Nutrition for the Older Adult
By Jennifer Turley and Joan
Thompson
© 2016 Cengage
Introduction
• Life Expectancy and Theories of Aging
• The Physical, Cognitive, and Social Triad for the
Older Adult
– The Theories and Physiology of Physically Aging
– Cognition and Brain Preservation
– The Social Network
• Nutrition Needs for the Older Adult
– Energy and Nutrient Needs
– Food Assistance Programs
• Older Adult Fitness and Lifestyle Management
– Fitness
– Diet and Health Issues in the Older Adult
– Aging Well
Life Expectancy and Theories of Aging
• Each person ages chronologically and
biologically
• Lifestyle choices greatly impact life
expectancy
• There are many theories of aging and
senescence: evolution, molecular, cellular,
and systems.
Leading Diseases and Conditions
Physiology of Physically Aging, Part 1
Organ/Site
Circulatory
System
Digestive
System
Endocrine
System
Damage
Blood vessel elasticity and cardiac output decline while blood pressure
steadily increases. Arteries harden and blood clots are more common.
The capillaries are more fragile.
Tooth loss, gum disease, loss of appetite, impaired taste and smell,
difficulty swallowing, and reduced salivary and mucous production may
cause reduced food intake and/or variety and fear of choking. The loss
of intestinal strength slows motility and increases constipation. The
reduction in stomach (gastric) acidity and villi atrophy causes impaired
digestion and reduced nutrient absorption (especially for iron, zinc,
calcium, folic acid, and vitamin B12). There is a reduced sensation for
thirst which increases the risk for dehydration and associated
confusion.
Abnormal glucose metabolism occurs as the pancreas produces less
insulin and cells become less responsive to insulin. Menopause and
andropause occur as evidenced by reduced estrogen and testosterone,
respectively. Thyroid hormone production, growth hormone secretion,
and vitamin D synthesis decrease.
Physiology of Physically Aging, Part 2
Organ/Site
Damage
Integumentary Drier skin and hair, reduced sweat production, loss of skin elasticity,
System
thinning skin, more wrinkles, reduced collagen, more easily bruised,
hyperpigmented age spots on the face, hands, and wrists, graying hair,
and hair loss are part of the typical aging process. Vitamin D
production from sunlight exposure to the skin is reduced creating an
increased need for dietary or supplemental vitamin D. Love vitamin D
levels increase the susceptibility for poor calcium status.
Lymphatic
Reduced immune functioning increases the risk for cancer, infectious
System
diseases, and complications from food-borne illness.
Muscular
Muscle capacity is reduced approximately 20% by age 45, 35% by age
System
65 and 50% by age 85. With the reduction in lean muscle mass there is
a reduction in metabolism, Calorie need, strength, and stability.
Strength, stamina, and flexibility diminish. Physical inactivity leads to
muscle loss and increased stiffness.
Nervous
There is diminished mental acuity and nerve conduction including
System
reduced peristalsis. Reduced appetite, thirst, sight, smell, and taste
negatively affect food selection and intake. Altered sleep patterns
occur.
Physiology of Physically Aging, Part 3
Organ/Site
Reproductive
System
Respiratory
System
Skeletal
System
Urinary
System
Damage
Sex hormone production decreases. Reproductive capability ceases in
women after menopause. Sperm count decreased in men.
Respiration and lung capacity is reduced approximately 5% by age 45,
15% by age 65, and 20% by age 85. There is increased risk of respiratory
infections and pneumonia.
Bone mass declines in men and women but especially after menopause
in women increasing the risk of bone fractures and breaks. Fractures
heal more slowly. Joints stiffen and are more painful.
Kidney function is reduced approximately 10% by age 45, 25% by age
65, and 45% by age 85. Blood filtration rate decreases and urine output
increases. Bladder control is compromised.
Cognition and Brain Preservation
• Cognition is the mental processes of thought,
perception, reasoning, and learning
• Dementia is the deterioration of cognition
– Signs: agitated behavior, confusion, delusions,
unclear thinking, and loss of memory, problemsolving skills, familiarity of usual surroundings, and
interest in daily activities
– Some diseases cause mental changes
– Impacts diet and food selection
– Healthy diet and lifestyle are preventative
Nutrition and Brain Preservation
Nutrient
Vitamin A
Vitamin E
Thiamin
Riboflavin
Niacin
Vitamin B6
Vitamin B12
Folate
Choline
Vitamin C
Iron
Zinc
Tyrosine
Tryptophan
Linoleic Acid
Linolenic Acid
ShortTerm
Memory
Problem
Solving
Cognition
NeuroMental
transmitters Health
Vision
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The Social Network
• Plays a vital role in the health of older adults
• Family, friends, neighbors, health
professionals, pets, and religious groups
– Emotional support, tangible aid, and valuable
information
• The local senior center is a wonderful place
– regular nutritious meals, crafts, games, experts
available for various kinds of advice, travel
opportunities, and exercise facilities
Energy and Nutrient Needs for the
Older Adult
• Caloric needs decline
• Carbohydrate, protein, and fat needs are
the same for the older adult as for the
adult
– Except the DRI for linoleic acid decreases
after 50
– Omega-3 fatty acids support brain function
and reduce the symptoms of inflammatory
diseases
Nutrient Needs for the Older Adult
• The vitamin and mineral needs of the older adult
are similar to the adult.
