1. Chapter 19: Nutrition Through the Life Cycle: The Later Years
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2. Older Adults Age 65 years and older Age ≥85 years:
"Very elderly" or "oldest of the old"
Fastest growing U.S. population subgroup
Average U.S. life expectancy = 78.8 years
Life span is the age to which the longest-living member of the species has lived
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3. Aging Process: Theories
Aging occurs at the molecular, cellular, and tissue levels
Programmed theories of aging
Error theories of aging
Cell damage from environmental insults
Linked to nutrient or energy status
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5. Aging Process: Lifestyle Factors
Biological age can be influenced by personal choices
Smoking
Excessive alcohol
Obesity
Sedentary
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6. Sensory Perception
Senescence: age-related processes that increase risk of disability, disease, and death
Systems begin to slow and degenerate
Declined odor, taste, and visual perception
Dysgeusia: abnormal taste perception
Loss of visual acuity
Support of family and friends helps older adults with food selection and preparation techniques
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7. Gastrointestinal Function
Xerostomia: declined salivary production
Dysphagia: difficulty swallowing foods
Achlorhydria: low gastric HCl production, limits calcium, iron, folate, vitamin B12 absorption
Gut microbiota changes ("aging gut"), resulting in
Increased inflammation
Decreased immune function of GI tract
Impaired functioning of gut mucosal cells
"Anorexia of aging"
Lactose intolerance
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8. Body Composition Increased body fat, sarcopenic obesity
Decreased muscle and lean tissue
Decreased production of hormones: testosterone and growth hormone
Bone mineral density declines
Adequate dietary intake and regular physical activity (strength/resistance training) help maintain muscle mass and strength
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10. Organ Function
Less adaptable to environmental or physiologic stressors
Kidneys: less able to concentrate waste
Liver: less efficient in breaking down drugs
Pancreas: reduced blood glucose control
Bladder control may decline
Connective tissues and blood vessels become increasingly stiff and less pliable
Neurons in the brain decrease: impaired memory, reflexes, coordination, learning ability
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11. Factors That Accelerate Aging
Biologic age is influenced by lifestyle:
Smoking habits
Alcohol consumption
Sun exposure
Weight status
Level of physical activity
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12. Macronutrients
Decreased energy needs from loss of muscle mass and lean tissue:
Lower basal metabolic rate
Reduced activity levels
Recommendations for fat, carbohydrate, proteins: same as for younger adults
Older adults can eat slightly less fiber
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14. Micronutrients
Calcium and vitamin D requirements increase: poor calcium absorption and reduced vitamin D production in the skin
Iron needs decrease: reduced muscle mass; cessation of menstruation in women
Zinc recommendations stay the same
Vitamins C and E recommendations stay the same
Adequate intake of B-vitamins (B12, B6, and folate) is a special concern
Vitamin A should not be consumed in excess of RDA
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16. Supplements
Older adults benefit from multivitamin/multimineral supplement
Single nutrients in some cases
Vitamin B12
Calcium
Vitamin D
High-potency supplements pose risks
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17. Fluid AI for fluid: same as for younger adults Men: 3.7 liters/day
Women: 2.7 liters/day
Impaired thirst mechanism
Hypernatremia (elevated blood sodium levels)
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18. Overweight and Obesity
Increases severity and consequences of osteoarthritis
Limits mobility
Causes functional declines in daily activities
Weight loss improves functional status
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19. Underweight Fewer protein reserves
Risk for poor wound healing and a depressed immune response
Geriatric failure-to-thrive: "the dwindles"
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20. The nine Ds of geriatric weight loss.
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21. Osteoporosis
Diagnosed after menopause as estrogen levels sharply decline
Males: linked to declining testosterone levels, steroid therapy, and alcohol abuse
Most serious risk: hip fracture
Osteoporosis treatment: vitamin D and calcium supplementation, resistance training, medications
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22. Arthritis One of the most prevalent chronic diseases
Osteoarthritis: a disease of "wear and tear"
Rheumatoid arthritis (RA): typically strikes younger adults, not associated with obesity or overuse syndromes
Nontraditional treatments (glucosamine)
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23. Additional Concerns Constipation—fluid and insoluble fiber
Dental health issues may cause older adults to avoid healthful foods
Vision disorder studies show beneficial effects of antioxidants
Cognitive impairment (demetia): lower risk with antioxidants, certain unsaturated fatty acids, folate, vitamin B12, healthy weight
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24. Medications Interactions can be harmful, should be monitored
Polypharmacy: more than five prescription medications at once
Appetite effects
Alters nutrient digestion and absorption
Appropriate use of nutrient supplements can enhance the nutritional status of older adults
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26. Social Concerns Elder abuse and neglect Food insecurity and hunger
Social isolation
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27. Community Programs Supplemental Nutrition Assistance Program (SNAP)
Senior Farmer's Market
Child and Adult Care Program
Commodity Supplemental Food
Nutrition Services Incentive Program
Emergency Food Assistance Program
End-of-life care
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28. Minority Elderly
Require adaptations in current medical and social service interventions
Increased risk for nutrition-related chronic diseases and complications
Cultural awareness
Flexible meal plans
Effective communication
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