Decreased appetite and food intake
Decreases in body weight are common in adults aged 65 to 90, as they may not eat enough to
meet energy needs. This poses a problem for the elderly because it increases the risk of
nutrition related illness, especially when the concentration of the serum protein albumin falls
below about 4g/100ml. There are many possible causes of inadequate food intake in the
elderly. Researchers suspect that biological origins, such as changes in the neuroendocrine
factors that influence feeding, account for some of this. Changes in taste and smell may also
be important. In addition social aspects play a role in reduced food intake. Many elderly
people live alone which is associated with less food consumption than when eating with
others. Declining weight needs to be addressed if health is to be maintained in the elderly
years. Significant weight loss in elderly people, sometimes termed the "dwindles," increases
the risk of death. It may also indicate ongoing illness and reduced tolerance to medication, or
simple withdrawal from life itself. In any event the reason for weight loss needs to be
investigated and, ideally treated.
The senses of taste and smell
Sensitivity to smell, taste and smell often decreases with age. The loss begins around age 60
and becomes more pronounced after age 70. This results from the effects of aging on the cells
that sense taste and smell, as well as from the use of certain medication and medical
therapies. Stronger seasonings may be required to make foods taste good; other foods may
require equivalent nutrient substitution or changes in preparation if they no longer taste good.
In the elderly, an inadequate diet, most notably a zinc deficiency, can also contribute to loss
of taste. Therefore a change in taste or smell should never be dismissed simply as a
characteristic of old age. Some causes can be remedied. In addition, variety in the diet helps
compensate for the decrease in taste and smell. Food companies also are filling a niche in the
marketplace- using a variety of flavor enhancers which make foods tastier for elderly people.
Dental health
Total loss of teeth is common in 55% of those over age 85, in 44% of those age 75 to 84, and
30% of those age 65 to 74. Attention to dental hygiene and dental care throughout life greatly
lessens this risk. Gum disease is also common and promotes tooth loss. Replacement dentures
also enable some to chew normally, but many elderly people, especially men, have denture
problems. A pureed diet is not necessarily the remedy. Solving individual dietary needs
requires identifying foods that need to be modified in consistency and those that can be eaten
in a typical state. When people have problems chewing, nutrient-dense snacks like yogurt,
banana, and peanut butter can help. Sometimes just allowing extra time for chewing and
swallowing encourages more eating.
Thirst
Elderly people often partially lose their sense of thirst, and in turn don’t drink enough fluids.
In addition, there is diminished activity of anti-duretic hormone and aldosterone. Total body
water also falls with aging. Together these changes make elderly people more likely to
become dehydrated, a condition that lead to confusion and sometimes hospitalization. It is
important for elderly people to consume enough fluid, and if necessary, they should be
monitored to ensure they do so, especially when ill and during hot weather. An approximate
fluid recommendation is the same as for young adults, 1ml/kcal expended. This works out to
about 8 cups (2000 ml of fluid daily). A glass of water at every meal provides a good start
towards meeting fluid needs. Some important signs of dehydration, other than confusion,
include dry lips, sunken eyes, swollen tongue, increased body temperature, decreased blood
pressure, constipation, decreased urine output, and nausea.
The gastrointestinal tract
The main gastrointestinal problem for elderly people is constipation. Complains associated
with constipation include decreased frequency of bowel movements, painful defecation, hard
stool, or a feeling of incomplete evacuation. To keep the intestinal tract performing
efficiently, elderly people generally need to consume more dietary fiber than they did in their
youth. The goal is approximately 10-13 g/1000 kcal in the diet, but generally no more than
35g on a daily basis. Eating nuts, vegetables, beans, and whole grains regularly provides
enough dietary fiber. Elderly persons should drink more fluid to transport fecal masses that
form from dietary fiber intake.
Physical activity likewise helps keeping things moving smoothly. In addition, the elderly
person should go to the bathroom as soon as the urge is felt. Delaying the process promotes
constipation. Because medication can induce constipation, a physician should be consulted if
constipation might be related to medication. If mineral oil is taken as a laxative, it should
always be used with caution and not at meal times because it binds fat soluble vitamins and
limits their absorption.
Lactase production frequently decreases with age. Acid production in the stomach slows
with age, usually associated with reduced synthesis of intrinsic factor. These two changes can
contribute to poor absorption of vitamin B12 and eventually pernicious anemia and other
health problems. Thus those responsible for the care of older individuals need to be vigilant
with regard to the diagnosis of early vitamin B12 deficiency.
Less stomach acid also hampers iron absorption. Other conditions that affect the body's iron
status occur with regular use of aspirin whose continued cause blood loss in the stomach, and
use of anti-acids, which may bind iron. Ulcers, hemorrhoids and colon cancer can also cause
blood loss and in fact are the most common causes of anemia in the elderly. Careful attention
to iron status is especially needed in these cases.
