Nutrition in the Elderly Flashcards

1
Q

What is the top 8 leading causes of death for adults >65 yo?

A
  1. Heart dx
  2. cancer
  3. COPD
  4. Stroke
  5. Alzheimer’s
  6. Diabetes
  7. Flu/Pneumonia
  8. Nephritis
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2
Q

What are nutrients that are commonly deficient in the diets of the elderly?

A
Fluid
Fiber
Protein
Vit B12
Vit D
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3
Q

How much does basal metabolism decrease for 50-70 yo? >70 yo?

A

50-70: down 10%

>70 yo: down 20-25%

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4
Q

T/F Elderly eat 1/3 fewer calories and decrease protein intake.

A

True.

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5
Q

What are some obstacles to healthy eating in older populations?
Acronym: MEALS on WHEELS

A
Medications
Emotional (depression, anxiety) 
Alcoholism
Late life paranoia or bereavement
Swallowing problems

Oral factors
Nosocomial infections

Wandering or dementia
Hyperthyroidism, hypercalcemia, hypoadrenalism
Enteral problems
Eating problems
Low salt, therapeutic diets 
Social isolation
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6
Q

What is a better indicator of nutritional status, aside from albumin?

A
Mini Nutrition Assessment
83% sensitive
food intake change
weight loss
mobility
psychological stress
BMI
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7
Q

What are some automatic warrants for a nutrition consults?

A

dialysis
enteral/parenteral nutrition
wounds
low Braden score

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8
Q

What are 2 methods of indirect calorimetry?

A
  • *Oxygen consumption v. carbon dioxide excretion

* *Respiratory Quotient

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9
Q

What are predictive equations of calorie needs in healthy non-overweight people?

A

Harris-Benedict

Mifflin St. Jeor (can also be used in obese patients)

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10
Q

ICU calorie need measurements?

A

Penn State 1998 (obese vented)

Penn State 2003 (non-obese vented)

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11
Q

What determines protein needs?

A

normal: 0.7-0.8 g/kg
geriatric: 0.8-1 g/Kg
stress & wounds need higher protein
kidney failure, decrease protein
dialysis can raise protein again.
plant protein better tolerated in cases of encephalopathy

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12
Q

Why should enteral nutrition be first line always, if possible?!

A

b/c if you use IV nutrition, run risk of decreasing blood flow to gut & causing damage.

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13
Q

T/F Medically-assisted nutrition and hydration should be considered medical interventions rather than basic provisions of comfort

A

True.

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14
Q

T/F Dehyration is a form of malnutrition.

A

T

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15
Q

What are some recommendations to increase fluid intake?

A

Keep water by the table/bed at all times
Remind them to drink even if they aren’t thirsty
Focus on whole foods that can provide some hydration
All beverages (except for high sources of caffeine) can be used to meet fluid recommendations

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16
Q

What are the benefits of fiber? How many grams/day?

A

15 g/day
gastric motility
improved glycemic control
reduced cholesterol

17
Q

How many grams of protein/meal should the elderly eat?

A

25-30 grams/meal

18
Q

How should the elderly get their Vitamin D & Calcium?

A

8 oz of milk
1 oz of cheese
6 oz of yogurt

19
Q

What is the upper limit of amount of folic acid/day?

A

1000 micrograms/day

don’t want to mask Vit B12 deficiency

20
Q

What are the daily recommendations for food in elderly?

A
5 ½ oz of protein
5-6 oz of grains (1/2 should be whole grains)
3 cups of dairy
2-3 cups of veggies
2-3 cups of fruit
Less than 6 teaspoons of oils
21
Q

What are the macronutrient recommendations?

A
Carb: 45-65%
Protein: 15-20%
Fat: 25-35%
7-10% sat. fat
Choelsterol 200-300 mg/day
22
Q

What are the macronutrient recommendations?

A
Carb: 45-65%
Protein: 15-20%
Fat: 25-35%
7-10% sat. fat
Cholesterol 200-300 mg/day
23
Q

What do you do with obese elderly people?

A

Encourage them to not gain weight.

Don’t decrease their BMI less than 25, prob leave them alone in case they get sick & need extra reserves.

24
Q

What are the physical activity guidelines for older adults?

A
Cardio/Aerobic exercise 
3 to 7 days per week 
1,000 to 2,000 calories burned per week
Walking, swimming, jogging
Resistance training 
2 to 3 days per week, 8 to 20 reps with 2-3 rounds, 
whole body routines, resistance bands, free weights
Balance/Flexibility – Daily