Nutrient Needs for Older Adults and Anemia

Nutrient Needs for Older Adults

Nutrition requirements that change with aging due to physiological and metabolic changes

Estimated Energy Requirement (EER) and Aging

Energy needs decrease as age increases

Protein RDA for Older Adults

0.8 g per kg of body weight per day

Protein and Kidney Health

Excess protein intake may place stress on kidneys and should not be routinely increased

DRI Equations

Mathematical formulas used to estimate energy needs based on age, sex, weight, height, and activity level

Carbohydrate Recommendation

45–65% of total daily kilocalories

Lipid Recommendation

20–35% of total daily kilocalories

Fiber Recommendation (Men)

30 g per day

Fiber Recommendation (Women)

21 g per day

Water Needs in Older Adults

Increased risk of dehydration due to reduced thirst sensation

Fluid Recommendation

Encourage approximately 1 mL of fluid per calorie consumed

Vitamin D Recommendation

600–800 IU per day

Vitamin D and Bone Health

Low vitamin D levels are associated with increased hip fracture risk

Iron RDA (Adults 51+)

8 mg per day

Vitamin B12 RDA

2.4 mcg per day

Calcium Recommendation (Older Adults)

1200 mg per day

Calcium Absorption and Aging

Absorption decreases with age

Potassium Recommendation

4700 mg per day

Potassium and Cardiovascular Health

Higher intake may reduce cardiovascular disease risk

Zinc RDA (Men)

11 mg per day

Zinc RDA (Women)

8 mg per day

Zinc Deficiency Effects

Impaired immune function and delayed wound healing

Anemia

A deficiency in the number, size, or hemoglobin content of erythrocytes

Erythrocytes

Red blood cells responsible for oxygen transport

Hemoglobin

Iron-containing protein that carries oxygen in red blood cells

Impact of Anemia

Reduced oxygen and carbon dioxide exchange between blood and tissues

Anemia Classification by Cell Size

Macrocytic, normocytic, and microcytic

Macrocytic Anemia

Anemia with abnormally large red blood cells

Normocytic Anemia

Anemia with normal-sized red blood cells

Microcytic Anemia

Anemia with abnormally small red blood cells

Anemia Classification by Hemoglobin Content

Hypochromic and normochromic

Hypochromic Anemia

Pale red blood cells with low hemoglobin content

Normochromic Anemia

Red blood cells with normal hemoglobin content

Megaloblastic Anemia

Anemia caused by impaired DNA synthesis affecting blood cell formation

Cause of Megaloblastic Anemia

Folic acid or vitamin B12 deficiency

Vitamin B12 Depletion

Progressive loss of vitamin B12 leading to anemia

Stage I B12 Depletion

Early negative vitamin B12 balance

Stage II B12 Depletion

Reduced body stores of vitamin B12

Stage III B12 Depletion

Impaired erythropoiesis due to B12 deficiency

Stage IV B12 Depletion

Clinical vitamin B12 deficiency anemia

Pernicious Anemia

A severe form of B12 deficiency anemia with neurological symptoms

Pernicious Anemia Symptoms

Numbness, poor coordination, memory loss, and hallucinations

Irreversibility of Pernicious Anemia

Neurological damage may be permanent if severe

Causes of Vitamin B12 Deficiency

Inadequate intake, absorption, utilization, or increased needs

Vitamin B12 Deficiency and Aging

Older adults are at increased risk due to reduced intake and absorption

Gastric Acid and B12 Absorption

Stomach acid is required to release B12 from food

Achlorhydria

Insufficient stomach acid production

Achlorhydria Prevalence

Affects approximately 30% of older adults

Vitamin B12 Deficiency Prevalence

Up to 43% of community-dwelling older adults

Clinical B12 Deficiency

Present in 1–2% of adults over age 51

Subclinical B12 Deficiency

Estimated in 10–20% of adults over age 51

B12 Deficiency Symptoms (General)

Weakness, fatigue, tachycardia, pallor, and anorexia

Pale Conjunctiva

Light-colored inner eyelid indicating anemia

Cutaneous Hyperpigmentation

Darkening of skin, especially on knuckle pads

Neurological Effects of B12 Deficiency

White matter and axon degradation

Cognitive Slowing

Reduced mental processing speed

Neuropathy

Nerve damage causing numbness or tingling

Gait Disturbances

Difficulty walking

Psychological Symptoms of B12 Deficiency

Depression, irritability, and insomnia

Medical Nutrition Therapy for B12 Deficiency

Supplementation tailored to absorption capacity

Preventive B12 Therapy

Monthly intramuscular injections or daily sublingual supplementation

Oral B12 for Normal Absorption

1000 mcg per day

Oral B12 for Impaired Absorption

Up to 2000 mcg per day

Food Sources of Vitamin B12

Meats, clams, seafood, milk, yogurt, nutritional yeast, and fortified foods

Vitamin B12 in Diet Assessment

Used to evaluate adequacy of intake

Sample Diet B12 Adequacy

Does not meet daily vitamin B12 needs for an older adult