Elderly Flashcards
How does weight fluctuate with age?
Increases to about 75 years, then decreases. Fat is re-distributed centrally with age.
How does fat free mass fluctuate with age?
Fat free mass starts to decrease in middle age slowly and then quickly after 60 years
What may affect body composition?
Starvation - loss of fat mass and lean mass
Disease - increased FFM loss, changes in hydration.
In the elderly the size of these losses may be greater.
Is the metabolic response to starvation ong or short term?
Metabolism response to starvation – short term. Overall energy needs decrease.
What is cachexia? What does it cause?
Cachexia is an acute immune response (TNF, cytokines are involved.) It results in less muscle repair, greater energy expenditure, muscle breakdown, less appetite, and protein catabolism. This all leads to weakness, disability, less function and reduced independence.
What is sarcopenia?
Sarcopenia - Appears to be part of the ageing process. Muscle decreases by between 2-5% per decade. It’s mainly skeletal muscle losses .
Less CNS input, more proinflammatory cytokines, less oestrogen, less GH secretion (due to inactivity causing weakness and vice versa, causing higher fat mass).
This lowers metabolic reserve and causes disability, mortality and morbidity.
How does BMD change with age?
decreases with age especiallly afte rmenopause
How does body water composition change with age?
- Decline in renal function and thirst perception
- Reduction of total body water
- Decreases in parallel with the reduction of FFM
Describe changes in the body as you age
- Decreased body energy stores after age 75yrs and increased risk of malnutrition
- Central accumulation of fat = risk of stroke, diabetes, hyperlipidaemia, heart disease and hypertension.
- Reduced muscle mass results in increasing weakness, affects mobility, respiratory function & independence.
- Bone mineral loss = fragile bones and increased risk of fractures.
- Increased risk of dehydration
Energy requirements decrease gradually after 50- 60yrs - less active and the basal metabolic rate is reduced.
• Since energy needs reduce, but protein, vitamins and minerals requirements remain unchanged, there is a need for higher nutrient density diet.
How do appetite and thirst vary with age?
- Decrease with age.
- Disease & drugs can also cause appetite loss.
- Possible alterations in appetite regulation with ageing.
How does smell vary with age?
The young can smell better
How do oral health and dental status vary with age?
- Older people have less of their own teeth.
- The more natural teeth present the less chewing problems occur.
- Edentate people shown to consume less energy, calcium, iron, vits A, C, E &; B complex, fibre and protein.
- Edentate people have lower BMIs
Which medical conditions are more prevalent with age?
- Dysphagia
- Gastrointestinal disorders
- Infections /trauma /surgery/cancer
- Respiratory disease
- Physical disability
- Drug side effects - nausea, anorexia, malabsorption, diarrhoea, delayed gastric emptying.
How does social factors affect age?
- Isolation - Those living alone had lower energy intakes than those living with others.
- Poverty - lower income groups found to have lower energy, protein, fibre and many micro-nutrients intakes.
- Ability to shop, cook - can be affected by diseases such as arthritis or other physical disabilities
How does psychological factors affect age?
Weight loss and altered eating behaviour recognised characteristic of the dementing process.
• Thinnest patients are those with the most behavioural problems
• Depression thought to be a major cause of reduced food intake and weight loss in the elderly.
