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NHD > Ageing > Flashcards

Ageing Flashcards

1
Q

What is the definition of ageing?

A

Ageing:
* Gradual decrease in mental and physical capacity
* Increased vulnerability to environmental stress and disease
* Diverse deleterious changes occurring in cells and tissues with advancing age that are responsible for the increased risk of disease and death
* Varies between person to person.

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2
Q

Which part of the body is particularly vunerable to the negative effects of ageing?

A

The gastrointestinal tract is particularly vunerable to the negative effects of ageing.

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3
Q

What impairs the sense of taste and makes it more difficult to swallow food in older adults?

A

The reduction of salivary flow impairs the sense of tasteof food and makes it more difficult for older adults to swallow food.

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4
Q

Stomach ______ production is reduced in older adults.

A

Stomach acid production is reduced in older adults.

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5
Q

What does the reduction of stomach acid in older adults do?

A

The reduction of stomach acid in older adults affects the bioavailabilty of some nutrients.

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6
Q

The bioavailability of which nutrients might be affected in older adults?

A

Due to reductions of stomach acid in OAs, the bioavailability of:
* Folic acid
* Vitamin B6 (pyridoxine)
* Vitamin B12 (cobalamin)
* Iron
May be affected.

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7
Q

What makes it harder for older adults to take part in exercise?

A

Reductions in the amount of alveolar in the lungs reduces vital capacity and makes it harder for older adults to exercise.

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8
Q

Do all people age the same?

A

No people do not age in the same way.

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9
Q

Are the changes witnessed in ageing linear?

A

The changes associated with ageing are neither linear nor consistent, and they are only loosely associated with a person’s age in years.

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10
Q

What is ageing usually associated with?

A

Ageing is usually associated with:
* Retirement
* Relocation to appropriate housing (e.g. assisted living, bungalow)
* Death of loved ones

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11
Q

Which age defines the elderly/old age?

A

Old age/elderly doesn’t have a definitive age and differs across the world.

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12
Q

According to Langley-Evans 2021, which age defines old age?

A

According to Langley-Evans 2021, >/=65 years generally defines old age.

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13
Q

How many people are over 65 in the UK according to Age UK 2019?

A

According to Age UK 2019 there are nearly 12 million (11,989,322)people aged 65 and above in the UK

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14
Q

The population in the UK is getting older with ?% aged 65 and over and ?% aged >85

A

The population in the UK is getting older with 18% aged 65 and over and 2.4% aged >85

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15
Q

What is one of the major threats to living independently in older age?

A

Sarcopenia is a major threat to living independently in older age.

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16
Q

What is sarcopenia?

A

Sarcopenia is the loss of muscle, muscle strength and muscle function.

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17
Q

? plays an essential role in the health and function of elderly adults

A

**Nutrition **plays an essential role in the health and function of elderly adults

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18
Q

According to Age UK 2019, what percentage of OAs (65+) have five portions of fruit and vegetables a day?

A

According to Age UK 2019 31% of adults aged 65+ eat 5 or more portions of fruit and vegetables a day.

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19
Q

What are the gastrointestinal changes typically observed in OAs?

A

Gastrointestinal changes in OAs:
* Changes in smell and taste (reduction of saliva)
* Loss of sense of thirst
* Changes in peristaltic activity of oesophagus
* Impaired absorption of nutrients (folic acid, Vitamin b6, vitamin b12, iron) due to stomach acid reduction
* Greater satiation (feel fuller faster)-CCK

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20
Q

What are the body composition changes typically observed in OAs?

A

Body composition changes in OAs:
* Decline in lean body mass
* Loss of mobility
* Increased rates of falls
* Gain fat mass (Guo, 1999)

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21
Q

What are the bone mass changes typically observed in OAs?

A

Bone mass changes in OAs
* Bone loss (osteoporosis)
* Mainly depends on peak bone mass achieved ~20yrs old

22
Q

What is osteoporosis?

A

Osteoporosis:
* Bone loss
*bone disease that develops when bone mineral density and bone mass decreases, or when the structure and strength of bone changes.

23
Q

What is vital capacity?

A

Vital capacity is the greatest volume of air that can be expelled from the lungs after taking the deepest possible breath.

24
Q

In regards to changes in taste in older adults, what might happen to the tongue?

A

In OAs there may be a progressive loss in the number of taste buds per papilla on the tongue.

25
Q

What does bone mass in older adults mainly depend on?

A

Bone mass in older adults mainly depends on: peak bone mass achieved ~20yrs old

26
Q

What might cause changes in swallowing in OAs?

