Nutrition for Older Adults PDF

Nutrition for Older Adults Understand the physiological changes that occur with age that affect nutrition status. Know the categories of changes and specific examples. ○ BMR decreases Rate at which we burn calories Gaining more weight Loss of b...

Nutrition for Older Adults Understand the physiological changes that occur with age that affect nutrition status. Know the categories of changes and specific examples. ○ BMR decreases Rate at which we burn calories Gaining more weight Loss of bone mass and muscle mass Decrease in general physical activity ○ Oral cavity issues Teeth decay Missing teeth Difficult for them to eat raw fibrous foods Hard to chew ○ GI issues Increase in constipation Decrease in peristalsis and muscle tone Less fiber We make less hydrochloric acid and this is needed to break down protein ○ Helps absorb B12, iron, and calcium Less digestive enzymes Glucose tolerance declines Synthesizing vitamin D declines CNS Slows down Memory impacted ○ Kidney issues Kidney works harder Difficult to concentrate urine Sodium is not able to clear as well Blood pressure increases ○ Sensory losses  Vision and hearing declines Loss of taste or sense of smell ○ Other changes Mobility declines This can have a negative impact on nutrition How do nutritional needs (calories, protein, micronutrients, fluid) change with aging? ○ Calories decrease with age Have less metabolic energy to eat as much Micronutrients stay the same ○ Protein increase to 1.0-1.2 gm/kg/day Increased protein intake accounting for 8% muscle mass loss Able to break down less protein due to decreased amount of HCL in stomach ○ Fluid higher risk for dehydration Multiple medication to create sense of thirst and change muscle in bladder tone to make urination more frequent and inconvenient ○ Vitamins and mineral don’t change with age Exceptions Calcium Vitamin D Iron Sodium decreases Blood pressure increases with age to combat hypertension Vitamin b12 deficiency With HCL being not as available vitamin b12 can’t be absorbed as much ○ Needs to be supplemented Why does nutrient density become more important for older people?Which vitamins and minerals are of concern for older people? ○ Focus on adequate calories with appropriate levels of macronutrients  ○ Maintain nutrient density to prevent deficiencies in micronutrients, supplement when necessary ○ Support digestion and absorption ○ Adaptable meal structure small frequent meals vs 3 meals per day ○ Lots of fluids Prone to dehydration ○ Vitamins and minerals are of concern Calcium Vitamin D Iron Sodium Vitamin B12 Know the MyPlate recommendations for older adults, and which foods older adults tend to eat less of and why. ○ ○ Simple and easy to prepare ○ Nutrient dense foods ○ Affordable ○ More convenient oriented foods Canned foods Eat less of sodium use herbs and spices in place of salt ○ Due to hypertension Frozen foods Packaged foods ○ Fluids is emphasized To avoid dehydration ○ Ample amounts of protein Nutrition related concerns in older adults ○ Alzheimer's disease and cognitive decline ○ Malnutrition ○ Obesity ○ Frailty ○ sarcopenia  What is frailty and how can it impact nutrition and health status in older adults? ○ Diminished strength, endurance, and physiologic function that increase an individual’s vulnerability for developing dependency ○ They become more vulnerable and dependent on others Challenging to not being able to get adequate nutrition They don’t have control over their diet What is sarcopenia and how does it impact older adults? What is the nutrition approach to managing this disease state? ○ Extreme loss of muscle mass, strength and function that occurs with age Related to sedentary lifestyle and less than optimal diet Commonly seen in 50% of people in the age of >75 yrs old Increasing protein intake can be helpful to maintain muscle mass 1.0-1.2 g/kg for older adult to offset loss of muscle mass What does a nutritional approach to osteoporosis & osteopenia look like in older adults? ○ Osteopenia Low bone mass ○ Osteoporosis Extreme loss of bone mass Skeletal frame vulnerable to break Risk factors ○ Low body weight ○ Petite frame ○ Low muscle mass ○ Female lose estrogen during menopause this keeps bones strong and dense Nutrition therapy ○ Calcium, vitamin D, and K2 supplementation Vitamin D and Vitamin K help to get calcium into the bone ○ Other bone minerals Phosphorous Zinc  Magnesium boron Collagen Made up of proteins and found in hair, skin, nails, soft tissues, and bones Collagen is like the glue that holds all these minerals together ○ Adequate amount of protein 1.0-1.2 g/kg for older adults like taking ensure or making your own protein shake ○ weight bearing and weight resistance exercise to maintain bone strength Review the screening criteria for malnutrition in older adults. What questions can you ask an older patient to assess their nutrition status? ○ Nurses do the malnutrition screening ○ we should ask, “have you gained or lost weight in the past 6 months?” If this is a yes this is a red flag ○ by assessing this can help an older adult to avoid a malnutrition ○ medications 51% of older adult are using 5 or more medications this is known as polypharmacy polypharmacy cause dry mouth changes in taste and smell GI upset PPIs ○ nutrient deficiency decrease stomach acid lower B12, iron, and calcium Statin ○ significantly reduce CoQ10 which is needed for the heart  vitamin D calcium potassium BP medications ○ reduce all of the electrolytes magnesium calcium potassium Metformin ○ reduces B12 Goals of nutrition intervention A care plan is created we want to maintain or restore health with adequate nutrition increase in protein putting them on multivitamin suggest foods that are affordable, convenient, and accessible maintain the client’s sense of dignity and imposing less restrictive