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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
Q

What does decreased lean body mass lead to?

A

Increased risk of developing osteoporosis and fractures

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26
Q

With decreases in lean tissue mass we also see increases in…

A

Fat mass

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27
Q

What kind of fat mass increases the most?

A

Visceral

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28
Q

Percent lean muscle mass in 20-25 year olds VS. 70-75 year olds

A

19% vs 12%
- 7% loss

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29
Q

Percent fat mass in 20-25 year olds VS. 70-75 year olds

A

14% vs 30%
- 16% increase

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30
Q

How does BMI interpretation change in older adults?

A

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
Q

What range is optimal for older adults?

A

25-30

32
Q

What can inadequate protein contribute to?

A

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

33
Q

What is the protein RDI for women aged 51-70 years?

A

46g/day

34
Q

What is the protein RDI for women aged over 70 years?

A

57g/day

35
Q

What is the protein RDI for men aged 51-70 years?

A

64g/day

36
Q

What is the protein RDI for men aged over 70 years?

A

81g/day

37
Q

What are factors involved with lower protein intake in older adults? (5)

A
  • Genetic predisposition
  • Physiological changes
  • Medical conditions
  • Disability & Mental disorders
  • Socioeconomic conditions
38
Q

What are factors involved with higher protein needs in older adults? (5)

A
  • Disease-related protein catabolism
  • Sarcopenia
  • Decreased muscle perfusion
  • Low postprandial AA availability
  • Anabolic resistance
39
Q

What is the optimal intake of protein for older adults?

A

1.0 to 1.5g protein/kg BW/day
- dependent on malnutrition risk

40
Q

Why do older adults have greater protein needs?

A

To compensate for anabolic resistance and hyper-metabolic disease

41
Q

Why may older adults have decreased intake?

A
  • Age related appetite loss
  • Medical conditions
  • Financial limits
42
Q

What is recommended for healthy muscle ageing?

A

A combination of resistance training and adequate dietary protein/AA intake

43
Q

Other than intake, what may be important?

A

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
Q

What is the median intake of older males in NZ?

A

1.16g/kg BW

45
Q

What is the median intake of older females in NZ?

A

1.09g/kg BW

46
Q

What are the main protein sources at breakfast?

A
  • Milk (28%)
  • Cereal (22%)
  • Bread (12%)
47
Q

What are the main protein sources at lunch?

A
  • Bread (18%)
  • Cheese (10%)
  • Milk (9%)
48
Q

What are the main protein sources at dinner?

A

Meat, poultry, fish (56%)

49
Q

What part of the decline in the GI system impacts digestion the most?

A

Decreased salvia secretion

50
Q

What happens to the GI system during older adulthood? (5)

A
  • Decreased saliva
  • Difficulty swallowing
  • Decreased secretion of HCl and digestive enzymes
  • Decreased vitamin B12 absorption
  • Decreased peristalsis
51
Q

What is difficulty swallowing called?

A

Dysphagia

52
Q

Reduced stomach acidity which impacts nutrient absorption, particularly what nutrient?

A

Vitamin B12

53
Q

Altered motility can result in…

A

Constipation or diarrhoea

54
Q

Why does intestinal motility slow during older adulthood?

A
  • Intestinal wall loses strength and elasticity
  • Hormonal secretions change
  • Lifestyle factors and medication can interfere
55
Q

What is atrophic gastritis?

A

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

56
Q

What does vitamin B12 need to be absorbed in the small intestine?

A

IF

57
Q

What can atrophic gastritis lead to?

A

Lower stomach acidity = less enzymes = less being bound to B12 = less absorbed = over time can lead to B12 deficiency

58
Q

What is a common medication that affects the acidity of the stomach?

A

Metformin

59
Q

What bacterial infection can affect Vit B12?

A

H. Pylori

60
Q

What happens to appetite and thirst regulation in older adulthood?

A

They get blunted

61
Q

Why do appetite and thirst regulation become blunted?

A

Declining number of olfactory receptors, blood flow to nasal smell organ, and increased thickness of nasal mucus

62
Q

What other parts of the nervous system decrease?

A
  • Nerve conduction velocity
  • Sense of smell
  • Sense of taste
  • Sense of touch
  • Cognition
63
Q

What happens to the wake cycle?

A

It becomes shorter

64
Q

How do these nervous system changes impact eating?

A
  • Can impact enjoyment of eating
  • Impairs ability to know when food has gone off - food safety
65
Q

What is polypharmacy?

A

use of multiple medications

66
Q

There is increasing concern about what?

A

High number of medications used by individuals
- Who monitors this?

67
Q

What is prescription medication?

A

Medicines ordered by a health professional (usually GP)

68
Q

What is over the counter (OTC) medication?

A

Other pills, liquids, creams and supplements purchased at a pharmacy, discount or grocery store without prescription

69
Q

Older adults taking multiple medications tend to be?

A
  • Frail
  • Experience greater weight loss
  • Weakness
  • Low activity
70
Q

Medications may require dietary restrictions and can interfere with:

A
  • Appetite
  • Digestion
  • Metabolism
  • Alertness
71
Q

What are the consequences of polypharmacy?

A
  • Drug-drug interactions increase
  • Adverse drug reactions
  • Adherence to medications declines
  • May increase renal impairment
72
Q

Why does polypharmacy increase renal impairment?

A

Due to the burdening impact on the kidneys

73
Q

Why does the use of polypharmacy decrease adherence to medications?

A

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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