A

Changes in peristaltic activityof the esophagus may result in a delay in esophageal emptying, affecting swallowing in OAs

27
Q

What is cholecystokinin (CCK)?

A

Cholecystokinin (CCK) is:
* Peptide hormone
* Produced in L cells of duodenum (small intestine)
* Also released by brain neurons
* Key hormone for digestion

28
Q

What does cholecystokinin (CCK) do?

A

Cholecystokinin:
* reduces appetite, promotes satiety (short term during a meal)
* slows down emptying of food from stomach
* stimulates bile production and release from gall bladder
* increases the release of fluid and enzymes from the pancreas to break down macronutrients.
* induces gallbladder contraction
* reduces gastric acid secretion

29
Q

Energy requirements for older adults

A

Energy requirements for older adults
- Needs decline 5% per decade
- Healthy adults: lower requirements with advancing age
- Due to decreased muscle mass and increased fat mass
- Older adults have less muscle and more fat

30
Q

What are the PROT-AGE recommendations for older adults?

A

PROT-AGE recommendations for older adults:
- 1.0g-1.2g/kg of protein per day
- 25-30g of protein per meal
- 2.5-2.8g of protein contributed should be from leucine to maintain optimum protein anabolism

31
Q

Micronutrient intake

A

Micronutrient intake
- Vitamin A: Absorption and storage no cause for concern. Processing time reduces.
- Vitamin D: Deficiency risks, needed for bone health and necessary for calcium absorption. 10ug per day during autumn and winter. Oily fish and margarine to be eaten regularly.
- Vitamin B6: Metabolism altered with age. Higher requirement

  • Vitamin B12: Low/deficient vitamin B12 status common in elderly Digestion inefficient Bacteria of inflamed stomach use it Anaemia
  • Vitamin C: Related to stroke risk, CVD risk and frailty
  • Salt: WHO recommends that salt intake should be limited to 5 g/d Ready meals are popular amongst older adults, and contribute to already high salt intakes (Hopkins & Thomas, 2008) Mean intake 8–11 g salt daily in European adults (Moreira et al 2018)
  • Iron: Fe requirements reduced. Disorders interfere with Fe absorption e.g. atrophic gastritis, blood loss, drugs Lower in hospital patients (Thomas, 1999) 11% of men and 10% of women >65yrs old are anaemic Fe deficiency anaemia linked with decline in physical performance, cognitive impairment, increased susceptibility to falling and frailty and mortality (Price et al Blood Cells, Mol Dis 2011)
  • Zinc: Absorption reduced. Medication can alter absorption and excretion Heal damaged tissues Improve immunity (too much can impair immunity; Chadra, 1989)
  • Calcium: 1000 mg + exercise can slow bone los. Avoid if history of stones and/or kidney problems
  • Iodine: More research needed on the impact on the older population. Low iodine intake linked with inner brain atrophy (del, C J Nutr Health Aging 2017)
  • Magnesium: associated with muscle function. Inadequacies reported in community
32
Q

Signs of ageing:
Loss of hair, teeth, wrinkling of skin
Metabolism slows
Homeostatic responses to changes in temperature, diet and O2
supply slows
Decrease in cell numbers
Dysfunction of remaining cells
Demineralisation of bone
Decrease in maximal strength
Slowing of reflexes
Muscle decreases, fat increases due to decreasing activity
Selective loss of muscle fibres
Progressive loss of skeletal muscle mass (sarcopenia)

A

Signs of ageing:
Loss of hair, teeth, wrinkling of skin
Metabolism slows
Homeostatic responses to changes in temperature, diet and O2
supply slows
Decrease in cell numbers
Dysfunction of remaining cells
Demineralisation of bone
Decrease in maximal strength
Slowing of reflexes
Muscle decreases, fat increases due to decreasing activity
Selective loss of muscle fibres
Progressive loss of skeletal muscle mass (sarcopenia)

33
Q

Sarcopenia:
Definition and pathophysiology

A

Sarcopenia
Definition: Progressive loss of muscle, strength and function in relation to ageing.
Pathophysiology: An exact understanding of the underlying
mechanisms leading to sarcopenia and its clinical
consequences is still lacking but there are some factors that may increase or decrease risk.

