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HUNT243 > Lecture 26-Older adult nutrition -Part 2 > Flashcards

Lecture 26-Older adult nutrition -Part 2 Flashcards

Older adult nutrition -Part 2

1
Q

What are the two main nutritional issues in older adults

A

dehydration and malnutrition

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2
Q

How does dehydration occur in older adults

A

water losses exceed water replacement
(caused by either an inadequate intake of fluid, or excessive loss (volume depletion) or both)

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3
Q

Important to understand the cause of dehydration in an individual as this will

A

Inform your intervention

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4
Q

dehydration in older adults contributes to …

A
  • confusion
  • constipation
  • urinary tract infections (UTIs)
  • risk of falls
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5
Q

what are the 7 signs and symptoms of dehydration in older adults

A
  1. upper body weakness
  2. speech difficulty
  3. confusion
    4.dry mucous membranes in nose and mouth
  4. longitudinal tongue furrows
  5. dry tongue
  6. sunken appearance of eyes in their sockets
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6
Q

What are the physiological reasons to low intake dehydration

A

decreased thirst sensation, decreased concentrating ability of the kidneys, lower total body fluid stores

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7
Q

What are the psychological reasons to low intake dehydration

A

Cognitive impairment (forgetful difficulty expressing need, unable to recognise thirst), self restriction (fear of incontinence)

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8
Q

what are the physical reasons to low intake dehydration

A

Reduced dexterity, poor vision, poor mobility, reliance on feeding assistance

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9
Q

what are the comorbidity reasons to low intake dehydration

A

poorly controlled diabetes, dysphagia, early satiety

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10
Q

what are the environmental reasons to low intake dehydration

A

hospitalised / aged care - reliance on carers for fluid

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11
Q

what is the method of prevention of low intake - dehydration in older adults

A

all older adults should be considered at risk and encouraged to consume adequate amounts of fluids

A range of appropriate drinks should be offered based on their prefernces

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12
Q

what is the fluid recommendations for older adults

A

women : 1.6 litres

men : 2.0 litres

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13
Q

What type of fluids is going to be beneficial for older adults

A

we are concentrating less on the concern of energy dense fluids and just focus more on them consuming enough fluids

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14
Q

ICD-10-AM (international classification of disease)= Malnutrition in older adults

A

BMI < 18.5 kg/m^2 or unintentional weight loss of >5% with evidence of suboptimal intake resulting in subcutaneous fat loss and / or muscle wasting

a lack of adequate nutrients to meet the body’s needs

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15
Q

globally what proportion of older adults are malnourished, or at risk

A

1/4

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16
Q

Unintentional weight loss definition

A

BMI <18.5- underweight

weight loss of 5% or more of body weight in the past 3-6 months

not universally defined

17
Q

what are the potential causes of unintentional weight loss

A
  • underlying, undiagnosed disease or illness
  • protein energy malnutrition
  • poverty
  • functional decline
18
Q

what are ways you could notice people around you becoming malnourished

A

their jewellery is loose

not enjoying their favourite foods anymore

clothes are getting loose

eating less

19
Q

malnutrition can lead to

A

higher infection risk

increased risk of falls

longer hospital stays

loss of strength

poor immunity

reduced ability to do usual daily activities

reduced quality of life

shorter life expectancy

20
Q

what is the prevalence of malnutrition across australia and New Zealand

A

up to 17%

21
Q

what is the prevalence of risk of malnutrition across australia and new Zealand

A

up to 63%

22
Q

There is higher prevalence of malnutrition in

A

older adults > 80 years

women

multiple medications

23
Q

screening for malnutrition is recommended for

A

All older adults across all health settings to identify those who are malnourished and those at risk

24
Q

Tools of malnutrition screening tools can be

A

anthropometry and questions around weight loss

25
Q

MNA stands for and used for??

A

Mini Nutritional Assessment (MNA) : grading system to determine if they are malnourished or at risk of being malnourished

26
Q

Who can the MNA be carried out by

A

This tool can be used by anyone
Its very easy to use

27
Q

Screening identifies …. not

A

risk it is not a diagnosis

28
Q

What are the three casual subcategories of malnutrition

A
  • disease related malnutrition driven by inflammation
  • disease related malnutrition with no perceived inflammation
  • malnutrition due to starvation not related to disease (either related to hunger, socioeconomic factors or psychological factors)
29
Q

Who usually carries out a nutrition assessment

A

Usually a dietitian, registered nutritionist or clinician with nutrition training

30
Q

nutritional assessment will often involve assessment of

A
  • anthropometry, body composition
  • biochemical markers
    dietary assessment
  • lifestyle factors
  • functional capacity
  • hydration
31
Q

what factors may contribute to malnourishment in elderly

A
  • Body image
    • Appetite
    • Economical reasons
    • Mobility
    • Psychological reasons
    • Health conditions
      etc
32
Q

what are the strategies for management / intervention of malnourishment

A
  • food first strategies
  • oral nutrition supplements
  • re-screen
33
Q

Food first stretegies

A

high protein, high energy extras

food fortification (meaning adding things like butter or cheese to something like mashed potatoes, so they don’t have to eat more food volume)

34
Q

Oral Nutrition supplements

A

OTC supplements

funded oral nutrition supplements (prescribed)

35
Q

Re-screen

A

repeat MNZ

comprehensive nutrition assessment

36
Q

PHARMAC special authority

A

an individual may be illegible to apply for funding

only application from a dietitian or relevant specialist

37
Q

malnutrition affects what proportion of people in hospital

A

more than 1 in 3 patients are affected by malnutrition

38
Q

Early identification =

A

Early intervention

HUNT243 (29 decks)

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