– Absorption and/or intakes of some nutrients may be
reduced: vitamins A, C, E, and zinc
– Deficiency of vitamin D may be more common
– The DRI for vitamin B6 increases after age 50
– Status may be low for vitamins B12, B6, and folate
– The DRI for calcium and magnesium increase after age
50
– The DRIs for sodium, chloride, and chromium decrease
and iron decreases for women
– Water or fluid needs for the older adult are the same
as the adult but the thirst sensation is diminished.
Food Assistance Programs
• Nutrition Services Incentive Program (NSIP)
• The senior farmer’s market nutrition
program
• Others: Child and adult care program,
commodity supplement food program,
nutrition services incentive program, and
emergency food assistance program
Fitness
• Aerobic and resistive physical activity
– Moderately intense aerobic exercise 30 minutes
a day, five days a week
– or vigorously intense aerobic exercise 20
minutes a day, 3 days a week
– and eight to 10 strength-training exercises, 1015 repetitions of each exercise twice to three
times per week
– Make a plan with a health care professional if
needed
Fitness Activities
• Start off easy and gradually increase time
and intensity
• Walking is a great and common form of
exercise
• Yoga and Thai Chi health with balance and
mental acuity
• It’s never too late to start and reap the
benefits of exercise
Diet and Health Issues
in the Older Adult, Part 1
• Alzheimer’s disease
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Abnormal aging process
Early dementia
Progressive and genetically based disease
Oxidative stress and free radical damage, excess
iron, copper, and aluminum and low antioxidant
nutrient status are implicated.
– Elevated blood pressure and blood glucose and
reduced blood flow to the brain
– Hyperhomocystemia and folate, vitamin B6 and B12
– Being mentally challenged helps with prevention
Diet and Health Issues
in the Older Adult, Part 2
• Arthritis
– Improved with exercise and omega-3 fatty acids
– Worsened with obesity
• Cataracts and macular degeneration
– Diets low in vitamins C and E, zinc, and the
phytochemicals lutein and zeaxanthin increase risk
– Eating more colorful plant foods is helpful
– Lifestyle factors such as smoking tobacco, oxidative
stress, and excess ultraviolet sunlight exposure are
risks
Diet and Health Issues
in the Older Adult, Part 3
• Osteoporosis
– A silent disease
– Postmenopausal smaller, thin, Asian or White
women with a family history are at greatest risk
– Osteopenia measured by DEXA scan
– Fractures of the wrist, spine, and hip are common
– Fall prevention is important
– Diet and lifestyle approaches are needed:
calcium, vitamin D, vitamin K, and weight bearing
exercise
Diet and Health Issues
in the Older Adult, Part 4
• Sarcopenia
– Loss of muscle mass and strength from hormonal
changes, diminished nerve function, sedentary
lifestyle, poor diet, and chronic disease
– Increase in fat mass especially visceral fat
• Sleep disturbances
– From medical and psychosocial diseases
– Worsened by foods and beverages containing
stimulates, living a sedentary life, some
medications, and some medical conditions
Eating &
Aging Well
Some
Summary Points, Part 1
• There are many theories of aging
• The physiology of aging involves many changes to the
body’s senses and organ systems
• Mental changes associated with aging can often be
prevented by diet, exercise, and lifestyle habits
• A social network is a vital component to the health and
wellbeing of the older adult.
• Age related diseases and conditions not age affect quality
of life
• Eating a healthy diet adequate and balanced in Calories,
energy producing nutrients, fiber, vitamins, minerals, and
water will support successful aging
Some
Summary Points, Part 2
• Food assistance programs are valuable resources
• Lifestyle practices such as being physically active and
not smoking or using alcohol in excess will add
significantly to the older adult’s quality of life
• Aerobic and strength training exercises will preserve
lean body mass and prevent age-related physical
decline
• Many common degenerative diseases seen in the
elderly are preventable with proper diet and a healthy
lifestyle
• Aging well is possible and requires diet, exercise, stress
management, mental stimulation, social and emotional
support, and adequate sleep
References for this presentation are the same as those for this topic found in module 6 of the textbook