Lecture 25-Adulthood and older people Flashcards
Adulthood and older people
what is said about the age status of our population
we have an aging population
what is happening to the life expectancy in New Zealand
increasing
what is the average life expectancy of males and females
males = 80 years
females = 83.5 years
human life expectancy is rising but lifespan remains stable at around the age of
110-120
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
72%
what is chronological age
age since birth
functional age reflects what and is highly
reflects the decline in function that occurs with time and is highly variable
some 80 year olds have the physcial and mental capacities similar to ….
year olds- other people experience decline much younger
what is the key focus to age in older adults
improving quality of life - adding life to years rather than simply more years to life
what is the third age in elderly years
the age between retirement age and age related physical, emotional and cognitive limitations
They have time to enjoy life
in the third age elderly are retired but
healthy and active
during the third age elderly have more time to
increase physical activity and give more attention to diet and healthy lifestyle
During third age do they have medical problems
Minor controllable medical problems
what is the fourth age in elderly
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
longevity is what % genetics, healthcare, environmental and lifestyle
19% genetics
10% healthcare
20% environment
51% lifestyle
what has the biggest impact on nutritional status in elderly
changes to musculoskeletal system has the biggest
lean body mass decreases what % after the age of 50
1 - 2 % per year
when does lean body mass reduction accelerate
accelerates further after the age of 80
what is the decline of lean body mass in men like compared to women
men = gradual decline
women = sudden drop after menopause
physical activity can mitigate losses of what
lean body mass losses
in elderly, bone mineral and collagen matrix are removed more rapidly than what, which leads to what
more rapidly than they are replaced
leads to increased risk of developing osteoporosis and fractures
what is another change to body composition in elderly years
body fat increases
BMI …… is considered what in the elderly
<18.5
higher body weight (BMI 24-30.9) is considered what in elderly
protective, less of an issue about being in the “overweight” category
how is BMI different in elderly
the BMI category that is overweight is not as much as a concern
…… BMI is recommended for older adults
20-30
inadequate protein intake can contribute to what in elderly
to muscle wasting (sarcopenia), weak bones, weakened immune system and delayed wound healing
what are the factors involved with higher protein needs in older adults
- anabolic resistance
- low postprandial amino acid availability
- decreased muscle perfusion
- sarcopenia
- disease related protein catabolism
what are the factors involved in lower protein intake in older adults
- genetic predisposition
- physiological changes
- medical changes
- physical disability and mental disorders
- socioeconomic conditions
optimal intake of at least …….. protein is recommended in older adults, individual needs depend upon the severity of malnutrition risk
at least 1 to 1.5 g protein/kg BW/day
in older adults regular exercise helps
maintain skeletal muscle strength and function in older adults
in older adults, resistance training has
limited but positive effect on recovery of muscle in older people
what is the recommendation for healthy muscle aging
a combination of resistance training and adequate dietary / amino acids intake for healthy muscle aging is recommended
Older adults have greater protein needs to compensate for …… and …..
Older adults may also have decreased intake due to
Anabolic resistance
Hyper-metabolic disease
age-related appetite loss, medical condition, financial limits
firstly it is important that older adults are getting enough protein, they may also see benefit from …
distributing their protein intake across all meals of the day
what meal in elderly is most commonly low in protein
breakfast
how is the gastrointestinal system affecting in elderly which influences nutrition
- decreased saliva secretion
- difficulty swallowing (dysphagia)
- decreased secretion of hydrochloric acid and digestive enzymes
- decreased vitamin B12 absorption
- decreased peristalsis
altered GI mobility in elderly can result in
constipation or diarrhoea
why is there slower intestinal mobility in elderly people
intestinal wall losses strength and elasticity and hormonal secretions change
what is atrophic gastritis
-Atrophy of the stomach mucosa resulting in reduced gastric acid, intrinsic factor and pepsin
what needs intrinsic factor to be absorbed into the small intestine
vitamin B12
atrophic gastritis can lead to what
can lead to vitamin B12 deficiency ( can take up to 3-6 years of poor absorption)
what are the changes to the nervous system in older adults that influences nutrition
- 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
what is polypharamcy
use of multiple medications
what are the two ways of getting medications
prescription medications (medicines ordered by a health professional)
over the counter medication
what is the concern with polypharamcy and older adults
concern when they are taking multiple medications, who is monitoring what they are taking
how many older adults are exposed to poly pharmacy approx
more than half
older adults taking multiple medications tend to be
- frail
- experience greater weight loss
- weakness
- low activity
medications may require dietary restrictions and can interfere with
- appetite
- digestion
- metabolism
- alterness
what are the consequences of polypharamacy
- drug - drug interactions increases
- adverse drug interactions
- adherence to medications declines
- may increase renal impairment
