Download Lecture 25

Increasing Elderly Population
Lecture 25:
Nutrition for the Elderly
• In 1900, 1 of 25 people was 65 or older
• In 2000, 1 of 8 was 65 or older
• In 2030, estimate that 1 in 5 will be 65
or older
Nutrition 150
Shallin Busch, Ph.D.
Key:
>65 years
45–64 years
25–44 years
15–24 years
>15 years
The Aging of the U.S. Population
Figure 17-1
Page 588
Length of Life
• Life expectancy: the average number
of year lived by people in a given
society
• Longevity: long duration of life
• Life span: the maximum number of
years of life attainable by a member
of a species (for humans is 130 yrs)
In text caption goes here
Life Expectancy in US
• White women: 80 yrs
• Black women: 75 yrs
• White men: 75 yrs
• Black men: 68 yrs
Influences on Life Expectancy
• 70-80% depends on individual health
related behaviors
• 20-30% depends on your genes
• If you live 80 yrs, you can expect to live
an additional nine yrs
What is your age?
• Chronological age: A person’s age in
years from his or her date of birth
• Physiological age: A person’s age as
estimated from his or her body’s
health and probable life expectancy
Identical twins at age 59
Slowing Physiological Aging
1) Eating well-balanced meals regularly
• Including breakfast
• Fruits and veggies rich in antioxidants
2) Engaging in physical activity regularly
3) Maintaining a healthy body weight
4) Not smoking
5) No or moderate use of alcohol
Physical Activity
• Regular physical activity is the most
powerful predictor of a person’s
mobility in the later years
• Helps with balance
• Increases blood flow to the brain
6) Sleeping regularly and adequately
Sarcopenia: Muscle Loss
Sarcopenia
• Muscle mass declines with age
• Regular physical activity:
– Slow muscle loss
– Prevents loss of balance and falling
– Decreases risk of injury when do fall
– Improves independence and confidence
These cross sections of two women’s thighs may appear to be about the same size
from the outside, but the 20-year-old woman’s thigh (left) is dense with muscle
tissue. The 64-year-old woman’s thigh (right) has lost muscle and gained fat,
changes that may be largely preventable with strength-building physical activities.
Body Weight
• Prevalence of being overweight
decreases after age 55
• When over 65, BMI for being
overweight increases from 25 to 27
• For older adults, being underweight is
more of a concern than being
overweight
GI Tract Changes
• Motility is slowed due to change in GI
hormones and decrease in elasticity
of GI tract
• Dysphagia: difficulty swallowing
– Can lead to weight loss, malnutrition,
dehydration
• Atrophic gastritis
GI Tract Changes: Teeth
• Tooth loss and dentures make it hard
to process food
– Especially fruits, vegetables, meats
• Eating can be painful with gum
disease and compromised teeth
• Inefficient chewing can increase risk
of choking
Atrophic Gastritis
• Symptoms: inflamed stomach,
increased bacterial growth, reduced
stomach acid
• Consequences: Impaired digestion and
absorption of nutrients, esp. B12,
biotin, folate, calcium, iron and zinc
• Affects 1/3 of people over 60!
Atrophic Gastritis and B12
• Low absorption due to low stomach
acidity
• Bacterial overgrowth uses up B12
• RDA is for older adults is the same
• BUT recommend B12 be obtained from
supplements
– Supplements have higher bioavailability!!
Water Needs
• Total body water decreases with age
– Can dehydrate rapidly
• Many older people do not feel thirsty or
notice mouth dryness
• It may be difficult to get a drink or get
to the bathroom
• Those who have lost bladder control may
be afraid to drink too much water
Other Changes
• Reduced ability to see and smell can
decrease a person’s ability or
willingness to eat
– WHY?
• Depression and loneliness are common
in older people and can reduce
willingness to eat
Dehydration
Can lead to:
– urinary tract infections
– pneumonia
– pressure ulcers
– confusion
– disorientation
Less Calories Needed
• Physical activity decreases
• Basal metabolic rate decreases
– Due to decrease in lean body mass
Protein
• High-quality protein needed because
of reduced calorie diet
• Important for supporting immune
system
• Helps prevent muscle wasting
• Problem of expense
Vitamin D
• Need more to prevent bone loss
• Less vitamin D made by body
– Limited exposure to sunlight
– Reduced capacity of skin to make it and
liver to activate it
• Older adults drink less milk
– Increased incidence of lactose
intolerance
Calcium
• Needed to prevent bone loss
• Problem of low dairy intake
• Solutions: Calcium-fortified juices,
adding milk powder to foods,
supplements
Iron
Food and Medicine
• Need in women decreases after
menopause
• Drugs can alter food intake
• Low food intake can lead to deficit
• Foods can alter drug absorption
• Loss of iron through chronic blood
loss due to disease or medicines
• Drugs and nutrients can interact and
alter metabolism
• Reduced iron absorption to due low
stomach acid and antacid use
• Drugs can alter nutrient excretion
Cataracts
• Thickening of eye lenses
• Negative relationship with intake of
Vit. C and E and carotenoids
• Positive relationship with
being overweight
• Drugs can alter nutrient absorption
• Foods can alter drug excretion
Macular Degeneration
• Deterioration of part of retina of eye
• Antioxidant vitamins, zinc and some
carotenoids can help prevent
• Omega-3 fatty acids can help prevent
• High dietary fat may increase risk of
developing
Rheumatoid Arthritis
• Immune system attacks bone
coverings
• Omega-3 fatty acids can reduce joint
tenderness and increase mobility
• Vit. C and E may help prevent or
relieve pain
Nutrition and the Brain
Brain function
Depends on Adequate
Intake of
Short-term memory
Vit. B12, C, and E
Performance on problem
solving tests
Vit. B12 and C, folate,
riboflavin
Mental health
thiamin, niacin, folate, zinc
Cognition
Vit. B6, B12, and E, folate, iron
Vision
Vit. A, essential fatty acids
Neurotransmitters
Tyrosine, tryptophan, choline