LC 3.5 - Nutrition and the Elderly

Question 1

Name 8 risk factors that may dispose an elderly individual to malnutrition?

Answer 1

Isolation
Chronic illness and cognitive impairment
Medication
Constipation
Low income
Disability
Depression
Dentition

Question 2

What physiological changes occur in the mouth with age?

Answer 2

Mouth becomes dry
Medication may effect salivation
Decreased taste and smell sensation
Decreased mastication muscle power

Question 3

What physiological changes occur in the oesophagus with age?

Answer 3

Delay in pharyngeal phase of swallowing

Question 4

What physiological changes occur in the stomach with age?

Answer 4

Increased risk of atrophic gastritis

Delayed gastric emptying for liquids

Question 5

What physiological changes occur in the mouth with age that may lead to malnutrition?

Answer 5

Mouth becomes dry
Medication may effect salivation
Decreased taste and smell sensation
Decreased mastication muscle power

Question 6

What physiological changes occur in the oesophagus with age that may lead to malnutrition?

Answer 6

Delay in pharyngeal phase of swallowing

Question 7

What physiological changes occur in the stomach with age that may lead to malnutrition?

Answer 7

Increased risk of atrophic gastritis

Delayed gastric emptying for liquids

Question 8

What physiological changes occur in the small intestine with age that may lead to malnutrition?

Answer 8

Increased risk of bacterial overgrowth
Decreased zinc and calcium absorption
Decreased vitamin D receptor concentration

Question 9

What happens to enterocyte functioning in the small intestine with age?

Answer 9

Function maintained

Question 10

What physiological changes occur in the G.I motility with age that may lead to malnutrition?

Answer 10

Orocecal transit time unchanged

Colonic transit time becomes variable

Question 11

What condition may lead to a decreased colonic transit time in G.I motility?

Answer 11

Hypothyroidism

Question 12

What condition may lead to a decreased colonic transit time in G.I motility?

Answer 12

Hypothyroidism

Question 13

Describe a common clinical assessment used to measure nutritional status?

Answer 13

Body mass index (BMI)

Question 14

In what patient groups would assessing BMI for nutritional status be particularly unreliable?

Answer 14

Patients with liver disease and congested heart failure

Question 15

What screening tool can be used to assess nutritional status?

Answer 15

MUST criteria

Question 16

Name the four clinical interventions that may be used to treat malnutrition in patients?

Answer 16

Supplemental feeds
Naso-enteral feeds
Per-cutaneous enteral feeds
Parenteral feeding (veins)

Question 17

Name the four clinical interventions that may be used to treat malnutrition in patients?

Answer 17

Supplemental feeds
Naso-enteral feeds
Per-cutaneous enteral feeds
Parenteral feeding (veins)

Question 18

Which micro-nutrients are commonly deficient in the elderly?

Answer 18

Vitamin A
Vitamin D - found in fish/eggs/meat
Thyamine

Question 19

Which micro-nutrients are commonly deficient in the elderly?

Answer 19

Vitamin A
Vitamin D - found in fish/eggs/meat
Thyamine

Question 20

How does the change in body composition in the elderly affect drug treatments?

Answer 20

A decrease of growth factor leads to a higher fat ratio around the body. Lipid soluble drugs may accumulate within this adipose tissue increasing risk of toxicity

Question 21

Name two osteoporosis drugs that affect food absorption in the G.I tract?

Answer 21

Alendronate

Risedronate

Question 22

Name a common drug administered for congested heart failure that causes food adsorption and which food is affected?

Answer 22

Digioxin

Adheres to high phytate foods (bran/oatmeal)

Question 23

Name a common drug administered for congested heart failure that causes food adsorption and which food is affected?

Answer 23

Digioxin

Adheres to high phytate foods (bran/oatmeal)

Question 24

What juice commonly inhibits the intestinal metabolism (cytochrome p450) of numerous drugs?

Answer 24

Grapefruit juice

Question 25

Which drug commonly prevents the conversion of Vitamin K to a usable form?

Answer 25

Warfrin