Nutrition in the Elderly Flashcards
One third of hospitalized patients suffer from this nutrition problem
protein calorie malnutrition
____% of people are overweight: BMI > 25
68
____% of people are obese: BMI > 31
31
At what age does the most dramatic change in weight occur in people?
60, 69
As people age, what are some of the changes to body composition that occur.
net decrease in : bone mass, lean mass, water content
net increase in : total body fat
What happens to the BMR as people age?
total energy expenditure decreases - BMR decreases
note: BMR is dependent on lean muscle mass
Energy requirements reduce by ____ kilocalories in women and _____ kilocalories in men per decade
70; 100
The current RDA for protein is ____gm/kg/day, with stress (infection, etc) as high as ___gm/kg/day
0.8; 1.5
Fat makes up what ___-___ % of total energy
20-35
N-6 polyunsaturated fatty acids make up ___-___ % of total energy
5-10
N-3 polyunsaturated fatty acids make up ___-___% of total energy
0.6-1.2
Carbs make up ____-____% of total energy
45-65
Protein makes up ____-____ % of total energy
10-35
For each of the following, give the amount in grams/day recommended: carbs fiber protein fat
carbs: 130gm/day
fiber: 30gm/day
protein: 56 for men and 46 for women
fat: not determined
A deficiency in B6 can come about how?
alcohol, medicine use
A deficiency in B12 can come about how?
avoidance of red/organ meats, gastric/illeal surgery
A deficiency in folate can come about how?
alcohol, medicine use, inadequate uptake, malabsorption syndromes
A deficiency in Vitamin C can come about how?
inadequate intake
A deficiency in Vitamin D can come about how?
institutionalized older patients, low dairy intake
This is the most common fluid/electrolyte disturbance
dehydration
How do changes in taste, smell, and thirst affect nutrition?
decrease in taste - less interest in food
impaired thirst sensation
note: also decline in gastric emptying can occur
Decreased HCl and intrinsic factor and impaired bioavailability of Vit B12, Ca, Iron, Folic Acid, and possibly since are caused by what?
atrophic gastritis
Age related skin changes can occur because of what?
decreased efficiency of Vit D synthesis
Unintential wt loss to what extent is associated with mortality in elderly?
5% a month
10% over 6 month period
In regards to Anthropometrics, what is the BMI cut off
18.5
What are some variables to be aware of when getting the nutrition history from patients in the hospital and patients at home?
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?
What are the lab tests that help a doctor asses nutrition?
albumin, prealbumin, hypocholestrolemia
What supplements can be taken to reduce risk of age related macular degeneration?
antioxidant mix of Vit C, E, Zn
What supplements can be taken to maintain immune function?
B6, Zn, low dose of Vit E
A syndrome of weight loss, decreased appetite, and poor nutrition, and inactivity, often accompanied by dehydration, depressive symptoms, impaired immune function, and low cholesterol
failure to thrive
How is failure to thrive treated?
nutritional support, remove dietary restrictions, treat underlying disorders, remove offending medications
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
megasterol: cancer and long term residents
dronabinol: cancer and AIDS
mirtazapine: depression with wt loss
