Nutrition for elderly Flashcards
What are geriatric syndromes?
Complex health states that tend to only occur later in life. They appear to be better predictors of death than the number of specific diseases a person has.
They can have multiple underlying factors and include frailty, urinary incontinence, falls, delirium and pressure ulcers.
What are the main factors that influence food intake and nutritional status in old age?
- Poverty
- Bereavement
- Social isolation
- Depression
- Disability
- Acute conditions
- Chronic disease
- Dementia
- Polypharmacy
- Health beliefs
- Food preferences
- Effects of social interaction and relationships
- Knowledge
What are some specific physiological factors that influence food intake and nutritional status in old age?
- Decreased appetite
- Decreased thirst sensation
- Decreased saliva production, dry mouth
- Poor dentition
- Poor vision
- Decreased muscle volume (sarcopenia)
- Decreased skin capacity for vitamin D synthesis
- Decreased calcium bioavailability
- Decreased bone density
- Decreased renal function
- Decreased basal metabolic rate
- Poor swallowing
- Decreased taste and smell sensitivity
How does body composition change in older people?
- Sarcopenia –> muscle loss, 0.7% in women and 0.9% in men muscle mass lost per year
- Dynapenia –> muscle strength lost more rapidly
What are some gastro-intestinal related changes that come with ageing?
GI tract changes
- decreased motility
- decreased elasticity
- decreased gastric acid/ intrinsic factor
- decreased absorptive efficiency causing impaired digestion/ absorption. Especially with B12, biotin, Ca and Fe
Tooth loss
Sensory loss
What increased the risk of malnutrition?
- Age
- Ill health
- Dependency
What are the sign of poor nutrition?
- Reduced appetite
- Reduced food intake
- Unintentional weight loss
- Reduced muscle mass
- Dehydration
- Skin breakdown
- Presence of pressure sores or ulcers
- Ill fitting dentures
- Loose clothes or jewellery
- No food in fridge, old food left out untouched
- Eating only one type of food
- Consuming alcohol only
What are some consequences of malnutrition?
- Reduced muscle function e.g. heart failure
- Reduced GI function
- Reduced immunity and poor wound healing
- Kidney struggle to regulate salt and fluid which can lead to over hydration or dehydration
- Apathy
- Depression
- Introversion, self neglect & deterioration in social interactions
- Impaired temperature regulation, can lead to hypothermia
Should the energy requirements change in ageing?
They should decrease with older age as basal metabolic rate is decreased and so is physical activity.
Should protein intake change with ageing?
It should increase
This is because it helps with illness, stress, infections and surgery.
They also help to make small and nutrient dense meals for those with a low appetite or poor oral intake.
Should protein intake change with ageing?
It should increase
This is because it helps with illness, stress, infections and surgery.
They also help to make small and nutrient dense meals for those with a low appetite or poor oral intake.
What nutrients are more at risk of not being absorbed due to ageing?
Calcium, iron, vitamin D and vitamin B12
Supplements may be needed
Why is it important that older people eat a more nutrient dense diet than adults?
They are at higher risk of deficiency of some nutrients.
Many older people have inadequate intake of protein, fibre, vitamin B6, vitamin D and calcium
Calcium, iron and B12 absorption is also reduced.
Increasing antioxidants help boost immune system.
Folate and vitamin B12 help prevent cardiovascular disease.
What are the key priorities for optimal health in elderly people?
- Eat a balanced diet consisting of lots of fruit and veg, wholegrain and wholemeal foods
- Decrease amount of sodium to lower blood pressure
- Increase physical activity
- Establish an energy balance to reduce chance of being overweight/ obese
- Prevent malnutrition and micronutrient deficiency - focus on nutrient rich foods
- Take supplements if deficient in anything
What is the ‘ideal’ BMI for older people?
22-27
