Nutrition of the Elderly PDF

Nutrition of the Elderly PART 1 Angielica R. Navasero, RND, MSc. Department of Nutrition and Dietetics College of Education https://drive.google.com/file/d/1q8lxRC8dhYSonmGftFtzrfVmcFA4brZJ/view?usp=sharing Intended Lea...

Nutrition of the Elderly PART 1 Angielica R. Navasero, RND, MSc. Department of Nutrition and Dietetics College of Education https://drive.google.com/file/d/1q8lxRC8dhYSonmGftFtzrfVmcFA4brZJ/view?usp=sharing Intended Learning Outcomes To understand the physical and physiological changes among the elderly stage To understand the different nutrition and diet-related problems among elderly individuals and to formulate recommendations to address these problems  Nutrition of the Elderly Aging ▫ complex process – progressive molecular, cellular, physiological, and psychosocial changes – conception to death Elderly ▫ over age 65 Old persons ▫ > 75 years old (Brown, 2011) Nutrition of the Physiological Elderly Changes Geriatrics Oral and GIT ▫ branch of medicine concerned with prolonging ▫ loss of teeth and periodontal disease – life, delaying onset of degenerative aspects of difficulty in chewing – limited food intake aging – treating diseases ▫ decreased sensitivity – taste (hypogeusia) Gerontology and smell (hyposmia) ▫ broader branch of science dealing with ▫ loss of appetite/anorexia – decreased food physiological, psychological, economic, and intake medical aspects of aging ▫ loss of sense of thirst – dehydration Senescence ▫ physical and behavioral changes – aging process (Brown, 2011) (Brown, 2011) Physiological Changes Oral and GIT ▫ decreased GIT secretions saliva – affected lubricant HCl and intrinsic factor synthesis - ↓ absorption of Fe, Ca, B9, B12, and utilization of protein gastric, pancreatic and intestinal enzymes - ↓ digestion and absorption of nutrients ▫ less efficient liver functions – ↓ secretion of bile and detoxification ▫ decreased GI motility/peristalsis – abdominal distention and constipation (Brown, 2011) (Tortora and Derrickson, 2014) (Tortora and Derrickson, 2014) (Mahan, Escott-Stump and Raymond, 2012) Physiological Physiological Changes Changes Renal Changes Cardiovascular Changes ▫ decrease in functioning nephrons - ↓ GFR - ↓ ▫ decreased cardiac output and heart rate excretion of waste (i.e. protein breakdown) ▫ increased DBP ▫ lowered ability to convert derivative of vit D to ▫ risk of atherosclerosis (thickening and active form decreased elasticity) ▫ impaired function of bladder and urethral sphincter – urinary incontinence Respiratory Changes ▫ decline in lung efficiency and vital capacity ▫ decreased functioning of alveoli – shallower, faster and more difficult breathing (Brown, 2011) (Brown, 2011) Physiological Physiological Changes Changes Neurological Changes Immune Function ▫ decreased number of brain cells – slowed ▫ increased susceptibility to infection reaction time, tremors, memory loss, reduced cognitive ability ▫ impaired nerve cell function – sensory loss (i.e. Body Composition and Energy Expenditure visual and auditory acuity) ▫ decline in muscle mass – loss of muscle ▫ decreased neuromuscular coordination strength – range of motion and motility ▫ altered sleep-wake cycle (circadian rhythm) ▫ build up of more fat or adipose tissue Skeletal Changes ▫ decreased resting energy expenditure - ▫ decreased bone density – risk of osteoporosis ↓ energy needs - ↓ energy requirements (Brown, 2011) (Brown, 2011)  Nutritional REE- measurement of resting metabolic rate extrapolated to 24 hours, usually expressed as Requirements kcal per 24 hrs *provided to conserve and delay onset of degenerative diseases RMR- energy expended for maintenance of normal body functions and homeostasis; Energy represents largest portion of total energy ▫ decreased – reduced BMR and physical expenditure; kcal/kg/hr activity ▫ 60-69 years old- lower by 20% ▫ >70 years old- lower by 25% (Brown, 2011) Nutritional Nutritional Requirements Requirements Protein Minerals ▫ allowance of 1.07 g/kg/day ▫ increased Ca – maintain Ca balance, reduce ▫ not in excess osteoporosis ▫ lowered Fe after menopause Vitamins ▫ reduced requirements for vit B1, B2, B3 – reduced energy needs Water and Fiber ▫ increased vit D, B6, E and B12 ▫ six to eight glasses of water/day or 1 mL/kcal ▫ allowances for vit A, C and B9 – same as ▫ high fiber – decrease constipation younger adults (Brown, 2011) (Brown, 2011) Nutrition-Related Nutrition-Related Disorders/Diseases Disorders/Diseases Anaemia- deficiency in the number of RBC Weight Problems or hemoglobin content or both ▫ weight gain- declining metabolic rate, ▫ IDA- poor intake, poor absorption, chronic reduced PA, consumption of high energy blood loss foods (women > men) ▫ megalobastic anaemia- caused by vit B9 ▫ weight loss- inadequate intake – lack of deficiency appetite, sensory losses, social isolation, poor ▫ pernicious anaemia- atrophy of stomach self-esteem, deterioration of physical mucosa – failure to produce IF for vit B12 condition, presence of disease absorption (Brown, 2011) (Brown, 2011) Nutrition-Related Nutritional Requirements (PDRI, 2015) Disorders/Diseases CVDs ▫ HPN- increased BP comes with age ▫ reduce consumption of alcohol and Na, smoking ▫ elevated homocysteine – action of B6, B9, B12 Osteoporosis ▫ loss of bone mass – postmenopausal women – Ca, vit D, PA and hormone therapy (Brown, 2011) Nutritional Requirements (PDRI, 2015) References 2015 Philippine Dietary Reference Intake (PDRI). FNRI-DOST. Brown, J. (2011). Nutrition Through the Life Cycle [PDF document]. CA, USA: Wadsworth, Cengage Learning. Mahan, K., Escott-Stump, S. and Raymond, J. (2012). Krause’s Food & Nutrition Care Process, 13th Edition [PDF document]. Canada: Saunders, Elsevier. Marcus, J. (2013). Culinary Nutrition: The Science and Practice of Healthy Cooking, 1st Edition [PDF document]. USA: Academic Press. Rolfes, S., Pinna, K. and Whitney, E. (2009). Understanding Normal and Clinical Nutrition, Eighth Edition [PDF document]. CA, USA: Wadsworth, Cengage Learning. Tortora, G. and Derrickson, B. (2014). Principles of Anatomy and Physiology, 14 Edition [PDF document]. USA: John Wiley & Sons, Inc. Worthington-Roberts, B. and Williams, S. (2000). Nutrition throughout the Life Cycle, Fourth Edition. Boston, USA: McGraw-Hill.