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HUNT243 Exam > Lecture 23: Older Adult Nutrition Part 1 > Flashcards

Lecture 23: Older Adult Nutrition Part 1 Flashcards

1
Q

What is happening to the aging population over time in NZ?

A

Increasing due to advances of healthcare/medical system

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2
Q

What is males life expectancy?

A

80 years

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3
Q

What is females life expectancy?

A

83.5 years

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4
Q

Human life expectancy is rising but life span remains stable at around what age?

A

110-120 years

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5
Q

What do 72% aged 75 years and older consider themselves to be?

A

In good, very good or even excellent health

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6
Q

What do 72% aged 75 years and older want?

A

To remain independent and living in their own home

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7
Q

What do 72% aged 75 years and older believe?

A

Good nutrition and exercise will help them maintain autonomy and independence

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8
Q

What is the NZ Healthy Ageing Strategy?

A

We do have a healthy aging strategy to make sure that older adults have a respectful end of life

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9
Q

What is chronological age?

A

Age since birth

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10
Q

What is functional age?

A

Reflects the decline in function that occurs with time
- High variable

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11
Q

What is the key focus when it comes to ageing?

A

Improving QOL - adding quality life to years, rather than simply more years to life

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12
Q

What is the third age?

A

The transition into the decline:
- Between retirement age and age-related physical, emotional and cognitive limitations

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13
Q

What is occuring during the third age?

A
  • Retired, but healthy and happy
  • Minor and controllable medical problems
  • Have the time to increase PA and give more attention to diet and healthy lifestyle
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14
Q

What is the fourth age?

A
  • Declines in general health, loss of weight (inc. muscle)
  • Frailty
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15
Q

What is occuring during the fourth age?

A
  • Impaired nutrition (malnutrition)
  • Serious disease or advanced ageing
  • Hospital or rest home care
  • Reliance on assisted services
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16
Q

What is longevity determined by?

A

19% genetics
10% healthcare
20% environmental
51% lifestyle

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17
Q

Pathways to nutritional health in older people are…

A

Complex and multi-factorial
- They interact with normal physiological changes associated with ageing

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18
Q

What has the biggest impact on nutritional status?

A

Changes to the musculoskeletal system

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19
Q

Does lean body mass increase or decrease over time?

A

Declines over time

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20
Q

At what rate does lean body mass decline?

A

1-2% per years after the age of 50
- Accelerates further after the age of 80

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21
Q

What does the lean body mass decline look like for men?

A

Gradual decline

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22
Q

What does the lean body mass decline look like for women?

A

Sudden drop after menopause

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23
Q

What can mitigate lean body mass losses?

A

PA - weight bearing, resistance

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24
Q

How does lean body mass get lost?

A

Bone mineral and collagen matrix are removed from bone more rapidly than they are replaced

