CD Week 30
Nutrition & Dementia
in the Elderly
Dietary Guidelines:
http://www.nhmrc.gov.au/_files_nhmrc/publications/at
tachments/n33.pdf
- See Wk 9: Diet and Nutrition.
- Particularly :
http://moritzcycling.com/eer.cgi
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Measures
Height weight tables
BMI body weight(kg)/height (m2)
Waist / Waist to Hip Ratio
Body Fat
– Skinfolds
– Electrical Impedance
– Buoyancy
– DEXA (Dual Energy X-Ray Absortiometry Scan)
Where do older Australians live?
Australia’s Welfare 2009 , pg88
http://blackboard.nd.edu.au/webapps/portal/frameset.j
sp?tab_id=_2_1&url=%2Fwebapps%2Fblackboard%2Fex
ecute%2Flauncher%3Ftype%3DCourse%26id%3D_4124_
1%26url%3D
• 92% private
 Family, group or lone-person household
 27% of these live alone
 66% of these live in family households (mostly single family)
84% of people with dementia in the community sometimes or always require assistance
with core activities. 93% receive some type of assistance with the condition.
• 8% non-private:
 Hotel/motel, guest house, cared accommodation (hospital, aged care
home, supported care at retirement village)
 Proportion increases with age
1 in 2 residents with dementia (50%) needed high-level care with the ADLs compared with
30% of residents without dementia
Likelihood of living in cared accommodation
increases with age
• 5% of ALL older people
• 31% of 85+
• 2008 – 60% of residents
were 85+
What assists or impedes the ability for older
Australians meeting the recommended dietary
guidelines?
• Assist – community services (Meals On Wheels),
deliveries, family/friends, A.C Facility,
supplements.
• Challenge- poverty, remoteness, mobility, access,
laziness, reversion to ethnic food patterns of
consumption, dentition/swallowing, diseases re
eating/digestion, cognitive decline, hand
function, inability to physically prepare food,
living alone/loneliness.
Disease states associated with poor
nutrition include:
• Cardiovascular disease
Elevated blood pressure
Elevated cholesterol levels
• Diabetes
• Some cancers
• Musculoskeletal and arthritis
To reduce falls/fractures important
for good muscle mass and reduced
osteoporotic fractures.
Demographic changes occurring in Australia
and other demographic changes:
Dementia in Australia
•More females 63% than males 37% have
dementia (AIHW 2011).
•222,100 Australians (1.0%) had dementia
in 2011.
• By 2031 expected to project more than
464,000 (1.6%)
•From 2000-2009, dementia rose from 7th to
3rd leading cause of death in Australia
•Dementia is already the single greatest cause of disability in older Australians.
•It is one of the fastest growing sources of major disease burden, overtaking
coronary heart disease in its total wellbeing cost by 2023.
•Australia faces a shortage of more than 150,000 paid and unpaid carers for
people with dementia by 2029.
Dementia internationally
Fun Facts
• The dementia epidemic is worldwide, more
prevalent in developed countries
• The total estimated worldwide costs of dementia were US$604
billion in 2010
• These costs account for about 1% of the world’s GDP (gross
domestic product)
• If dementia were a country, it would be the world’s 18th largest
economy
• If it were a company, it would be the world’s largest, exceeding
Wal-Mart (US$414 billion)
Important features in the design of an aged care
facility for dementia residents?
• Falls prevention:
Rails, steps, even surfaces, rugs, slippery/wet,
footwear, obstacles/clutter. Chairs for rest. Avoid
sharp corners/edges. Shower chairs/hoses.
Toilet commodes/raised seat/ alert system.
• Staff awareness
Important features in the design of an aged
care facility for dementia residents?
• Monitors/technology – contained area, microchipping,
identification
• Physical condition – skills – balance retraining &
maintenance. Ex classes. Chairs for rest
• Cognitive maintenance – games, skills, etc –
puzzles/papers/ipads
• Social interaction – common rooms, personal belongings &
familiarity, visitor friendly,
Fall Prevention Strategies in people
with dementia
From week 26, the risk factors for falls in elderly:
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History of previous falls
Psychoactive medications
Cognitive or functional impairment
Environment impairment
Balance or gait problems
Loss of muscle strength
Impaired vision
V: Alzheimers /Dementia
Wimo, A., Prince, M. (2010) World Alzheimer
Report 2010: The Global Economic Impact of
Dementia. London : Alzheimer’s Disease
International (ADI )
www.alz.co.uk/research/files/WorldAlzheimerRe
port2010ExecutiveSummary.pdf