2. Aging occurs at different rates with different people DO NOT STEREOTYPE !!

3. DIET/NUTRITIONAGING GENERALORAL HEALTH HEALTH

4. NUTRITION AND AGING n aging mechanisms not well understood n nutrition influences the aging process. n malnutrition increases disease risk n good diet may delay chronic diseases.

5. Adequate Nutrition can n Improve tolerance and response to treatment n improve immune response n promote healing n reduce complications n improve quality of life

6. Types of Changes n physiological n oral n psychological n functional

7. AGE-RELATED PHYSIOLOGICAL CHANGES n Rate of aging differs with individuals and organs and tissues n Progressive decline/changes in many organ systems and associated functions

8. Physiological Changes n Increase in Adipose Tissue/Decrease in Lean Body Mass n Decrease in Basal Metabolism/Decrease in Calorie Requirement n Kidney changes lead to decrease in total body water

9. Physiological Changes n Impaired Digestion lactose intolerance lactose intolerance n Malabsorption (B-12) n Changes in Nutrient Utilization n Impaired Elimination constipation constipation POSSIBLE RESULTS Overt malnutrition Overt malnutrition Latent malnutrition Latent malnutrition Laxative Abuse Dehydration

10. Gastrointestinal Disorders n Atrophy of gastric mucosa leads to achlorhydria (25% of those over age 60) n Result is bacterial overgrowth and malabsorption of protein, calcium, B-12 folic acid and non-heme iron n Bowel disease leads to altered motility, constipation, decreased appetite and possibly laxative abuse

11. ORAL CHANGES n Decreased Taste & Smell Sensitivity Atrophy of gustatory papillae leads to decreased tasteAtrophy of gustatory papillae leads to decreased taste Olefaction (smell ability) decreased with ageOlefaction (smell ability) decreased with age –(Only 32% of 70 year olds can smell as well as young adults ) Many drugs decrease taste and smellMany drugs decrease taste and smell n Decreased Salivary Function (xerostomia from drugs) (xerostomia from drugs)

12. ORAL SOFT TISSUE AND BONE PROBLEMS n Impaired Healing or Tissue Fragility (Vitamin deficiencies, e.g., Vitamin C) (Vitamin deficiencies, e.g., Vitamin C) (Vitamin toxicities, e.g., Vitamin A) (Vitamin toxicities, e.g., Vitamin A) n Increased Alveolar Ridge Resorption (Calcium, Vitamin D) (Calcium, Vitamin D)

13. ORAL CAVITY n Loss of teeth leads to poor chewing ability and decreased appetite n Dentures do not improve perceptual response

14. Dentures are the MAJOR cause of deaths from choking !!!!

16. Root Caries n Multiple meds xerostomia xerostomia n Smoking cessation n Hard candies and breath lozenges

18. Functional Changes Affecting Eating n Decline in Manual Dexterity (Arthritis, Paralysis, Amputation can affect eating, cooking, carrying food) n Decreased Vision or Hearing

19. Psychological Influences n Depression anorexia due to loneliness, poor health, lack of money or mobility n Decreased concern for the importance of food and eating to health and well being

20. POTENTIAL RESULTS Possible Results n Malnutrition n Alcohol Abuse n Dehydration

21. Alcohol can be a Problem n 50% + of Americans over 60 drink regularly n 5-10% drink heavily n alcohol can replace food and decrease appetite n alcohol can contribute to neurological and memory problems n can cause physical problems (liver etc.)

22. Nutrition Requirements for Seniors n Needs Increase for: calcium, vitamin D, vitamins B-6 and B-12calcium, vitamin D, vitamins B-6 and B-12 n Needs Decrease for: vitamin A, caloriesvitamin A, calories

23. Senior Nutrition Concerns n total food intake (calories) - ask about weight changes n food choices: (“tea and toast syndrome”) see elder food pyramid see elder food pyramid n specific nutritional issues such as ---------

24. Vitamin B-12 n Achlorhydria (low stomach acid) low absorption increased bacteria competing for B-12 low absorption increased bacteria competing for B-12 Deficiency results in: damage to myelin sheath impeded electrical impulses poor balance and sensations of feeling dementia and confusion

25. Iron Deficiency Anemia n almost 1/2 of healthy 60+ year old women had iron deficiency n resulting in: breathlessness, fatigue, frequent infections, concentration problems n T-cell production for fighting infection was up to 50% less than women with normal iron N Ahluwalia, Penn State, 4th European Nutrition Congress 2004

27. 24 hour Recall n Breakfast: coffee & donut n Lunch: bouillon, roll & butter roll & butter tea tea n Dinner: Spaghetti & sauce tea tea Bedtime: crackers & jam n Milk group? (calcium & vit. D) n Fruits & vegs ? (vitamins, antioxidants) n Meat,fish etc. ? (protein) n Fiber ?

30. Supplements n increase response to infection n about 100 men & women aged 68-86 had multivitamin with 100% DRI for vits. & mins. n Results: half the infections half the days on antibiotics half the days on antibiotics increased antibodies increased antibodies lowered vitamin & mineral deficiencies lowered vitamin & mineral deficiencies n seniors take wrong supplements n Recommend: multivitamin/mineral