Adults and Older Adults: Conditions & Interventions Study Notes

Adults and Older Adults: Conditions & Interventions

Osteoporosis

• Definition: Generalized skeletal fragility resulting from decreased bone mass and disruption of bone architecture, leading to increased fracture risk.
• Prevalence: Approximately half of older women and one-eighth of older men will experience an osteoporosis-related fracture in their lifetime.
• Etiology:
  • Inadequate bone mass development due to insufficient calcium intake during adolescence.
  • Increased bone loss linked to:
    • Decreased estrogen levels (menopause in women).
    • Blood calcium imbalances.
    • Inadequate intake of calcium (Ca), magnesium (Mg), vitamin D, and vitamin K.

Nutritional Remedies for Osteoporosis

• Adequate calcium and vitamin D intake are crucial.
• Consume milk or calcium/vitamin D fortified foods or take supplements with meals.
• Consume foods rich in vitamins C and K.

Oral Health

• Approximately 25% of adults over 75 years have no natural teeth.
• This can lead to:
  • Decreased chewing ability.
  • Gum inflammation.
• Omega-3 fatty acids can help decrease inflammation.
• Deficiencies in vitamin C and zinc are associated with periodontal disease.

Inflammatory Diseases

• Examples: Osteoarthritis, rheumatoid arthritis, atrophic gastritis, celiac disease, irritable bowel disease (IBS), diverticulitis, asthma.
• Osteoarthritis is the most common, affecting approximately 50% of adults over 65.
• For obese individuals, weight loss is the primary treatment for osteoarthritis.

Cognitive Disorders: Alzheimer’s Disease

• Dementia: A progressive cognitive decline characterized by impaired thinking, memory, decision-making, and linguistic ability.
• Dementia is often associated with neurological conditions like Alzheimer’s and Parkinson’s disease.
• Nutrient deficiencies, specifically B12 and folate, can contribute to dementia.
• There is not strong evidence that other nutrients (aluminum, copper, carnitine, B6, choline) cause dementia.

Nutritional Therapy for Cognitive Decline

• The Mediterranean diet and aerobic exercise have shown positive impacts on cognitive ability and longevity.
• Food supplements containing fish oil, antioxidants, and B-vitamins led to modest memory improvement in patients with mild Alzheimer’s.

Medication and Polypharmacy

• Polypharmacy: Taking multiple medications daily, increases with age.
• The average older adult spends approximately 1807 per year on medications.
• Effects of Medications: Medications may require dietary restrictions and can interfere with appetite, digestion, and metabolism.
• Refer to Table 19.15 for medications associated with chronic conditions (focus on understanding how some medications impact nutritional status).

Weight Loss Among Elderly

• Weight loss is not problematic if the person has always been thin.
• A loss of greater than 10% body weight in 6 months is associated with increased mortality.
• Causes:
  • Illness
  • Poverty
  • Functional decline
  • Loss of smell and taste
  • Restrictive diets (low salt, low cholesterol)
  • Blunted hunger signals (decreased ghrelin, increased leptin).

Nutrition Interventions for Low Body Weight/Underweight

• Calories: Eat and exercise to build muscle mass and strength.
• Protein: Consume 1 to 1.5 g/kg of body weight.
• Water: Consume 1 mL/kcal; rehydrate slowly.

Dehydration Among Elderly

• Causes:
  • Less sensitivity to detecting thirst
  • Illness
  • Kidneys less functional
  • Medications
  • Swallowing problems
  • Mental health issues
  • Decreased mobility
  • Fear of incontinence

Signs and Consequences of Dehydration

• Signs and Symptoms:
  • Upper-body muscle weakness
  • Speech difficulty
  • Confusion
  • Dry nose and mouth
  • Fissured tongue
  • Sunken appearance of eyes
• Consequences:
  • Increased heart rate
  • Urinary tract infection
  • Pneumonia
  • Pressure ulcers
  • Confusion/disorientation and dementia