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NUTR451 > EXAM 4 > Flashcards

EXAM 4 Flashcards

1
Q

Government definition of young old

A

65-75 yr

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2
Q

Government definition of Aged

A

75-84

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3
Q

Government definition of oldest old

A

> 85 yr

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4
Q

Senior Nutrition Program (Older Americans Act 1972) Eligibility

A

60 years or older

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5
Q

eligible for retirement age

A

65

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6
Q

eligible for full payment age

A

66

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7
Q

eligible for early retirement age

A

62

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8
Q

Eligible for medicare age

A

65

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9
Q

Biological aging refers to process or group of processes that with passage of times leads to …(3)

A
  1. Loss of adaptability
  2. Functional impairment
  3. Eventual death
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10
Q

What are the four leading causes of death in people 65 yrs and older (in order)

A
  1. Heart disease
  2. cancer
  3. stroke
  4. diabetes
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11
Q

___% of 65+ have atleast 1 chronic condition. ___% of 65+ have atleast 2 chronic conditions. But many rate their health as good to excellent.

A
  1. 80%

2. 50%

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12
Q

Which health conditions are more prevalent in older men than women? (2)

A

heart disease and stroke

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13
Q

Which health conditions are more prevalent in older women than older men? (3)

A

osteoporosis
arthritis
circulatory diseases

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14
Q

Which sex is living alone in their elder years?

A

women (almost double that of men)

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15
Q

Since 1957-2002 tooth loss has ____.

A

decreased from 55% to 24%

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16
Q

Which part of the country has to most old people?

A

north east

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17
Q

Name the 3 states with the highest amount of older people in order.

A
  1. Florida
  2. West Virginia (most poverty)
  3. PA
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18
Q

Name the 3 determinants of Aging

A
  1. Genes
  2. Environment
  3. Epigenetics
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19
Q

Genes explains ___-___% of longevity

A

20-30%

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20
Q

Give some examples of environment factors

A

health behaviors (eating, medicine, physical activity), social support, mental health, daily activities, cognitive ability, personality, coping

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21
Q

Explain epigenetics

A

genes are there but have to be turned on and off. Increases and decreases certain traits

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22
Q

Name the 2 theories of programmed aging

A
  1. Hayflick’s theory of limited cell replication

2. Molecular clock theory

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23
Q

Explain Hayflick’s theory of limited cell replication

A

cells can divide only a certain number of times.

Humans max out at 110-120 years

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24
Q

Explain the Molecular Clock Theory

A

telomeres=clocks= repetitive nucleotide sequences at the end of chromosomes which shorten with each cell division

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25
Q

Increase ___ AND ____ blood levels slow shortening of telomeres

A

DHA and EPA

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26
Q

Name the theories of wear-and tear (cytotoxicity of metabolic processes)

A
  1. Oxidative stress

2. Rate of living theory

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27
Q

Explain oxidative stress

A

increase in reactive O2 compounds with age–>increase free radicals (ex. smoking, ozone, radiation, pollution)

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28
Q

Explain the rate of living theory

A

“fasting living”= fast aging

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29
Q

Name the three theories concerning whether aging process can be slowed

A
  1. caloric restriction and longevity
  2. health behaviors and mortality
  3. components of successful aging
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30
Q

What have the studies shown about caloric restriction and longevity?

A

Wisconsin monkeys show that caloric restriction increases longevity and quality of life.

The Washington monkey study showed no effect

However there are differences in studies that could affect results

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31
Q

What were the 4 healthy behaviors in the Khaw study and what were the results?

A

non-smoking
not sedentary
moderate alcohol
plasma vit C >50 nmol/L

Studied showed that having these factors decreased chronological age

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32
Q

Name the 6 lifestyle behaviors that have the greatest influence on physiological age.

