Lecture 19: Nutrition In Older Age

Question 1

What are 4 changes in mouth and smell with age?

Answer 1

• Reduction in taste sensitivity
• Reduced ability to detect odour
• Decreased secretion of saliva; difficulties swallowing
• Tooth loss, gum disease, poor fitting dentures; impairs biting and chewing hence decreased food intake

Question 2

What are 2 changes in gastrointestinal track with age?

Answer 2

• motor function; impaired relaxation in the stomach, increased risk at constipation
• sensation; changes in feeling hungry/full, can lead to under or overeating

Question 3

What are 2 changes in the endocrine system with age?

Answer 3

• increase of vitamin D requirements: less intake because people go outside less
• decreased sensitivity to insulin —> higher incidence of type 2 diabetes

Question 4

What are 2 changes in body composition with age?

Answer 4

• less lean body mass, change in distribution of fat stores
• sarcopenia, loss of muscle mass and function associated with chronic diseases

Question 5

What are 6 other physical changes related to aging?

Answer 5

• Decreased blood flow to tissues, decreased oxygen and nutrient uptake
• Reduced cardiac output
• Kidney function reduces, more prone to dehydration
• Deteriorating vision
• Arthritis
• Dementia

Question 6

What are 4 social and community influences with aging?

Answer 6

• Change in living arrangements
• Social networks
• Sharing meals
• Food security, reduced income

Question 7

Explain frailty

Answer 7

Concept used to identify those at high risk of adverse health outcomes (e.g. falls), becoming dependent, co-morbid illness, admission to an institution.
Overall state of vulnerability.
Achieving adequate energy intake and physical
activity important for functional capacity and
maintaining weight.
Signs of frailty: fatigue, resistance (ability to climb
stairs), illness, loss of weight.

Question 8

What are 6 risk factors for malnutrition?

Answer 8

• Age
• Marital status
• Difficulty walking
• Difficulty climbing stairs
• Prior hospitalization
• Hospitalization during f/up

Question 9

What are 3 eating guidelines that are extra relevant for older adults?

Answer 9

1. Take opportunities to eat meals with other people.
   —> emphasizing social eating for health
2. Eat three meals every day. Nutritious snacks are recommended, especially for those who are underweight or have a small appetite.
3. Consider food safety when purchasing, preparing, cooking and storing food.
   —> extra important because of weaker immune system

Question 10

What are 6 micronutrients with special nutritional needs considering aging, and what are they?

Answer 10

1. Water: Lack of thirst and decreased total body water can lead to dehydration
2. Dietary fibre: Important for gut health, along with plenty of fluids and activity can alleviate constipation
3. Iron: Reduced needs, but other factors increase risk for anaemia (e.g., ulcers, medications)
4. Calcium: Increased needs in postmenopausal women due to low oestrogen levels
5. Vitamin D: Increased needs due to diminished synthesis in skin and limited sun exposure
6. B Vitamins: Increased needs for energy metabolism and positive effect on plasma homocysteine levels, reduced Vit B12 absorption in some

Question 11

What are 9 pieces of nutritional advice for older adults?

Answer 11

• Eat protein rich foods
• Lots of milky drinks, custards – calcium and protein, liquid form of energy
• High fat dairy ok
• Add salt to foods? Consider herbs
• Nutrient rich foods
• 3 small main meals with snacks in between
• Share meals with others
• Be physically active
• Take care of teeth

Question 12

What are some solutions for increasing nutrition in older adults?

Answer 12

• Eating meals with others
• Make the eating environment attractive
• Just cook programme to increase cooking skills
• Shopping for One handy shopping guide