients with physical frailty¹. Their recommendations consist of an exercise program, dietary management with high energy, high protein products, calcium and vitamin D supplementation.

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  1. Morley JE, et al. Frailty Consensus: a call to action. JAMDA 14 (2013): 392 397.

Early Alzheimer’s Disease

Memory and Alzheimer's Disease

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Alzheimer’s disease is a complex condition that often starts to develop decades before symptoms appear. Early signs include memory problems and difficulties with complex tasks. These signs can be subtle and people often think this is a result of ageing. In the early stages of Alzheimer’s disease, certain regions in the brain crucial for memory are affected. This causes the frequency and severity of memory lapses to become more evident than with normal aging.Our brains communicate through a vast network of billions of nerve cells. These nerve cells connect with each other through connections called ‘synapses’. Throughout our lives we lose and regrow these brain connections. In a healthy brain the amount of new synapses generated balances the loss of older ones. In the case of Alzheimer’s disease, the rate at which these connections are damaged accelerates so that new ones formed can no longer compensate for those lost. This is when the brain network starts to fail and symptoms such as memory loss appear.

Nutricia’s pledge to providing the Best Care in the field of Alzheimer’s disease

Meet the patients, carers and healthcare professionals who are benefitting from Nutricia’s approach to the dietary management of early Alzheimer’s Disease. 

Nutrition and the brain

Nutrients within food are important for keeping the brain tissue healthy. Specific key nutrients are important to help build the brain connections or synapses.
These nutrients are :
  • Omega 3 fatty acids
  • Uridine
  • Choline
  • B Vitamins
  • Antioxidants
  • Phospholipids
Studies have shown that people with early Alzheimer’s disease often have low levels of these key nutrients, despite eating a normal diet. Increased intake of these nutrients is necessary because the pathways supporting synapse formation and function depend on them. Research has shown that taking these single nutrients alone or together has not consistently demonstrated benefits in early Alzheimer’s disease. In contrast, a multi-nutrient combination, taken daily at the right levels, have shown benefits in clinical trials in early Alzheimer’s disease. Other benefits that have been reported by patients taking this multi-nutrient combination, are lower levels of apathy, increased energy, alertness and improved mood. This was reported to lead to increasing social interactions, renewed interest in hobbies and restarting activities recently stopped due to the illness.
Early Alzheimers Disease - 2 | Nutricia Adult Healthcare

The role of nutrition in brain health

Learn more about how certain nutrients can help rebuild connections in the brain.

Patient stories

Patients around the world are taking Souvenaid today. Learn more about one family’s real-life experiences here.

Souvenaid stories

Healthcare professionals from around the world are using Souvenaid with their patients with early Alzheimer’s disease. Learn more about their experiences here.

Inaugural MCI Masterclass 2021: This Australia first event led by Associate Professor Michael Woodward and Associate Professor Mark Yates brought together leading experts to present the latest evidence and insights which will help drive change in the early identification and management of patients with mild cognitive impairment.

For Carers and Patients

Are you a carer or a patient who has been recommended to take Souvenaid by your Healthcare Professional? Please visit our consumer website for more information.
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Souvenaid is a food for special medical purposes that nutritionally supports memory function during the early stages of Alzheimer's disease.
  1. Scheltens P, et al. Alzheimers Dement. 2010;6:1-10.e1.
  2. Scheltens P, et al. J Alzheimer’s Dis.2012;31:225-236.
  3. Olde Rikkert MG, et al. J Alzheimers Dis. 2015;44(2):471-80.
  4. Bianchetti A et al. Psicogeriatria 2014; 9(2):66-75.
  5. Kalisvaart CJ et al. European Geriatric Medicine 2014; 5 (S1): 98. Poster P051.
  6. Freund-Levi Y, et al. J Nutr Health Aging. 2012; 16(9): 859.
  7. *LipiDiDiet, is registered under the European Union’s 7th Framework Programme for research, technological development and demonstration (grant agreement number 211696).

