NUTRITION in AGING
Vocabulary
Xerostomia:
Atrophic Gastritis:
Sensory Losses
• Reduced senses of taste and smell are common in the elderly and may result from a variety of
factors – normal aging, Alzheimer’s disease, medications, etc.
• May not only reduce pleasure and comfort associated with food, but may pose as a risk factor
for food poisoning
• Also, since taste and smell stimulate metabolic processes, salivary, gastric, and pancreatic
secretions may be impaired
Gastrointestinal Changes
Salivary Flow
• Aging is associated with decreased salivary flow
• Xerostomia is particularly prevalent and tends to cause:
• Decreased ability to taste
• Food sticking to tongue and inside of mouth
• Difficulty swallowing
• Gum disease (increased susceptibility to bacteria) and tooth loss
Esophagus
• Often in older adults, normal peristaltic waves do not always occur, and can cause
accumulation of food in the esophagus – painful swallowing and acid reflux
• Also, heartburn may be caused by loss of normal control of the esophageal sphincter
Stomach and Small Intestine
• Decrease in gastric motility
• General decrease in secretory ability of digestive glands
• Decreased levels of digestive enzymes especially amylase, pepsin, trypsin, and pancreatic
lipase
• Atrophic Gastritis – chronic inflammation of the stomach, combined with lack of HCl (affects
protein, calcium, iron, B12, B6, zinc, and folate digestion)
Malnutrition
• Malnutrition is often the most prevalent nutrition-related problem of the elderly
• As many as 50% of nursing home residents may be malnourished and underweight
• It often remains unrecognized because the result of malnutrition – excessive loss of lean body
mass – resembles the signs and symptoms of the aging process
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Risk Factors for Malnutrition
Difficulties in chewing or swallowing
Difficulties in procuring or preparing food
Recent loss of a spouse
Oral health problems
Poverty
Multiple drug use
Confusion or depression
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• Neurological disorders
• Altered taste or smell
Consequences of Malnutrition
• Consequences are far-reaching and complex, depending on specific nutrients that are deficient
• Common adverse effects are poor wound healing and defense against infection, depression,
and cognitive effects
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Dehydration
Elderly people are at risk for dehydration because of:
They may not feel thirst, or notice mouth dryness
Loss of bladder control may lead to limiting water intake
Those with ambulation difficulties may have trouble obtaining water
Those taking diuretic medications
Health Consequences of Dehydration
• Common cause of confusion and dementia
• Symptoms of dehydration can rapidly progress from thirst, to weakness, to exhaustion, to
delirium. If not corrected, death will occur
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Vitamin and Mineral Deficiencies
Elderly people are at risk for vitamin and minerals deficiencies due to:
Decreased food intake
Reduced absorptive function of the GI
Reduced secretion of gastric HCl
Drug-nutrient interactions
Increased use of laxatives
Fewer functioning enzymes
Vitamin and Mineral Deficiencies
Vitamin D
• Due to decreased exposure to sunlight, age-related decreased in synthesis and activation, and
low dietary intakes, elderly people may be at risk for deficiency
• Too little Vitamin D can lead to brittle bones that are susceptible to fracture
B Vitamins
• At least 15% of elderly people have a B12 deficiency (decreased HCL, intrinsic factor,
H.pylori) – may lead to anemia, neuropathy, fatigue
• Large scale NHANES indicates that elderly people may be deficient in B6 – may lead to
homocysteinemia, fatigue, anemia, impaired immune function
• Severe dietary deficiencies of B vitamins impair mental ability, including memory
BRAIN FUNCTION
Short-Term Memory
Performance in Problem-solving tests
Mental Health
Cognition
Vision
DEPENDS on ADEQUATE:
B12, vitamin C and E
Riboflavin, folate, B12, vitamin C
Thiamin, zinc, niacin, folate
Folate, B6, B12, iron, vitamin E
EFAs, vitamin A
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Iron
Iron deficiency is a concern for elderly people
May develop from decreased HCl, chronic blood losses, antacids (decrease absorption)
May lead to fatigue and weakness (anemia), decreased immune function, intellectual
impairment
Calcium
Maintaining adequate calcium reduces the rate of bone loss and the incidence of fractures
Deficiency may arise from decreased Vitamin D, decreased HCl, fiber supplements, lactose
intolerance, diuretics (antacids?)
Zinc
• Older adults frequently have marginal zinc intakes
• A deficiency may develop from stress, decreased HCl, fiber supplements, diuretics
• May affect taste perception and appetite regulation, suppress immune function, cause poor
wound healing, mental disturbances
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