Older Adult Health Flashcards
list nutritional challenges that come with age
decreased food intake
decreased basal metabolic rate, lean body mass, sense of taste/smell
causes of malnutrition in the elderly
poor dentition difficulty swallowing declining coordination + eyesight arthritis low mood cognitive decline cancer, HF, CKD, hypothyroidism coeliac disease + IBD medications (diuretics, antihypertensives) reduced physical activity dependent on staff if in care homes
effects of malnutrition in the elderly
impaired immune function poor wound healing osteoporosis cognitive impairment mood disturbance joint + muscle pain Ca2+, vit D/C/B12, folate deficiencies > osteomalacia, anaemia, sarcopenia
how to assess nutrition in the elderly
changed weight/BMI? mental health social/drug/past medical history food and fluid diary MUST (malnutrition universal screening tool)
which healthcare staff are involved in the support of the elderly in terms of nutrition?
doctors dieticians occupational therapists social care speech and language therapists dentists
list examples of common sleep disorders
obstructive sleep apnoea
insomnia
OSA results from?
partial/fully blocked airway
partial/fully blocked airway in OSA is predisposed by?
tonsils too large
jaw set too far back
excess weight
outline what occurs in OSA when sleeping
airway blocked > brain hypoxia > mini arousal > sharp intake of breath
OSA increases risk of?
CVD stroke T2DM severe depression severe COVID-19
presentation of OSA
loud snoring > pause in breathing > large gasp of air
excessive daytime sleepiness
diagnosis of OSA
ideally with PSD - expensive + resource intensive
STOP-bang questionnaire
STOP-bang questionnaire
snoring tiredness observed pressure (blood) BMI age neck gender
risk factors for OSA
sleeping on back
anything that impacts REM sleep (alcohol, some antidepressants)
treatment of OSA
CPAP gold standard but low compliance
lifestyle: weight loss, quit smoking, reduce alcohol
always consider bed partner
insomnia is a predictor of?
depression
cause of insomnia?
continuously heightened stress
diagnosis of insomnia
difficulty initiating/maintaining sleep, waking up earlier + resistance going to sleep, difficulty sleeping w/o parent, daytime difficulties
time course of short term insomnia
1-3 months
time course of chronic insomnia
3 months
first line treatment for insomnia
CBT (sleep hygiene, relaxation training, paradoxical intention, sleep restriction therapy)
what is NOT recommended in the treatment of insomnia?
psychotropic medications
side effects can be worse
what is social isolation?
objective measure of the measure of the number of contacts someone has (QUANTITY)
what is loneliness?
subjective feeling about the gap between a person’s desired levels of social contact compared to the actual level (PERCEIVED QUALITY)
measurement of loneliness
community life survey
UCLA 3
role of social prescribing
enables primary care professionals to refer people to local, non clinical service
professionals involved in social prescribing
GP > link worker > community organisation > follow up
successes of social prescribing
improves QoL
improved mental health
reduction in use of NHS services
challenges of social prescribing
hard to measure outcomes due to the heterogenous nature of the programmes/service users/outcomes
w/o strong evidence hard to commission programmes
risk of seeming to trivialise the patient’s issues
outline the health benefits of green space
improved social cohesion
reduced stress
improved attention + memory
reduced diastolic BP/salivary cortisol/HR
reduced risk of preterm birth/small size gestational age/all cause mortality/T2DM
reduced incidence of stroke/hypertension/dyslipidemia/asthma/CHD
reduced crime
increased job opportunities/work productivity
outline the anti-inflammatory effects of physical activity
reduced inflammatory visceral fat
anti-inflammatory myokines during muscle contraction
outline the effects at a mitochondrial level of physical activity
ATP use in muscle contraction reduces charge in mitochondria > reverses inflammation + telomere shortening
^ number and size of mitochondria
outline health benefits of physical activity - CVD
weight loss
CVD: CAD plaque regression, reduces BP, prevents rehospitalisation after an MI
outline health benefits of physical activity - diabetes
diabetes: reduces mortality, ^ insulin sensitivity, better HbA1c, lipids, waist circumference, BMI
