Lecture 23 - Older Adult Nutrition Part 1

Question 1

what is said about the age status of our population

Answer 1

we have an aging population

Question 2

what is happening to the life expectancy in New Zealand

Answer 2

increasing

Question 3

what is the average life expectancy of males and females

Answer 3

males = 80 years

females = 83.5 years

Question 4

human life expectancy is rising but lifespan remains stable at around the age of

Answer 4

110-120

Question 5

despite the prevalence of chronic diseases that accompanies older age, what % of people aged 75 an older consider themselves to be in good, very good or even excellent health

Answer 5

72%

Question 6

what is chronological age

Answer 6

age since birth

Question 7

functional age reflects what and is highly

Answer 7

reflects the decline in function that occurs with time and is highly variable

Question 8

what is the key focus to age in older adults

Answer 8

improving quality of life - adding life to years rather than simply more years to life

Question 9

what is the third age in elderly years

Answer 9

the age between retirement age and age related physical, emotional and cognitive limitations

Question 10

in the third age elderly are retired but

Answer 10

healthy and active

Question 11

during the third age elderly have more time to

Answer 11

increase physical activity and give more attention to diet and healthy lifestyle

Question 12

what is the fourth age in elderly

Answer 12

declines in general health, loss of weight

impaired nutrition / malnutrition

serious disease or fast aging

hospital or rest home care

reliance on assisted living services

Question 13

longevity is what % genetics, healthcare, environmental and lifestyle

Answer 13

19% genetics

10% healthcare

20% environment

51% lifestyle

Question 14

what has the biggest impact on nutritional status in elderly

Answer 14

changes to musculoskeletal system has the biggest

Question 15

lean body mass decreases what % after the age of 50

Answer 15

1 - 2 %

Question 16

when does lean body mass reduction accelerate

Answer 16

accelerates further after the age of 80

Question 17

what is the decline of lean body mass in men like compared to women

Answer 17

men = gradual decline

women = sudden drop after menopause

Question 18

physical activity can mitigate losses of what

Answer 18

lean body mass losses

Question 19

in elderly, bone mineral and collagen matrix are removed more rapidly than what, which leads to what

Answer 19

more rapidly than they are replaced

leads to increased risk of developing osteoporosis and fractures

Question 20

what is another change to body composition in elderly years

Answer 20

body fat increases

Question 21

higher body weight (BMI 24-30.9) is considered what in elderly

Answer 21

protective, less of an issue about being in the “overweight” category

Question 22

how is BMI different in elderly

Answer 22

the BMI category that is overweight is not as much as a concern

Question 23

inadequate protein intake can contribute to what in elderly

Answer 23

to muscle wasting (sarcopenia), weak bones, weakened immune system and delayed wound healing

Question 24

what is the protein RDI for women (51-70, >70)

Answer 24

51-70 : 46g/day

> 70 : 57g/day

Question 25

what is the protein RDI for men (51-70, >70)

Answer 25

51-70 : 64 g/day >70 : 81 g/day

Question 27

what are the factors involved with higher protein needs in older adults

Answer 27

- anabolic resistance - low postprandial amino acid availability - decreased muscle perfusion - sarcopenia - disease related protein catabolism

Question 28

what are the factors involved in lower protein intake in older adults

Answer 28

- genetic predisposition - physiological changes - medical changes - physical disability and mental disorders - socioeconomic conditions

Question 29

optimal intake of at least ........ protein is recommended in older adults, individual needs depend upon the severity of malnutrition risk

Answer 29

at least 1 to 1.5 g protein/kg BW/day

Question 30

in older adults regular exercise helps

Answer 30

maintain skeletal muscle strength and function in older adults

Question 31

in older adults, resistance training has

Answer 31

limited but positive effect on recovery of muscle in older people

Question 32

what is the recommendation for healthy muscle aging

Answer 32

a combination of resistance training and adequate dietary / amino acids intake for healthy muscle aging is recommended

Question 33

firstly it is important that older adults are getting enough protein, they may also see benefit from ...

Answer 33

distributing their protein intake across all meals of the day

Question 34

what meal in elderly is most commonly low in protein

Answer 34

breakfast

Question 35

how is the gastrointestinal system affecting in elderly which influences nutrition

Answer 35

- decreased saliva secretion - difficulty swallowing (dysphagia) - decreased secretion of hydrochloric acid and digestive enzymes - decreased vitamin B12 absorption - decreased peristalsis

Question 36

altered GI mobility in elderly can result in

Answer 36

constipation or diarrhoea

Question 37

why is there slower intestinal mobility in elderly people

Answer 37

intestinal wall losses strength and elasticity and hormonal secretions change

Question 38

what is atrophic gastritis

Answer 38

inflammation of the stomach lining atrophy of the stomach mucosa resulting in reduced gastric acid, intrinsic factor (IF) and pepsin

Question 39

what needs intrinsic factor to be absorbed into the small intestine

Answer 39

vitamin B12

Question 40

atrophic gastritis can lead to what

Answer 40

can lead to vitamin B12 deficiency ( can take up to 3-6 years of poor absorption)

Question 41

some medications in elderly can also reduce

Answer 41

stomach mobility (for example metformin)

Question 42

what other things can affect stomach acidity in older adults

Answer 42

partial stomach removal or bacterial infection

Question 43

what are the changes to the nervous system in older adults that influences nutrition

Answer 43

- blunted appetite regulation - blunted thirst regulation - declining number of olfactory receptors, blood flow to nasal smell organ and increased thickness of nasal mucus - reduced nerve conduction velocity, affecting sense of smell, taste, touch, cognition - changed sleep at the wake cycle becomes shorter

Question 44

how many older adults have difficulty tasting one or more of the 4 common tastes (and what are they)

Answer 44

1/4 adults bitter, salty, sweet or sour

Question 45

what is polypharamcy

Answer 45

use of multiple medications

Question 46

what are the two ways of getting medications

Answer 46

prescription medications (medicines ordered by a health professional) over the counter medication

Question 47

what is the concern with polypharamcy and older adults

Answer 47

concern when they are taking multiple medications, who is monitoring what they are taking

Question 48

how many older adults are exposed to poly pharmacy approx

Answer 48

more than half

Question 49

older adults taking multiple medications tend to be

Answer 49

- frail - experience greater weight loss - weakness - low activity

Question 50

medications may require dietary restrictions and can interfere with

Answer 50

- appetite - digestion - metabolism - alterness

Question 51

what are the consequences of polypharamacy

Answer 51

- drug - drug interactions increases - adverse drug interactions - adherence to medications declines - may increase renal impairment