A
  1. Eating well-balanced meals
  2. Engaging in physical activity regularly
  3. Not smoking
  4. Not using alcohol
  5. Maintain a healthy body weight
  6. Sleeping regularly
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33
Q

Name the 3 components of successful agiing (Rowe and Kahn, 1998)

A
  1. Avoiding disease and disability
  2. High cognition and physical function
  3. Engagement with life
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34
Q

Health Care: 2020 Healthy People Objectives- Some concerns for older adults (5)

A
  1. Preventive health services
  2. Improve quality of life–>adults stay in their homes
  3. 20% of older adults engage in physical activity
  4. 1/3 older adults fall each year
  5. Caregivers are typically unpaid family
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35
Q

HP 2020: Goals related to nutrition and health care (5)

A
  1. Increase older adults who are knowledgeable of clinical prevention services
  2. Increase confidence in managing health conditions
  3. Increase diabetes self-management benefits
  4. Increase engagement in light, moderate, or vigorous leisure-time physical activities
  5. Increase registered dietitians with geriatric certification
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36
Q

Future challenges due to people staying healthier longer and postponing old age (2)

A
  1. Smaller work force supporting retired adults

2. Ballooning pension and health care money

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37
Q

Possible changes to help with the increase in elderly people

A

increase retirement age

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38
Q

At what age does smell and taste start to decline?

A

60

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39
Q

___% of individuals over age 80 have olfactory impairment.

A

75%

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40
Q

What are the causes of olfactory impairment? (3)

A
  1. # of olfactory receptors
  2. decreased blood flow
  3. increased thickness of nasal mucus
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41
Q

What can cause taste impairment? (4)

A

comorbidity, medications, smoking, dentures

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42
Q

During old age ____ ____ are not altered and taste perception of _____ does not change.

A
  1. taste buds

2. sucrose

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43
Q

_____ distortions, olfactory and taste impairment can cause a blunted sense of the enjoyment of food.

A

taste distortions

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44
Q

Name the 3 possible mechanical problems in eating

A
  1. Oral health affects intake
  2. difficulty chewing
  3. difficulty swallowing
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45
Q

Oral health–> _____–>nutrition status–>health

A

intake (amount and type)

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46
Q

Why do elders have a difficult time chewing? (4)

A
  1. No natural teeth
  2. poor fitting dentures
  3. poor oral hygiene
  4. consumption of foods that erode tooth enamel
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47
Q

What percentage of 65-74 y/o and 75+ have no natural teeth?

A

65-74: 19%

75+: 33%

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48
Q

____% of 65+ with a dental visit in the past year

A

60%

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49
Q

Reason for slowing of peristalsis (4)

A
  1. Aging digestive tract: brain-muscle transmitters faulty
  2. Weakened muscle esophagel-stomach junction
  3. slower stomach emptying
  4. consipation
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50
Q

Weakened muscle of the esophageal-stomach junction can lead to _____. Do not feed in ____ position; remain ______ after eating.

A
  1. GERD
  2. supine
  3. upright
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51
Q

Define constipation

A

hard stool, straining, sensation of incomplete bowel movement or blockage, infrequent (

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52
Q

Causes of constipation (5)

A
  1. decreased peristalsis
  2. medications (opioids, NSAIDS)
  3. mineral supplements (iron, calcium)
  4. dehydration
  5. disease (dementia)
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53
Q

Advice for constipation (3)

A

fiber, water, exercise

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54
Q

slowing of peristalsis can cause which conditions (2)?

A

diverticulosis, diverticulitis

55
Q

small, bulging pouches develop in digestive tract

A

diverticulosis

56
Q

infection and inflammation within on of the small, bulging pouches that have developed in the digestive tract

A

diverticulitis

57
Q

prevention and treatment of diverticulitis

A

prevention: high fiber diet
treatment: antibiotics

58
Q

What is gastritis?

A

inflammation of the lining of the stomach

59
Q

Changes during aging due to atrophic gastritis (2)

A

autoimmune disease

overgrowth of H. pylori

60
Q

Prolonged inflammation from gastritis can cause _____ ____ ____ leading to _____ malabsorption.

A
  1. atrophied stomach mucosa

2. vitamin B12

61
Q

What vitamin are elders at risk for deficiency?

A

B12

62
Q

Causes for B12 deficiency in elders (4)

A
  1. Autoimmune gastritis
  2. Atrophic gastritis from H.pylori infection
  3. Use of antacids
  4. weight loss surgery
63
Q

Why would autoimmune gastritis cause b12 def?

A

loss of parietal cells (cannot secrete HCL and IF needed for B12 digestion)

64
Q

Why would atropic gastritis from an H.pylori infection cause B12 def?

A

lower HCL and pepsin secretion- less free B12 available

65
Q

Why would the use of antacids cause B12 def?

