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NUT2005 > Older age and senescence > Flashcards

Older age and senescence Flashcards

1
Q

It has been estimated that the greater use of healthcare because of malnutrition results in what?

A

more GP visits
more hospital admissions
longer hospital stay

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2
Q

Definition of malnutrition?

A

a body mass index (BMI) of less than 18.5 kg/m2
unintentional weight loss greater than 10% within the past 3 to 6 months
a BMI of less than 20 kg/m2 and unintentional weight loss greater than 5% in the past 3 to 6 months

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3
Q

The literature highlights four main areas on which programmes can focus to reduce the burden of malnutrition:

A

how do older people access healthier food and drink
can older people prepare a healthy balanced meal
are older people functionally able to eat a healthy balanced meal
what support systems are available to ensure older people can help themselves

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4
Q

Most the people at risk of malnutrition are people in … …?

A

The community

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5
Q

The literature shows that those living in … or … circumstances are at greater risk of undernourishment and malnutrition. This means there is an important health inequalities dimension to the subject.

A

deprived or isolated

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6
Q

Malnutrition can effect those who are obese true or false?

A

true

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7
Q

Some potential effects of malnutrition?

A

Malnutrition impacts whole body. It reduces the ability to fight infections, increasing the risk of pneumonia and septicaemia. Muscle density reduces, decreasing mobility and increasing the risk of falls. The heart is a muscle, so severe malnutrition will eventually lead to heart failure. Wounds heal more slowly and there is an increased risk of pressure sores/ulcers. Finally, malnutrition can impact on the body’s ability to regulate temperature, leading to an increased risk of hypothermia.

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8
Q

four organisations/programs which attempts to prevent/ give advice/ set standards to prevent malnutrition in older adults?

A

Malnutrition Task Force
PHE and the British Dietetic Association (BDA)
Workforce Competence Model in Nutrition for health and social care

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9
Q

Issues older people face when grocery shopping?

A 
•	difficulty getting to the shops
•	difficulty in store
•	shopping for one
•	age-unfriendly packaging
•	bad weather
Additionally keep in mind poverty might play a role in what a person buys to eat.
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10
Q

Issues older people face when preparing food?

A

Weight and packaging of the food (e.g hard to open), Mobility issues such as arthritis, might struggle to cut the food, use oven safely, stand for long periods of time etc.

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11
Q

How can depression, dementia and cognitive impairment effect a persons ability to eat?

A

Depression can lead to loss of interest in food. Dementia can affect appetite and food intake. Cognitive impairment is also a significant issue for older people with dementia. For example, they may have difficulty in recognising food and drink and lack the concentration to eat a full meal.

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12
Q

Social isolation can also result in a loss of interest in food why

A

Previous social interaction may have been a positive factor in encouraging healthier eating. However, living alone with no social contact removes the positive link between social interaction and eating.

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13
Q

What do people who have lost there natural teeth tend to eat less of?

A

These people tend to eat less fruit and vegetables and have lower intakes of some micronutrients such as vitamin C. This is a risk factor for malnutrition.

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14
Q

What is dysphagia?

A

Inability to swallow it is linked to malnutrition

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15
Q

What four things are key for older people to eat well?

A

prioritising eating well, doing whatever it takes to keep eating well, being able to do it yourself, and getting help when you need it

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16
Q

What is important for older people to over come nutritional vulnerabilities?

A

Personal food resources such as food and nutrition knowledge, cooking skills, good physical health, financial adequacy, and independent transport facilitates the development of adaptive strategies among participants to overcome their nutritional vulnerabilities. Independence (lots of older people didn’t want to rely on others) played a role in overcoming nutritional vunerabilities

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17
Q

What does the MUST tool which checks for malnutrition screen for?

A

frailty, social isolation and loneliness using recognised evidence-based tools; determining whether there are any concerns around sight and hearing, risk of falls, mobility, chewing and eating difficulties, mental health, and social wellbeing; adapting the meal service and/or referring issues identified to internal and external services

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18
Q

A way to measure malnutrition?

A

Paperweight armband further can slide arm higher risk if malnutrition.

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19
Q

What four aspects should be taken into account for malnutrition in older people?

A
  • access to healthier food and drink options and food poverty
  • ability to prepare healthier food
  • functional and cognitive impairment and ability to eat healthier food including poor oral health
  • food and dietary resilience
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20
Q

1 in 4 will be over what age?

A

65

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21
Q

What is function of age?

A 
Ageing is not a matter of chronology but
restricted activity (age is just a number the restriction of activity is the important factor of age)
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22
Q

What is heterogeneity?

A

Huge variation in demography, social and

health characteristics

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23
Q

What can a significant portion of the oldest old (usually refers to over 80) do?

A

Care for themselves as a significant portion aren’t severely disabled

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24
Q

Physiological changes with ageing?

A

Fluid balance and renal function
Skeletal changes
Physical fitness and strength
Changes in the immune system

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25
Q

Changes in body from aging?

A 
Sarcopenia
Changes to the gastrointestinal tract
Oral changes and food intake
Atrophic gastritis
Changes in sensory function
Changes in fluid and electrolyte regulation
26
Q

Factors that can effect how well a person ages?

A
  • Chronic illness
  • Medication and hospitalization
  • Drug-diet interactions (poly pharmacies)
  • Social and economic determinants (think pensions)
27
Q

What are some health status indicators (quantifiable characteristics of a population which researchers use as supporting evidence for describing the health of a population that relate to nutrition?

A
  • Life expectancy
  • Health expectancy
  • Prevalence of chronic illness
  • Hospital discharges
  • GP utilisation
  • Surgeries (particularly surgeries with a dietary element)
28
Q

What causes a change in nutritional status in older people?