34
Q

Prevention and treatment of sarcopenia

A

Sarcopenia prevention and treatment
* Hormone supplementation (to re-establish youthful concentrations of
testosterone, growth hormone etc have been investigated)
* Physical activity and resistance exercise to maintain muscle mass
* Targeted control of daily protein intake and dietary derived amino
acids important for muscle repair and regeneration
* Vitamin D supplementation
* Alcohol misuse associated with selective atrophy of type II muscle
fibres, leading to reduction of muscle mass by up to 30% (Preedy 2001)
Aric & Ulger (2016)

35
Q

Insulin and sarcopenia

A
  • Insulin resistance is involved in one of several underlying mechanisms of sarcopenia induction.
  • Insulin is an anabolic hormone, which stimulates protein synthesis including the synthesis of muscle.
  • The process of protein degradation and synthesis constantly repeats in skeletal muscle. Defects in insulin signalling can lead to reduced muscle synthesis.
36
Q

Which condition is an important risk factor for age related muscle loss?

A

Type 2 diabetes is an important risk factor for age related muscle loss

37
Q

At what age does the number of muscle fibres decline?

A

From mid-life (40-50 years) the number of muscle fibres declines

38
Q

What age do people lose half of their muscle fibres?

A

By age 80 years people lose half of their muscle fibres

39
Q

Which nutrients are important for sarcopenia?

A

Nutrients important for sarcopenia: Protein and Vitamin D

40
Q

Osteoporosis prevention tips?

A

EVIDENCE IS INCONCLUSIVE BUT:
Osteoporosis prevention:
* increase physical activity
* reduce sodium intake
* increase consumption of fruit and vegetables
* maintain a healthy body weight
* avoid smoking
* moderate alcohol intake
* increase protein intake: PMW

41
Q

Smoking can inhibit absorption of which mineral?

A

Smoking can inhibit calcium absorption.

42
Q

Ageing may affect the absorption of which nutrients?

A

Ageing may affect the absorption of
* Carbohydrates: possible decrease
* Lactose: decreased
* Vitamin B12: decreased with atrophic gastritis
* Calcium: decreased
* Vitamin A: increased
* Zinc: decreased
* Magnesium: decreased
* Iron: decreased

43
Q

DoH protein recommendation for older adults?

A

DoH protein recommendation for older adults:
0.75- 0.8g/kg

44
Q

Why do PROT-age propose greater protein requirements in elderly?

A

PROT-age propose greater protein requirements in elderly because:
* Inadequate protein intake
* Reduced ability to use available protein (insulin resistance, protein anabolic resisitance, immobility)
* Greater need for protein: inflammatory disease, oxidative modification of proteins

45
Q

Healthy older men are _____ sensistive to low protein intakes and require a greater relative protein intake in a single meal to promote myofibrallar protein synthesis.

A

Healthy older men are **less **sensistive to low protein intakes and require a greater relative protein intake in a single meal to promote myofibrallar protein synthesis.

46
Q

Study comparing protein intakes of 0.8g/kg/day and 1.6kg/day in males >70 years found what?

A

Study comparing protein intakes of 0.8g/kg/day and 1.6kg/day in males >70 years found increased whole-body lean mass/

47
Q

Higher protein intake in pwople with osteoporosis and post menopausal women is linked to what?

A

Higher protein intake in people with osteoporosis and post menopausal women is linked to:
* Higher BMD
* Slower rate of bone loss
* Reduced hip fracture risk

48
Q

Osteoporosis risk factors

A

Osteoporosis risk factors:
* Nutrition
* Age
* High alcohol intake
* Female
* Medication
* Smoking
* Oestrogen
* Metabolic disease
* Family history
* Previous fracture history
* Corticosteroid use
* Low body weight

49
Q

Calcium and vitamin D for osteoporosis risk

A

Calcium and vitamin D for osteoporosis risk:
* Problematic to make recommendations for calcium intake based on clinical trials and previous cohort studies
* Calcium’s role remains unclear. May be beneficial for menopausal women
* Vitamin D combined with calcium may help

50
Q

Calcium and vitamin D for fracture risk

A

Calcium and vitamin D for fracture risk
* Calcium supplementation doesn’t seem to reduce fracture risk
* Combined calcium and vitamin D might be effective for bone fracture prevention

51
Q

Protein and bone health. Why is it important?

A

Protein and bone health. Why is it important?
* Provides structural matrix for bone
* Optimizes levels of IGF-1: stimulates bone growth, increases calcium and phosphorous absorption in the gut
* Adequate supply is essential for bone maintenance

52
Q

Describe the physiological changes that occur during ageing that can affect nutritional status

A

Describe the physiological changes that occur during ageing that can affect nutritional status
* Cholecystokinin: anorexia of ageing
* Loss of sense of thirst
* Oesophageal peristaltic activity: swallowing difficulties
* Changes in taste and smell
* Decreased absorption of some nutrients
* Decline in lean body mass: independence, meal preparation,
* Bone loss:
* Tooth loss: could affect consumption of fruit and vegetables
*

NHD (15 decks)

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