Nutrition in the Elderly

Question 1

One third of hospitalized patients suffer from this nutrition problem

Answer 1

protein calorie malnutrition

Question 2

____% of people are overweight: BMI > 25

Answer 2

68

Question 3

____% of people are obese: BMI > 31

Answer 3

31

Question 4

At what age does the most dramatic change in weight occur in people?

Answer 4

60, 69

Question 5

As people age, what are some of the changes to body composition that occur.

Answer 5

net decrease in : bone mass, lean mass, water content

net increase in : total body fat

Question 6

What happens to the BMR as people age?

Answer 6

total energy expenditure decreases - BMR decreases

note: BMR is dependent on lean muscle mass

Question 7

Energy requirements reduce by ____ kilocalories in women and _____ kilocalories in men per decade

Answer 7

70; 100

Question 8

The current RDA for protein is ____gm/kg/day, with stress (infection, etc) as high as ___gm/kg/day

Answer 8

0.8; 1.5

Question 9

Fat makes up what ___-___ % of total energy

Answer 9

20-35

Question 10

N-6 polyunsaturated fatty acids make up ___-___ % of total energy

Answer 10

5-10

Question 11

N-3 polyunsaturated fatty acids make up ___-___% of total energy

Answer 11

0.6-1.2

Question 12

Carbs make up ____-____% of total energy

Answer 12

45-65

Question 13

Protein makes up ____-____ % of total energy

Answer 13

10-35

Question 14

For each of the following, give the amount in grams/day recommended:
carbs
fiber
protein
fat

Answer 14

carbs: 130gm/day
fiber: 30gm/day
protein: 56 for men and 46 for women
fat: not determined

Question 15

A deficiency in B6 can come about how?

Answer 15

alcohol, medicine use

Question 16

A deficiency in B12 can come about how?

Answer 16

avoidance of red/organ meats, gastric/illeal surgery

Question 17

A deficiency in folate can come about how?

Answer 17

alcohol, medicine use, inadequate uptake, malabsorption syndromes

Question 18

A deficiency in Vitamin C can come about how?

Answer 18

inadequate intake

Question 19

A deficiency in Vitamin D can come about how?

Answer 19

institutionalized older patients, low dairy intake

Question 20

This is the most common fluid/electrolyte disturbance

Answer 20

dehydration

Question 21

How do changes in taste, smell, and thirst affect nutrition?

Answer 21

decrease in taste - less interest in food
impaired thirst sensation

note: also decline in gastric emptying can occur

Question 22

Decreased HCl and intrinsic factor and impaired bioavailability of Vit B12, Ca, Iron, Folic Acid, and possibly since are caused by what?

Answer 22

atrophic gastritis

Question 23

Age related skin changes can occur because of what?

Answer 23

decreased efficiency of Vit D synthesis

Question 24

Unintential wt loss to what extent is associated with mortality in elderly?

Answer 24

5% a month

10% over 6 month period

Question 25

In regards to Anthropometrics, what is the BMI cut off

Answer 25

18.5

Question 26

What are some variables to be aware of when getting the nutrition history from patients in the hospital and patients at home?

Answer 26

in hospital: 24/48 hr calorie count, % of food consumed, diet restrictions?

at home: meals on wheels?, who does the cooking?, food lying around house?

Question 27

What are the lab tests that help a doctor asses nutrition?

Answer 27

albumin, prealbumin, hypocholestrolemia

Question 28

What supplements can be taken to reduce risk of age related macular degeneration?

Answer 28

antioxidant mix of Vit C, E, Zn

Question 29

What supplements can be taken to maintain immune function?

Answer 29

B6, Zn, low dose of Vit E

Question 30

A syndrome of weight loss, decreased appetite, and poor nutrition, and inactivity, often accompanied by dehydration, depressive symptoms, impaired immune function, and low cholesterol

Answer 30

failure to thrive

Question 31

How is failure to thrive treated?

Answer 31

nutritional support, remove dietary restrictions, treat underlying disorders, remove offending medications

Question 32

For each of the following drugs used to treat failure to thrive, give the correct patient that it should be given to:
megasterol
dronabinol
mirtazapine

Answer 32

megasterol: cancer and long term residents
dronabinol: cancer and AIDS
mirtazapine: depression with wt loss