Nutritional Considerations for the Elderly

Question 1

As we age, our caloric needs usually?

Answer 1

decrease

Question 2

What nutritional needs have to be increased in the elder?

Answer 2

• calcium
• vit D
• vit B6
• protein

Question 3

A decrease in caloric needs are usually related to:

Answer 3

• decreased physical activity
• decreased lean muscle mass
• decreased overall metabolic rate

Question 4

Obesity can cause or exacerbate which medical conditions?

Answer 4

diabetes, HTN, heart disease, arthritis

** BMI 30+

Question 5

Overweight (BMI 25-29.9) seniors >70 yrs old have?

Answer 5

they have better health and lower risk of death than obese or those with low BMIs

Question 6

Protein is necessary for?

Answer 6

• maintaining or building muscle
• provides antibodies for the immune system
• provides enzymes and hormones
• helps maintain fluid, electrolyte, and acid/base balances

Question 7

Recommended dietary allowance (RDA): protein

Answer 7

0.8 g/kg for all adults

1.0-1.6 g/kg for elderly

Question 8

Why do the elderly need more protein?

Answer 8

• maintain muscle mass
• promote wound healing
• increase immune function

Question 9

Micronutrient intake: What is decreased in the elderly?

Answer 9

calcium
zinc
iron
B vitamins

Question 10

Micronutrient intake: What is increased in the elderly?

Answer 10

sugar
fat
sodium

Question 11

Micronutrient intake: At risk for not meeting the RDA

Answer 11

calcium
vit D
vit E
vit K
potassium
fiber

Question 12

What foods should the elderly eat?

Answer 12

increase fruits, vegetables, and lean protein

Question 13

Fruits and vegetables are sources of?

Answer 13

• vit A, C, K
• potassium
• calcium
• fiber
• iron

Question 14

Lean proteins are source of?

Answer 14

• iron
• zinc
• niacin
• vit B12

Question 15

Which diet slows the rate of cognitive and physical decline in elderly community dwellers?

Answer 15

the Mediterranean diet

Question 16

What are the barriers to eating healthy foods?

Answer 16

• physical
• functional
• financial
• family/friends

Question 17

Barriers to eating health foods: physical

Answer 17

• illnesses (SOB with COPD, CHF, cancer, anemia)
• generalized weakness
• emotional/cognitive changes (depression/dementia)
• changes in taste and smell
• decreased appetite (anorexia of aging)
• alcohol use (replace food with alcohol)

Question 18

Barriers to eating health foods: functional

Answer 18

• loss of ROM and ability to stand
• impaired eyesight
• chewing problems (loose teeth or poorly fitting dentures)
• swallowing problems (stroke)

Question 19

Barriers to eating health foods: financial

Answer 19

• fixed income (poverty levels)
• medical costs (meds, help, Dr.)
• healthy food is more expensive
• outliving retirement or investments

Question 20

Barriers to eating health foods: family/friends

Answer 20

• living alone, widowed
• unable to drive
• isolation leading to depression
• family or friends not available or dead

Question 21

Determine Your Nutritional Health: checklist highlights

Answer 21

• most were at moderate nutrition risk
• tend to be lower income and less educated
• most women eat alone
• many changed their diet to illness/condition

Question 22

What conditions may benefit from a dietitian referral?

Answer 22

diabetes, CHF, COPD, anemia

Question 23

What to look for in diabetes

Answer 23

signs and symptoms of hypoglycemia
- dizziness
- sweating
- irritability
- confusion
- palpitations
- shakiness
- poor foot health
- poorly healing wounds
- neuropathy

Question 24

What to look for in CHF

Answer 24

• edema
• SOB
• convenience foods (increased salt intake)

Question 25

What to look for in COPD

Answer 25

SOB can lead to - inability to prepare or buy food - chewing difficulty - uses a ton of energy/calories

Question 26

What to look for in anemia

Answer 26

- fatigue - weakness - SOB - cognitive impairment - dizziness - apathy ** anemia is often overlooked in the elderly

Question 27

Types of anemia:

Answer 27

- anemia of chronic disease - iron deficiency - post hemorrhagic - vit B or folate deficiency - unknown

Question 28

What are the two most common types of anemia?

Answer 28

1. anemia of chronic disease 2. iron deficiency anemia

Question 29

Anemia of chronic disease

Answer 29

may be caused by: - acute/chronic infection - chronic inflammatory diseases - malignancy - protein caloric malnutrition treatment is to treat the chronic disease, the anemic itself if not treatable

Question 30

Iron deficiency anemia

Answer 30

may be caused by: - chronic GI bleed associated with NSAID use - ulcers or diverticulitis - colon cancer - inadequate iron intake treatment is possible with iron supplementation and stopping bleeding that is occuring

Question 31

When should I refer to a registered dietitian?

Answer 31

- if they score "moderate" or "high" risk - they exhibit symptoms of poorly controlled disease - any questions about food or nutrition