Ageing 3: Body Composition & Nutrition

Question 1

BMI Formula

Answer 1

Weight/[Height^2]

Weight is most important, which is why it’s on top, and doesn’t need to be squared to be compared with height (already potent enough as is)

Question 2

Approx healthy BMI range in older people (men vs women)

Answer 2

Men: 31-32
Women: 27-28

(almost looks like an age gap)

Question 3

Two people have same BMI. One is markedly stronger than the other in all fitness tests. What explains this?

Answer 3

• Body composition
• One person may have very high muscle content, and less fat and/or water and/or bone. Other may have more fat, less, muscle, more water, and be “big boned”

Question 4

What substances/vitamins may be more important in the diet during aging, and why?

Answer 4

• Vitamin D for bone health
• B12 for brain/blood health
• FIbre for gut health
• Water in case sense of thirst is lost

Question 5

How does daily calorific intake change between the age of 20 and 80? How does the magnitude of this change differ between men and women?

Answer 5

• Calorific intake decreases with age
• Decreases more in men (they were eating more in the first place, so have further to drop)

Question 6

What causes older people to eat less calories than younger people?

Answer 6

• Reduced smell and taste decrease pleasure of eating
• Decreased grehlin (hunger hormone) and feeling full earlier lead to reduced feeling of hunger

Question 7

Why is it bad news when an older person starts losing weight?

Answer 7

• When they do this, they disproportionately lose muscle mass over fat, and can also lose bone mass
• This muscle/bone is very hard to gain back, and can predispose to sarcopenia and frailty

Question 8

Impacts of poor nutrition in old age

Answer 8

• Increased mortality/reduced QOL
• Increased falls/post-op complications
• Increased infections
• Increased healthcare costs/use
• More frequent/longer hospitalisation

Question 9

Mnemonic + risk factors for undernutrition and weight loss in old age

Answer 9

• MEALS ON WHEELS
• Medication effects
• Emotional problems (e.g. MDD)
• Anorexia/alcoholism
• Late-life paranoia
• Swallowing
• Oral factors
• No money
• Wander/dementia
• Hormoal (e.g. hyperthyroidism)
• Enteric problems (e.g. malabsorption)
• Eating problems (e.g. can’t feed self)
• Low-salt/-cholesterol diets
• Social problems (e.g. isolation)

Question 10

What drug effects might increase undernutrition risk?

Answer 10

• Nausea
• Diarrhoea/vomiting
• Consttipation
• GI ulcers

Question 11

Define sarcopenia + health implications

Answer 11

• Loss of muscle mass/strength (age related)
• Most important consequences are falls, increased hospitalisation risk, loss of independence, and death

Question 12

Sarcopenia risk factors

Answer 12

• Social isolation
• Polypharmacy
• Smoking
• Lack of physical activity

Question 13

Functional problems of sarcopenia in old age

Answer 13

• Reduced balance/mobility
• Difficulty with ADLs