Nutrition in later life

Question 1

What are the main factors the influence nutrition in older people?

Answer 1

• poverty - 16% over 75 live below the poverty line
• bereavement
• social isolation - nearly half of people over 75 live alone
• depression
• disability
• chronic disease
• polypharmacy
• dementia
• health beliefs
• food preferences
• knowledge e.g. cooking knowledge

Question 2

What are the physiological factors that influence food intake and nutritional status in old age?

Answer 2

• decreased taste and smell sensitivity - reduced appetite - malnutrition
• decreased thirst sensation - decreased fluids = dry mouth - dehydration
• produce less saliva - affects chewing and swallowing
• poor dentition
• poor vision
• reduced muscle volume (sarcopenia) - decrease in physical activity
• decreased basal metabolic rate - largely due to reduction in the lean body mass they have
• reduced capacity for vitamin D synthesis as skin is thinner
• reduced bone density
• reduced calcium bioavailability
• reduced renal function

Question 3

What are the GI tract changes associated with ages?

Answer 3

• decreased motility
• decreased elasticity
• decreased gastric acid/ intrinsic factor
• decreased absorption - impaired absorption of B12, Biotin, Calcium and Iron

Question 4

What are the signs of poor nutrition?

Answer 4

• reduced appetite
• reduced food intake
• unintentional weight loos
• reduced muscle mass
• dehydration
• skin breakdown
• pressure sores and ulcers
• ill fitting dentures
• loose clothes or jewellery
• no food in fridge
• eating only one type of food
• consuming only alcohol

Question 5

What are the consequences of malnutrition?

Answer 5

• reduced muscle function e.g. heart failure
• reduced GI function
• reduced immunity and poor wound healing
• kidneys - struggle to regulate salt and fluid which can lead to over-hydration or dehydration
• brain - malnutrition causes apathy, depression, introversion, self-neglect
• impaired temperature regulation - can cause hypothermia

Question 6

What nutrients are important in aging?

Answer 6

• reduced energy requirements as reduced physical activity and reduced basal metabolic rate
• Increased protein requirements because protein is processed less efficiently with age. Also old age more likely to be unwell, have falls, need surgery etc so protein can help with immune support, bone health, muscle mass, wound healing. Not eating enough protein can cause them to lose muscle mass faster.

Question 7

What diet and exercise would you recommend for an older person?

Answer 7

• nutritionally dense diet - low energy, high protein, nutrient dense foods.
• small meals
• meals that are attractive to them so they are more likely to eat them
• high protein - 1-1.3 g/kg/day
• resistance training to slow muscle loss

Question 8

What supplements may be needed for an older person?

Answer 8

• Vitamin D, Vitamin B12, B7, Iron and Calcium
• Increasing antioxidants may help boost immune system
• Folate and B12 reduce risk of Cardiovascular disease.

Question 9

What is sarcopenia?

Answer 9

• The loss of skeletal muscle mass and strength as a result of ageing.
• In 75+ muscle mass is lost at a rate of 0.7% per year in women and 0.9% per year in men

Question 10

Why does vitamin D contribute to increased risk of osteoporosis?

Answer 10

Vitamin D helps regulate the amount of calcium and phosphate in the body.