Dysphagia & Stroke

Dysphagia and Stroke

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Dysphagia Stroke - 1 | Nutricia Adult Healthcare

A stroke is distressing for both the patient and their family. It is caused by a disruption of the blood supply to a part of the brain, either by a blood clot (most common) or a weakened blood vessel. Strokes can result in problems with movement and balance, as well as swallowing difficulties, also known as dysphagia. Dysphagia, which occurs in around half of stroke patients, can also be brought on as a side effect of the treatment of some forms of cancer, as well as neurological disorders such as dementia, Parkinson’s disease, multiple sclerosis and other conditions. It can not only be an uncomfortable and sometimes painful condition, but also potentially a dangerous one, with patients at risk of choking and lung problems, including pneumonia.

The role of nutrition

Swallowing difficulties can lead to increased anxiety at mealtimes. The risk of drinks or food “going down the wrong way” leads to loss of enjoyment when eating or drinking with patients reducing their fluid and food intake out of worry. The levels of malnutrition and dehydration in stroke patients is high and can affect the recovery process.

It is important that stroke patients have their nutritional ‘risk’ assessed by a qualified healthcare professionals and, if necessary, appropriate nutritional management put in place to improve the chances of recovery.

An effective and widely used way of managing dysphagia is to change the consistency and texture of food and drinks. This makes it easier and safer for people with swallowing difficulties to control their swallow, significantly reducing the chance of food or fluids entering the lungs, and ensuring they get the nutrition they need.

Dysphagia Stroke - 2 | Nutricia Adult Healthcare

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Critical Care and Surgery

Critical Care and Surgery

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Critical Care Surgery - 1 | Nutricia Adult Healthcare

Intensive Care Units (ICU) today are treating older patients with more complications than ever before. However, their chances of survival and recovery have significantly improved in the past decade due to advances in science and technology. New surgical techniques and improved anesthesia, as well as improved pre and post nursing care, optimal nutrition and early mobilisation has helped to reduce the impact of surgery on patients. These advancements in healthcare enable patients to return home more quickly, spending less time in the ICU and the hospital, while at the same time reducing hospital costs.¹⁻³ Patients are now able to recover earlier enabling them to return to their normal lives more speedily.

The role of nutrition in critical care

There has also been scientific progress in the field of medical nutrition, and now there is a better understanding of optimal feeding in the critical care setting. ⁴⁻⁹ Both clinical nutrition guidelines and ICU experts have recognised the need for a new, individualised approach to nutritional care.¹⁰⁻¹⁴ At Nutricia we are aware of the importance of optimal nutritional support and continue to develop our science and technology – offering innovative feeding solutions designed for the ICU and surgical environments. We support healthcare professionals by offering a comprehensive range of tube feeds, complimented with medical devices, accessories and services to provide best care to their patients.

Critical Care Surgery - 2 | Nutricia Adult Healthcare

Medical devices in critical care and surgery 

Enteral (or ‘tube’) feeding pumps, sets and tubes are used to deliver nutrition into the patient’s stomach. To help patients and their families follow the tube feeding advice given by their healthcare professional, a trustworthy enteral feeding pump is essential, both in the hospital and back at home.

Patients and healthcare practitioners need a device that is intuitive, accurate and that will not hinder movement. Nutricia’s Flocare range of innovative medical devices, accessories and supporting tools have been developed to simplify tube feeding for patients and their families, because Nutricia strongly believe that your feeding routine should fit comfortably into your daily routine.

Flocare Infinity pumps are renowned for their reliability, safety and ease-of-use. The cartridge style giving set makes it easy to set up a feed. The clear step-by-step interface makes programming your feed straightforward. Troubleshooting is facilitated by the clear audio and visual alarm messages. In addition, the robust design means that the pumps may be rinsed under running water and are usable in any orientation.

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Anderson AD et al. 20031; Gustafsson UO et al. 20122; Yeh et al. 20153; Doig GS et al. 20094; Casaer MP et al. 20115; Van Zanten AR et al. 20146; Weijs et al. 20147; Allingstrup M J et al. 20128; Elke G et al. 20149; McClave S et al. 200910; Dhaliwal R et al. 201411; Martindale RG 201512; Evans DC et al. 201513; Preiser JC. et al. 201514.