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25
What does decreased lean body mass lead to?
Increased risk of developing osteoporosis and fractures
26
With decreases in lean tissue mass we also see increases in...
Fat mass
27
What kind of fat mass increases the most?
Visceral
28
Percent lean muscle mass in 20-25 year olds VS. 70-75 year olds
19% vs 12% - 7% loss
29
Percent fat mass in 20-25 year olds VS. 70-75 year olds
14% vs 30% - 16% increase
30
How does BMI interpretation change in older adults?
Being slightly overweight in older adults is seen to be a bit more protective and less problematic (U-shaped relationship) - Still see problems in obesity and beyond but see less issues in overweight category
31
What range is optimal for older adults?
25-30
32
What can inadequate protein contribute to?
Muscle wasting (sarcopenia), weak bones, weakened immune system and delayed wound healing
33
What is the protein RDI for women aged 51-70 years?
46g/day
34
What is the protein RDI for women aged over 70 years?
57g/day
35
What is the protein RDI for men aged 51-70 years?
64g/day
36
What is the protein RDI for men aged over 70 years?
81g/day
37
What are factors involved with lower protein intake in older adults? (5)
- Genetic predisposition - Physiological changes - Medical conditions - Disability & Mental disorders - Socioeconomic conditions
38
What are factors involved with higher protein needs in older adults? (5)
- Disease-related protein catabolism - Sarcopenia - Decreased muscle perfusion - Low postprandial AA availability - Anabolic resistance
39
What is the optimal intake of protein for older adults?
1.0 to 1.5g protein/kg BW/day - dependent on malnutrition risk
40
Why do older adults have greater protein needs?
To compensate for anabolic resistance and hyper-metabolic disease
41
Why may older adults have decreased intake?
- Age related appetite loss - Medical conditions - Financial limits
42
What is recommended for healthy muscle ageing?
A combination of resistance training and adequate dietary protein/AA intake
43
Other than intake, what may be important?
Distribution throughout the day: - Breakfast seems to be lowest - We want smaller amounts consistently rather than a lot at once as there is only so much that can be utilised at once
44
What is the median intake of older males in NZ?
1.16g/kg BW
45
What is the median intake of older females in NZ?
1.09g/kg BW
46
What are the main protein sources at breakfast?
- Milk (28%) - Cereal (22%) - Bread (12%)
47
What are the main protein sources at lunch?
- Bread (18%) - Cheese (10%) - Milk (9%)
48
What are the main protein sources at dinner?
Meat, poultry, fish (56%)
49
What part of the decline in the GI system impacts digestion the most?
Decreased salvia secretion
50
What happens to the GI system during older adulthood? (5)
- Decreased saliva - Difficulty swallowing - Decreased secretion of HCl and digestive enzymes - Decreased vitamin B12 absorption - Decreased peristalsis
51
What is difficulty swallowing called?
Dysphagia
52
Reduced stomach acidity which impacts nutrient absorption, particularly what nutrient?
Vitamin B12
53
Altered motility can result in...
Constipation or diarrhoea
54
Why does intestinal motility slow during older adulthood?
- Intestinal wall loses strength and elasticity - Hormonal secretions change - Lifestyle factors and medication can interfere
55
What is atrophic gastritis?
Atrophy of the stomach mucosa resulting in reduced gastric acid, intrinsic factor (IF) and pepsin
56
What does vitamin B12 need to be absorbed in the small intestine?
IF
57
What can atrophic gastritis lead to?
Lower stomach acidity = less enzymes = less being bound to B12 = less absorbed = over time can lead to B12 deficiency
58
What is a common medication that affects the acidity of the stomach?
Metformin
59
What bacterial infection can affect Vit B12?
H. Pylori
60
What happens to appetite and thirst regulation in older adulthood?
They get blunted
61
Why do appetite and thirst regulation become blunted?
Declining number of olfactory receptors, blood flow to nasal smell organ, and increased thickness of nasal mucus
62
What other parts of the nervous system decrease?
- Nerve conduction velocity - Sense of smell - Sense of taste - Sense of touch - Cognition
63
What happens to the wake cycle?
It becomes shorter
64
How do these nervous system changes impact eating?
- Can impact enjoyment of eating - Impairs ability to know when food has gone off - food safety
65
What is polypharmacy?
use of multiple medications
66
There is increasing concern about what?
High number of medications used by individuals - Who monitors this?
67
What is prescription medication?
Medicines ordered by a health professional (usually GP)
68
What is over the counter (OTC) medication?
Other pills, liquids, creams and supplements purchased at a pharmacy, discount or grocery store without prescription
69
Older adults taking multiple medications tend to be?
- Frail - Experience greater weight loss - Weakness - Low activity
70
Medications may require dietary restrictions and can interfere with:
- Appetite - Digestion - Metabolism - Alertness
71
What are the consequences of polypharmacy?
- Drug-drug interactions increase - Adverse drug reactions - Adherence to medications declines - May increase renal impairment
72
Why does polypharmacy increase renal impairment?
Due to the burdening impact on the kidneys
73
Why does the use of polypharmacy decrease adherence to medications?
The more medications we are taking, the harder it is to remember what we have taken or need to take (can cause double ups)

HUNT243 Exam (18 decks)

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