Older Adult Health Flashcards
What are the nutritional challenges faced by older people?
- decreased food intake -> decreased metabolic rate, lean body mass, sense of taste/small
What are the possible physical causes of malnutrition?
- poor dentition
- difficulty swallowing
- declining co-ordination and eyesight
- arthritis
- reduced physical activity
- dependent of care home care
What are the possible effects of malnutrition?
- impaired immune function
- poor wound healing
- osteoporosis
- cognitive impairment
- mood disturbance
- joint and muscle pain
- calcium, vitamin C/D/B12, folate deficiency (osteomalacia, anaemia, sarcopenia)
How do you assess for malnutrition?
- weight/BMI changes
- mental health
- social/drug/past medical history
- food and fluid diary
- MUST (malnutrition universal screening tool)
Who can provide support for those being treated for malnutrition?
- doctors
- dieticians
- occupational therapy
- social care
- speech
- language therapists
- dentists
What are the common sleep disorders seen in older adults?
- sleep apnoea
- insomnia
How do you treat sleep apnoea?
- CPAP (gold standard, low compliance)
- lose weight/smoking and alcohol cessation)
What risk factors can predispose someone to sleep apnoea?
- sleep on back
- anything that impacts REM sleep (alcohol, anti depressants)
How does sleep apnoea present?
- loud snoring, pause in breathing, large gasp of air
- excessive daytime sleepiness (EDS)
How do you diagnose obstructive sleep apnoea?
- ideally diagnosed with PSD (expensive and resource intensive)
- use STOP-bang questionnaire
What does obstructive sleep apnoea increase your risk of?
Increased risk of:
- CVD
- stroke
- T2DM
- severe depression
- severe COVID-19
What happens in obstructive sleep apnoea?
- airway blocked in sleep > brain hypoxia > mini arousal > sharp intake of breath
- caused by a partial/fully blocked airway (large tonsils, jaw set too far back, excess weight)
What is insomnia a predictor of?
depression
What can cause insomnia?
Continuously heightened stress
How does insomnia present?
- difficulty initiating/maintaining sleep
- waking up earlier and resistance going to bed
- difficulty sleeping without a parent/caregiver
- daytime difficulties due to sleep
What are the different classifications of insomnia?
- 1-3 months (short term)
- >3 months (chronic)
What is the treatment available for insomnia?
- first line: CBT
- sleep hygiene, relaxation training, paradoxical intention, sleep restriction therapy
- psychotropic medication
Define social isolation?
An objective measure of the number of contacts someone has (quantity and quality)
Define loneliness?
A subjective feeling about the gap between a person’s desired levels of social contact compared to the actual level (perceived quality of the person’s relationships)
What is social prescribing?
Enables GPS, nurses and other primary care professionals to refer people to local,non-clinical services
What professionals are involved in social prescribing?
GP assesses patient needs and refers to link worker, who will signpost to a community organisation and follow-up the patient
What are the benefits that have been found from social prescribing?
- improves quality of life and mental health
- reduction in the use of NHS services
What are the challenges that have been associated with social prescribing?
- hard to measure outcomes due to the heterogenous nature of the programmes/service users/outcomes
- without strong evidence, hard to commission the programmes
- risk of the patient feeling that you have trivialised their issues
What are the benefits of green space on ageing?
- improved social cohesion and interaction
- reduces stress
- improved attention and memory
- reduced BP/salivary cortisol/HR
- reduced crime
- reduced risk of all cause mortality/stroke/hypertension/asthma/CHD