A

neutralizes pH in stomach (inhibits B12 digestion)

66
Q

Symptoms of B12 def (2)

A
  • Pernicious anemia

- Neurological symptoms: numbness, tingling in hands, poor muscle coordination, poor memory, hallucinations

67
Q

Treatment of B12 definciency (2)

A
  1. Intramuscular or subcutaneous injections

2. Large oral dose

68
Q

Prevalence of B12 def (poor data)

A

12-20%

69
Q

Diagnosis for Osteoporosis (porous bone)

A

2.5 or more stanard deviations below values for healthy adults

70
Q

Diagnosis for osteopenia (low bone mass)

A

1-2.5 standard deviations below the adult normal

71
Q

___% of adults aged 65+ has osteoporosis at the lumbar spine or femur

A

16%

72
Q

____% of adults aged 65% had low bone mass at the lumbar spine or femur neck

A

48%

73
Q

Peak bone density is reached between ___-__ y/o

A

18-30

74
Q

Bone mass remains stable until ___-___ y/o for women and ____ y/o for men

A

women: 40-50
men: 60

75
Q

Factors that contribute to bone loss (3)

A

nutrition, hormones, inactivity

76
Q

Poor ___ and ____ intake early in life leads to lower peak bone density

A

calcium and Vit D

77
Q

Older adults consume ______ mg Ca less than the DRI

A

300-450 mg

78
Q

Reason for bone loss: Hormones
Females: post-menopause sharp decline in _____.
Can lose up to __% bone mass 5-7 years post-menopause. Males ______ levels fall more slowly.

A
  1. estrogen
  2. 20%
  3. testosterone
79
Q

TRUE OR FALSE

There is less previtamin D in the skin for activation in older adults.

A

TRUE

80
Q

_____ _____ are the leading cause of death from injury in those 65+ in 2009

A

unintentional falls

81
Q

___% who fracture a hip have permanent functional disability; ___-___% die within a year

A
  1. 50%

2. 10-20%

82
Q

Kyphosis

A

shrinking height from compression pr vertebral fracture

Can cause dowager’s hump

83
Q

Diet advice for bone health for seniors (4)

A
  1. Meet Vit D and Ca RDA
  2. Adequate protein
  3. Increase fruits & vegetables
  4. Limit coffee/ caffeine
  5. Avoid high sodium intake
84
Q

How to meet Vit D and Ca RDA (2) and risks (2)

A
  1. dietary intake and supplements
  2. take Ca supp throughout the day
  3. high Ca increases risk for kidney stone
  4. High Vit D increases risk for hypercalcemia
85
Q

Bone Health

Increase fruits and vegetables to create ______ _____ that decreases bone resorption

A

alkaline environment

86
Q

Bone Health

Adequate protein because _______

A

muscle supports bone

87
Q

Activity advice for bone health for seniors

A

particiapate in weight bearing activities or resistance exercise

88
Q

Most common form of arthritis and leading cause of disability in community-dwelling adults

A

osteoarthritis

89
Q

degeneration of bone and cartilage in joints, bone hypertrophy, changes in synovial membrane, hardening of soft tissues, inflammation. Affects knee, hand and hip

A

osteoarthritis

90
Q

____% of adults 65+ have osteoarthritis

A

33%

91
Q

Cause and treatment (4) of osteoarthritis

A

Cause is unknown
There is no cure

Treatment: weight loss, exercise, healthy diet, NSAIDS

92
Q

Name the different levels of cognitive impairment with aging (3)

A
  1. Normal memory loss associated with getting old
  2. mild cognitive impairment (MCI)
  3. Dementia
93
Q

less mentally flexible, slower to process, memory changes

A

normal memory loss associated with getting old

94
Q

memory changes noticeable to others, do not interfere with daily life, increased risk for dementia

A

mild cognitive impairment (MCI)

95
Q

Umbrella term to describe symptoms: impaired memory, thinking, decision making, language, planning, problem solving

A

dementia

96
Q

Causes of dementia (3) in order

A
  1. Alzheimer’s disease
  2. lewy body disease
  3. cerebrovascular disease
97
Q

What is the most common type of dementia

A

Alzheimer’s disease

98
Q

Nutritional interventions for dementia (3)

A
  1. B12 and folate
  2. tea, coffee, caffeine
  3. Vit D
99
Q

Reasoning for B12 and folate intervention to prevent dementia (2)

A

low b12 and folate is related to high homocysteine–>slow info processing

low folate and B12 status linkrd to poor memory

100
Q

Reasoning for Vit D intervention to prevent dementia?

