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Successful Aging
Sorosh Roshan, MD, MPH
International Health
Awareness Network
www.ihan.org
Who is Old?
Second childhood - Shakespeare late 16th
century “sans teeth, sans eyes, sans taste,
sans everything”
 The United Nations defines older people
as those 60 years of age and over, and
 The oldest old as those over 80 years of
age

The Human Rights of Older Women
Equal access to health and social services
 Eliminate gender, age, race and income related
inequalities
 Life long training opportunity
 Involving older workers right across the company’s
activities e.g., training, worker involvement in
redesigning the work place, etc.
 Access to the labor market
 Elimination of elder abuse

Aging

“A process of gradual and spontaneous
change, resulting in maturation through
childhood, puberty and young adulthood
and then decline through middle and late
age”
Senescence

“The process by which the capacity for cell
division, growth, and function is lost over
times, ultimately leading to an
incompatibility with life; i.e., the process
of senescence terminates in death”
Successful Aging
A process by which deleterious effects are
minimized
 Healthy lifestyle from preconception
though out life cycle
 Nutrition and an active physical, mental
and spiritual life

Accelerated Aging
Progeroid syndrome
 Warner syndrome
 Wiedmann-Rautenstrauch syndrome and
Hutchinson-Gilford syndrome
 Down syndrome

Physiology of Aging
Aging is a normal process in which the
rate of catabolic changes become greater
than the rate of anabolic cell regeneration.
 Loss of cells and body mass can lead to
varying degree of decreased efficiency and
impaired organ function.

Physiological Changes
Sensory losses
 Oral health problems
 Gastrointestinal and metabolic abnormalities
 Cardiovascular diseases

Physiological Changes (con’t)
Reduction of pleasure of eating due to
hyposmia (the ability to taste and smell
reduced) and dysgeusia (the capability to
digest foods is reduced)
 Reduced ability to detect odor can cause
food poisoning
 Dry mouth (xerostomia), hyposalivation;
difficulties in chewing and swallowing;
constipation

Gastrointestinal Changes
Constipation due to inadequate intake of
fiber, fluid, sedentary life style
 Glucose intolerance
 Increase in plasma levels of 1.5mg/dl per
decade
 Deficient insulin production or function
 Diet modification and exercise are the
treatment of choice

Gastrointestinal Changes (con’t)
Hypochlorhydria (Lower levels of digestive
enzymes)
 Diminished absorption of nutrients such as
B12, iron and calcium
 Metabolism of calcium and vitamin D is
altered during aging
 These factors and poor dietary intake will
accelerate bone loss and osteoporosis

Nutritional Requirements
Age, gender, level of activity, food allergies,
environment and medical conditions
 Caloric requirements begin to decline from
55-60, (500kcal per for men and 300 kcal for
women)
 Protein requirements increase slightly
 20-30 kcal per kg of body weight-depending
on the person’s weight.

Nutritional Requirements (con’t)
1.25g of protein per kilogram of body
weight is appropriate for the elderly (12 16% of total daily calories).
 The US RDA for adults is .8g of protein
per kilogram of body weight.
 Need varies depending on illness, stress,
open wounds, burns, vigorous exercise,
infection and altered GI function.

Carbohydrate Intake
Limited to 55% of total daily calories.
 40% of it from complex carbohydrate,
whole grains, vegetables and fibers.
 Fibers help reduce cholesterol and plasma
glucose level.

Dietary Fat
30% of daily calories.
 Reduce saturated fats.
 Increase intake of monounsaturated and
polyunsaturated sources including Omega
3 fatty acids (salmon, tuna fish, walnuts
and flaxseed powder)

Nutrients and Vitamins
– Calcium intake 800-1200mg/day
– Phosphorus intake to be reduced to
700mg/day.
– Vitamin D for the homebound with limited sun
exposure.
– Iron store tends to increase with age. The
recommended dose is 10mg/ day for men and
women. (50% of the required dose for under
the age of 50)
Anemia in the Elderly

Is due gastrointestinal bleeding and
malignant disease.
Zinc

Zinc deficiency causes:
– Impaired immune function
– anorexia
– dysgeusia
– delayed wound healing
– development of pressure ulcers

Treat with Zinc supplements
Antioxidants
Vitamin E enhances immune function.
 400 IU daily.
 Vitamin C may help to protect against
cataract, 150-250 mg/day.
 B12, B6 and folate may help to improve
nutritional status and energy, protects
against elevated serum homocysteine, a
risk factor for depression, cardiovascular
and neurological deficits.

Hydration and Fluid Intake
Dehydration is the most important cause
of fluid and electrolyte disturbances in the
elderly.
 A daily fluid intake of 30-35 ml per
kilogram of body weight, or a minimum of
1.0-1.5 ml per kilogram's necessary.

Daily Fluid Requirements

Fluid requirements increase with:
– Exercise
– Use of laxative or diuretics
– Hot environment
– Increase protein or fiber intake
– Fever

The elderly often experience reduced
thirst sensation
The Menu
The food should be prepared for the
individual needs.
 Good presentation, fresh, nutritious, tasty
and nutrient dense. Be considerate of
those who wear dentures or suffer from
dysphasia. Add supplements if you must.
 Serve the food with bouquet of tender
loving care.

Special Thanks
Azi Ahmadi, MS Nutrition
 Laura DiClementi, MS Health Education
 Courtney Essary, MBA
 Hewitt Simon, Age in Action-S. Africa
Council for the Aged
