Nutrition In Older Adults And Elderly Flashcards
What are the current demographic trend’s?
People tend to be living longer and there are less people having children
Is there a difference in life expectancy between different social classes?
Yes. Those in the least deprived areas tend to live approximately 24 years longer than those in the most deprived areas of Scotland.
How is the ageing process determined?
Genetics
Chronic disease
Molecular and cellular damage resulting in the loss of function and frailty
Behavioural and environmental factors - nutrition, physical activity, smoking
Dietary restrictions
Luck
What does young vs frail older adults refer to?
Younger older adults - very fit, fit and managing well. The focus of this group is to add health to years. This is to try and avoid preventable disease.
Frail older adults - vulnerable, mildly frail, moderately frail, severely frail, very severely frail. Less likely to live on own home. It is important to try and maintain as much independence.
What is sarcopenia?
The progressive loss of muscle mass and physical functions
What can help minimise sarcopenia?
Weight bearing and resistance exercise increases lean muscle mass and bone density. Exercise can also help improve protein uptake from food
How does BMI differ with older adults?
In younger adults 18.5-25 g/m2 is typically healthy.
In older adults <24kg/m2 can be associated wi5 health problems.
24-29kg/m2 maybe be a more suitable weight range.
Waist-hip ratios over the recommendations of older adults are?
64% in men
62% in women
How does fluid balance change physiologically for older adults?
- Reduction in total body water
- Decline in thirst perception
- Dehydration occurs more quickly and rehydration is less efficient.
- Deterioration in renal function.
What are the considerations of fluid balance for older adults
- Reduced ability to prepare drinks.
- Increased urine output with diuretic drugs.
- Unwillingness to drink
- Dehydration can lead to constipation, cognitive impairment, and efficacy of medications.
How does bone mineral density change over time?
Peak bone mass around 30yo
After 30yo bone loss begins. Around 0.7-1% a year
This increases in women post menopause. 2-3% a year
By 60years old what is the average loss of bone?
There is a 20% loss of bone mineral from 20 years old
What does the ageing process begin to start?
Between the ages of 20-30
How does ageing affect taste?
Taste receptor cell turnover rate reduce.
The threshold for sweet/salty increase
Drugs, treatment and disease can affect taste
How does ageing affect dentition
A reduced ability to chew and swallow
Lack of teeth or poorly fitting dentures influence food type, quality and quantity. Those who have their own teeth tend to have higher vitamin and mineral uptakes.
How does ageing affect the oesophagus?
Gastro-oesophageal reflux disease (GORD) - can cause pain and difficulty swallowing, uncomfortable heartburn, feeling sick.
What is the difference between young older adults and frail older adults?
Young older adults - Are on the very fit to managing well on the scale. The focus is to add on years to their health and try to prolong any further illnesses or disabilities.
Frail older adults - Vulnerable to very severely frail on the scale. The focus is to try and keep independence for the individual for as long as possible, even if they are no longer living at home. This group is more likely to have nutrient deficiencies.
How does aging and body composition differ with age?
As you get older the fat free mass starts to decrease during middle age and after 60 years old the FFM decrease speeds up.
How does food bioavailability change as we age?
Bioavailability of certain nutrients can begin to decrease over age. This is due to changes in the gastrointestinal system.
How does atrophic gastritis affect the stomach?
Inflammation and thinning of the gastric mucosa.
Parietal cells are more slowly replaced.
Less acid, pepsin and intrinsic factors are secreted
Iron, B12 and Folate absorption are affected due to changes in the pH of the stomach - low pH is needed for absorption
Bacterial growth can affect absorption
How is B12 absorption affected in the stomach?
Dietary B12 separated by digestion bind to B12 binding proteins or intrinsic factor. This digestion takes place under influence of acid and pepsin. Stomach acid lacking this digestion cannot take place and B12 cannot bind into the intrinsic factor further down the small intestine.
How does the stomach absorb iron?
Ferric iron is insoluble above pH five.
The stomach acid keeps iron and solution until it reaches the absorb sites in duodenal mucosa. Vitamin C can only bind when the iron is in solution so it needs to be a low pH.
How is calcium absorbed in the stomach?
Calcium carbonate reacts with hydrochloric acid to form soluble calcium chloride.
The soluble calcium chloride is absorbed in the proximal small bowel .
In atrophic gastritis, calcium may not be solubilised or absorbed.
How is the gut microbiota affected by aging?
In the older adult population, the lower levels of stomach acid secretion may lead to small bowel bacterial overgrowth. The growth of bacteria throughout the length of the small intestine tends to be more common in the older age and this can lead to malabsorption and vitamin B deficiencies.