A

Vit D receptors and enzymes have been found in many regions of the brain

101
Q

What do studies show about Fish/EPA and DHA supplementation and its affects on dementia?

A

results differ

102
Q

2015 IOM report on cognitive aging (6)

A
  1. Physical activity
  2. Healthy Diet
  3. Control BO and diabetes, dont smoke
  4. Keep socially and intellectually active
  5. Get enough sleep
  6. Caution: products that claim to improve cognitive functioning
103
Q

Physiological changes and diseases associated with aging have ______ _____.

A

nutritional implications

104
Q

Need to account for the effect of comorbidities on ______ _____ when assessing nutritional status and prescribing diets.

A

functional ability

105
Q

What are the implications in changes in height? (2)

A
  1. compression of spine

2. osteoporosis

106
Q

The decline in height is sharper in women due to

A

menopause

107
Q

Body composition decline is more of a flat line for which sex?

A

female

108
Q

Muscle mass decline is more drastic in which sex?

A

females

109
Q

At which age is decrease in muscle mass greatest?

A

70yrs and older

110
Q

What is the optimal BMI for 70yr and older?

A

27

111
Q

A study found that people who were slightly overweight in their 50’s but kept their weight relatively stable were the most likely to survive over the next 16 years. What was the BMI?

A

25-29.9

112
Q

The study also showed that those who started out as very obese in their 50’s and whose weight continued to increase were the most likely to…

A

die

113
Q

How does body composition change with age?

A
  • increase in adiposity (especially in torso)

- decrease in fat-free mass (due to decrease in PA, estrogen and testosterone)

114
Q

Changes in adiposity affect (3)

A
  • decrease in BMR
  • Metabolism of nutrients and drugs
  • nutrient requirements
115
Q

Those who are 70 yr and older may have difficulty meeting vitamin and mineral needs at intake of ______. Advice:_____.

A

1,

116
Q

How does muscle mass change? (3)

A
  • smaller muscle mass
  • more subcutaneous fat
  • increased intramuscular fat
117
Q

Loss of skeletal muscle mass, quality and strength associated with aging

A

sarcopenia

118
Q

How to measure muscle mass (3)

A

DEXA

Walking gait or hand drip

119
Q

Past age 40 lose __-__% of muscle/decase (increased rate with time)

A

2-3%

120
Q

wasting syndrome; loss of wt, muscle atrophy, fatigue, weakness, loss of appetite (ex. cancer)

A

cachexia

121
Q

Studies show that _______ increases muscle loss 3 times more

A

inactivity

122
Q

Major reason for decrease in muscle mass

A

decrease in muscle synthesis

123
Q

What are the reasons for decline in muscle synthesis (3)

A

decrease in hormones, activity, and protein intake

124
Q

Muscle degradation depends on _______.

A

total kcal intake

125
Q

Advice to minimize the risk of sarcopenia (3)

A
  1. Consume protein slightly above RDA
  2. 1-1.3 g/kg BW
  3. Consume high quality protein throughout day
126
Q

To minimize sarcopenia ____ ____ and ______ are even more important than protein.

A

energy balance and activity

127
Q

Body water changes with age. What are the reason for this? (3)

A

-blunted thirst
-changes in kidney fxn (reduced # of nephrons)
-urine
concentration mechanisms diminish

128
Q

Aging does not cause dehydration but increases risk. What tips the balance? (3)

A
  1. Inadequate intake
  2. Forgetting to drink
  3. Illness
129
Q

Reasons for inadequate fluid intake (5)

A

decreased thirst, increase bladder issues, enlarged prostate, immobility, difficulty swallowing liquids

130
Q

Consequences of dehydration (7)

A 
constipation
nausea
hypotension
mental confusion
difficulty with meds
increased body temp
skin flushing
131
Q

Fluid requirements (2)

A

30 ml/ kg BW

minimum of 1500 ml/day

132
Q

Elders may be at risk for over hydation because of over secretion of ______. This causes risk for hyponatremia.

A

ADH

133
Q

Symptoms of over hydration (4)

A

confusion, lethargy, anorexia, weakness

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