A

physiological decline, socioeconomic changes, a multitude of disease
processes and the therapeutic regimens prescribed to cure or treat those illnesses

29
Q

Out of free-living, hospitalised, nursing homes and institutionalized which have the lowest to highest incidence of malnutrition?

A

Where people are either:

Free-living
Institutionalized
Hospitalized
Nursing home

30
Q

What is malnutrition?

A

Malnutrition is defined as poor nutrition which encompasses not only inadequate intake but also excess intake of nutrients.

31
Q

What is specific malnutrition?

A

deficiency of a particular nutrient

32
Q

What is long-standing malnutrition?

A

the clinical appearance of energy and nutrient deficiencies after a period of inadequate eating often linked to general neglect

33
Q

What is sudden malnutrition?

A

results from a sudden marked change in food intake, often
following a significant disruptive life event such as a fall or a
bereavement

34
Q

What is recurrent malnutrition?

A

existing inadequate nutritional status followed by a period
of illness and subsequent malnutrition leading to repeated cycles of
illness

35
Q

What are the consequences of malnutrition?

A 
Increased liability to heart failure
Increased risk of pneumonia and other
respiratory tract infections
Increased risk of thromboembosism
Increased risk of pressure sores
Increased risk of infections
36
Q

Why might it not be as clinically relevant that a person is obese/ overweight in the older old?

A

Because it could be protective against some diseases that the older people suffer with.

37
Q

What is the demispan index?

A

distance form sternum to tip of middle finger used instead of height because old people shrink in height. A low demi span index is not always good for health.

38
Q

In a hospital setting which category predicts mortality and tends to have people staying in the hospital for more than 2 weeks?

A

Underweight

39
Q

As you start to get old there is a 1-2% decrease in functionality p.a. of what and what accelerates this?

A

Strength, power, bone density, flexibility, endurance, balance and co-ordination, mobility and transfer skills. Sedentary behaviour accelerates these lossess.

40
Q

Each decade, older women lose about …kg of muscle mass

while men lose about …kg?

A

0.6, 1.6

41
Q

Age related factors(primary) that play a role in sarcopenia?

A

sex hormones, apoptosis, mitochondrial dysfunction

42
Q

Endocrine factors that play a role in sarcopenia?

A

Corticosteroids, GH, IGF-1, abnormal thyroid function, insulin resistance

43
Q

Neuro degenerative disease factors that play a role in sarcopenia?

A

Motor neuron loss

44
Q

Disuse factors that play a role in sarcopenia?

A

Immobility, physical inactivity, zero gravity

45
Q

Nutrition factors effecting sarcopenia?

A

Inadequate nutrition or malabsorption

46
Q

What is Cachexia?

A

General physical wasting and malnutrition. Its related to sarcopenia

47
Q

What is sarcopenia? What is the nutritional consequence of this?

A

The major age-related physiological change in older people is a decline in
skeletal muscle mass. The nutritional consequences of a reduced lean body mass are reduced
metabolic rate together with a proportional decline in total energy
requirements

48
Q

Sarcopenia leads to reduced energy expenditure, what can be the consequences of this?

A

A reduction in energy expenditure is associated with sedentary
behaviour and a loss of mobility related to systemic (e.g., cardiovascular,
pulmonary) or bone and joint disease
Reduced energy intakes can lead to inadequate consumption of protein,
vitamins, and minerals.

49
Q

Nutrients may not be digested or absorbed well in older adults what can cause this?

A

a decrease in hormone and enzyme production
senescent changes in the cells of the bowel surface
interactions among drugs and nutrients
chewing and swallowing may also be impaired for a variety of
reasons (poor oral health, dentures that may not fit properly,
or lesions in the oral cavity)

50
Q

Drugs effect of nutrition?

A

Drugs can affect nutrition by altering appetite,
absorption, metabolism, action on target tissues, or
excretion of macronutrients and micronutrients,
thereby causing a deficiency.
• Malnutrition may also affect drug metabolism and
hence the required dosage and possible toxicity.

51
Q

Social and economic changes that make an older person more likely to be malnourished?

A

Surveys of independently living older people
indicate that those living alone, or eating
alone, eat less and are at higher risk of poor
nutritional status.
Limited income has its own financial
challenges leading to prioritization of
expenditure which may not include food as a
main concern.
Thus, overall dietary quality decreases.

52
Q

What kind of food are the elderly more likely to consume?

A

The elderly are more likely to consume foods
which fall into the category of “favourite and
comfort”, and are frequently those that are
high in fat and carbohydrate. More likely to be the case for those that live alone

53
Q

In free living elderly, those in the lower socio-economic group had
significantly lower intakes of …?

A

energy, protein, carbohydrate, fiber, some

vitamins notable vitamin C and minerals

54
Q

The better their oral health, including how many natural teeth they had,
the better their …?

A

diet and nutritional status

55
Q

The oral health of adults living in institutions was poor compared with
their… counterparts?

A

free living counterparts.

56
Q

Poor vitamin D status was widespread particularly in those in…?

A

institutions and around winter

57
Q

Folate status was poor in a significant proportion. Especially in what age group?

A

85+ years

58
Q

• In the context of security of household food stocks, 90% of free-living
persons had in their home … or more items from a list of 10 staple
items
• One in 3 free-living individuals reported that they took dietary
supplements the most common being …

A

seven, cod liver oil

59
Q

Factors influencing health in very old age (85+)?

A 
Genes
Nutrition
Health
Lifestyle
Environment
Socioeconomic status
Attitude
60
Q

What is the fastest growing age group?

A

85+

NUT2005 (8 decks)

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