lec 10 elderly

Question 1

can we use albumin as a specific marker of malnutrition?

Answer 1

no, albumin has poor specificity to nutrition status.
Albumin is a marker of inflammation rather than malnutrition

Question 2

what is the albumin level in starvation-disease related malnutrition?

Answer 2

remain in normal range due to compensatory decrease in albumin breakdown and transfer from extravascular to intravascular compartment

Question 3

what is refeeding syndrome?

Answer 3

a potentially life-threatening condition that can occur when nutrition is reintroduced to individuals who are severely malnourished or have undergone prolonged periods of fasting or starvation.
It results from sudden shifts in fluids and electrolytes as the body transitions from a catabolic (breaking down) state to an anabolic (building up) state.

Question 4

what are the nutrients of concern for refeeding syndrome, and why

Answer 4

K, Mg, PO4, thiamine might be deficient
*Why: Insulin release after prolonged starvation evokes movement of intracellular
ions, K, Mg, P04 into cells and utilization of thiamine occurs via CHO pathways

Question 5

what is FRS and what is it used for

Answer 5

FRS= framingham risk score, to estimate 10-year cardiovascular disease risk

Question 6

why elderly people need to get Vit D supplements

Answer 6

1. as people age, the synthesis declines 4x, setting the stage for deficiency
2. many older adults drink little or no vitmin D fortified milk or get little or no exposure to sunlight

Question 7

what is the recommendation for Vit D for elderly

Answer 7

50-70 YO, 600 IU/d
>70 YO, 800 IU/d

Question 8

what is 25-OHD

Question 9

classifications of 25-OHD

Question 10

cytokines decrease in response to CoV2 with Vit D

Question 11

dehydration is a major risk for older people, why

Answer 11

1. thirst mechanism may become imprecise, older ppl might go for longer periods without drinking
2. kidney become less efficient at recapturing water before it is lost as urine=more wate loss

Question 12

fluid requirments for elderly people

Answer 12

1500 ml is the minimum
+15 ml/kg x (actual weight -20kg)

Question 13

what is the standard for oliguria

Answer 13

< 500 ml urine

Question 14

signs and symptoms of dehydration

Answer 14

*Thirst
Oliguria [<500 ml urine]
* skin turgor, pale skin
Dry mouth/lips, thick saliva
* Coated, wrinkled tongue
* Headache, dizziness, confusion
*Low Body temperature, low BP, high heart rate

Question 15

clinical examination data for elderly

Answer 15

1. evaluation of swallow (working with SLP)
2. evaluation of micronutrient deficiencies or disease states on skin, vision, oral cavity
3. monitoring of changes in health and signs and symptoms, Skin infection, pressure ulcers, appetite, sensory losses,

Question 16

what is the protein requirement in wound healing protocol

Answer 16

2g/kg

Question 17

what to cover in a dietary assessment

Answer 17

1. usual eating pattern
2. quantity, types, where and when food and beverages are consumed
3. who is responsible for food preparation
4. energy intake and adequacy
5. macro/micro nutrient intake
6. fluids intake
7. fiber intake

Question 18

what is the best way to consume antioxidants

Answer 18

Having FV, better than taking supplements

Question 19

what the role of zinc

Answer 19

essential for metabolism and free radical clearance