Chapter 13: Nutrition Needs for Older Adults

What are some psychosocial changes that may occur with age?

- change in income related to retirement - reliance on medications - social isolation - poor self esteem

Evidence shows most adults exceed the RDA for protein, yet older adults do not. Why?

- cost of protein foods - decreased ability to chew tough meat - lower overall food intake - changes in digestion & gastric emptying

Why are older adults at a higher risk for dehydration?

- decreased sense of thirst -medication effects - mental status & cognition - impaired mobility - fluid restriction - avoid trips to bathroom (arthritis, immobility)

What are some changes in oral & GI tract that may occur with aging?

- difficulty chewing -constipation -difficult digestion -decrease in nutrient absorption

What are some sensory losses that may occur with age? *what affects them when eating*

- hearing loss - taste bud loss - loss of visual activity - *decreased sensation of thirst*

Above age 80 is the highest risk for malnutrition. What are some factors that put them at risk?

- increases morbidity & mortality - length of hospital stay - cognitive function - physical weakness -muscle wasting - pressure ulcers (bed sores) - infections

In relation to long-term care, what are nurses to do? What is their goal?

-The goal is to prevent malnutrition, and thus, promote intake. This should be done with nutrient dense foods & small, frequent meals.

What are some renal changes that may occur with age?

-ability to concentrate urine decreases

What are some red flags for malnourished older adults?

-anorexia of aging -functional limitations -social isolation -polypharmacy

Dehydration can put the elderly at risk for... -C -C.I. -F.D. -D.

-constipation - cognitive impairment -functional decline -death

What are some metabolic changes that may occur with aging? (G & VD)

-decreased insulin sensitivity/secretion, thus altered glucose tolerance -decreased vitamin d synthesis (degeneration of skin)

What are some changes in composition and energy expenditure that may occur with aging?

-decreased lean body mass -decrease BMR (basal metabolic rate) -decrease physical activity -increase fat tissue

Increasing fiber intake can...

-help prevent constipation -improve glycemic control -reduce serum cholesterol levels

Explain Age- Related Macular Degeneration (AMD)

-it is a deterioration of the macula in the eye, patients with AMD will see a black blob in the middle of their eyesight.

What are somethings that help people to age healthily?

-laugh -travel -learn new things -positive outlook -stay active

What are some strategies to prompt intake?

-neat dining environment -family involvement -honor food preferences -allow for independence, avoid staff interruption

What are some options, considering complication such as decreased ability to chew meats, for an older adult to increase protein intake?

-shredded / ground meat - adding powder milk to liquids - adding eggs & soft cooked beans, or fish to diet

What are some CNS changes that may occur with age?

-tremors -slowed reaction time -short-term memory deficits -depression

What is the protein RDA for older adults? What may it be between?

0.8 g / kg / day. Protein needs increase due to loss of lean muscle mass. It could be between 1.0 g to 1.6 g / kg / day to prevent loss of lean body mass.

Calcium RDA 31-50 51-70 71+

1000 1200(F) 1000(M) 1200

Explain "Anorexia of Aging"

A decrease in appetite & increase in satiety leads to unintentional weight loss

How do functional limitations affect the nutrition status of an older adult?

A decrease in muscle mass and strength leads to limitations on ADL's (activities of daily living) & decrease in intake

____ is a gradual process of progressive physiologic, cellular, cultural and psychosocial changes.

Aging

T/F: The RDA for Calcium is the same for adults of all ages.

FALSE!

T/F: The period when calcium intake has the greatest impact on bone density occurs between ages 18-30 years.

FALSE! ages 4-20 is when calcium intake has the *greatest impact on bone density*

T/F: Kcal needs increase as activity decreases.

FALSE! kcal needs decrease as activity decreases.

Even though the AI is lower, research show that older adults consume less than the recommended amount of fiber per day. Why?

High fiber foods may be difficult to digest

_____ medications = _____ fiber, vitamins & minerals.

More = less

This is the reduction of cartilage, it is the leading cause of functional limitations, very *painful*

Osteoarthritis

How can Alzheimer's Disease have a devastating impact on nutritional status?

Patients with alzheimer's are often confused, and often forget to eat.

This is muscle wasting/deterioration, and risk can be reduced with resistant exercise.

Sarcopenia

T/F: Generally, the calorie needs in older adults decrease and the need for other nutrients stays the same or increases.

TRUE

T/F: In care of the older adult, the major cause of under nutrition is loss of appetite.

TRUE

T/F: Weight loss in older adults is associated with mortality.

TRUE

T/F: 80% of adults 65+ have at least 1 chronic health problem.

TRUE!

Why is the AI of fiber decreased for older adults?

The AI is based on median calorie intakes and older adults eat fewer calories.

a healthy diet of nutrient-dense foods that contains neither excessive nor restrictive amounts of fat, cholesterol, sugar, and sodium

a Liberal Diet

What two nutrients are essentially protective against AMD?

antioxidants & omega 3's

What are the basic guidelines for older adults in relation to physical activity?

avoid inactivity

As _____ age, degenerative changes cause impairment of organs, tissue and body functions.

cells

How is MyPlate for older adults similar to younger adults?

focuses on: -fluids -activity -fiber -protein

Malnutrition is a ______dimensional problem in the elderly.

multi

This is the thinning of bone, and prevention begins at an early age.

osteoporosis

What is polypharmacy?

poly = many, pharmacy = medications. It refers to the poor nutrition acquired by drug interactions. Drugs may alter nutrient intake, metabolism & absorption.

Loss of muscle and bone in older adults can be prevented by _____________ training.

resistance