Liver, bladder and pancreas
With age, the liver functions less efficiently. When there is a history of significant alcohol
consumption, fat build up in the liver and accounts for some decline. If cirrhosis develops, the liver functions even less efficiently. When a liver function deteriorates, many medications
cannot be efficiently detoxified. Alcohol abuse is a problem among a small but significant
group of older individuals who may continue alcohol abuse from earlier in life of developed
heavy drinking patterns and alcoholism later in life. The latter sometimes arises from the
loneliness and social isolation of retirement or loss of a spouse. Alcohol related sickness is
high in older people, so the health consequences of this excess are considerable. Also, elderly
people are more likely to take chronic medications that potentate alcohol's effect. The
possibility of vitamin A toxicity also increases from the effects of liver diseases. Elderly
people, especially those with liver disease, should be warned not to take excessive amounts of
vitamin A because toxic effects can easily result, causing malaise, head ache, bone pain, liver
dysfunction, and a decrease in white blood cell count.
The gall bladder also functions less efficiently as we age. Gall stones may dam up the bile to
be secreted through the gall bladder, causing it to pool and back up into the liver instead. Gall stones can also interfere with fat digestion by allowing less bile into the small intestines. A low- fat diet or even surgery may be necessary.
Although the digestive function of the pancreas may decline with age, the pancreas has a
large reserve capacity. A sign of a failing pancreas is high blood glucose which occurs under
several different conditions. Glucose instead may circulate primarily in the blood, rather than
being taken up by cells, because the pancreas secretes less insulin or because cells resist
insulin action- especially the enlarged adipose cells in obese people. Another cause can be
insufficient chromium intake. Where appropriate, improved nutrient intake, regular physical
activity, and weight loss can improve insulin action and blood glucose regulation.
Kidney function
The kidney filters waste more slowly as they lose nephrons. Kidneys deteriorate more often
in people who have regularly eaten excessive protein, and in some cases, excess energy. The
deterioration, when present, significantly reduces the kidneys' ability to excrete the products
of protein breakdown. People with decreased kidney function cause urea, a main by-product
of protein metabolism, to accumulate in the blood.
Immune function
The immune system often operates less efficiently with age, starting after age 25. The change
is quite variable among people of a specific age bracket. Consuming adequate proteins,
vitamins such as vitamin B6, and zinc helps to maintain the health of the immune system.
Recurrent sickness and delayed wound healing are warning signs of a deficiency, especially
of protein and zinc, usually caused by eating too little food in general or too few animal
protein sources. Older people may eliminate meat from their diet because it is too hard to
chew or just doesn’t taste good. Animal proteins are an excellent source of zinc. Nutrient
supplements can help with vitamin B6 and zinc intake if dietary intake is marginal. On the
other hand, over nutrition is equally harmful to the immune system. For example, obesity and
excessive fat, iron, and zinc can suppress the immune system.
Lung function
Lung efficiency declines somewhat with age, and is especially pronounced in the elderly
people who have smoked and continue to smoke tobacco products. Breathing becomes
shallower, faster, and more difficult as the number of alveoli decreases. Smoking often leads
to lung cancer. The decrease in lung efficiency contributes to a general downward spiral in
body functions; breathing difficulty limit physical activity and endurance and frequently
discourage eating. These changes eventually cancel other efforts to maintain overall health.
Along with not smoking, exercise help to prevent lung problems. \
Hearing and vision
Hearing and vision both decline as we age. Approximately 4% of people under 45 years of
age and 29% of those 65 years or over have a handicapping loss of hearing. Hearing
impairment occurs mainly in members of industrial societies with urban traffic, aircraft, and
loud music.
A decline in vision can affect a person's ability to physically get to a grocery store, locate the foods desired, read labels for nutrition contents, and prepare the foods at home. Elderly
people may also avoid social contacts because they can't hear. Such changes may make
people afraid to socialize, be active, or take care of important routines in daily life, such as shopping and correctly following instructions of medications. If so, family members and
others need to step in to help as appropriate.
Decrease in lean tissue
Some muscle cells shrink and others are lost as muscles age; some muscles lose their ability
to contract as they accumulate fat and collagen. Lifestyle greatly determines the rate of
muscle mass deterioration. An active lifestyle tends to maintain muscle mass, whereas a very
inactive one encourages its loss. Overall, physical activity increases muscle strength and
mobility, improves mental outlook, eases daily tasks that require some strength, improves
sleep and slows bone loss. Physical activity is also desirable for elderly people because it
allows them to eat more food by raising energy expenditure, thereby increasing their chances
of consuming adequate amounts of nutrients.
Increase in fat stores
As lean tissue decreases with age the body often takes on more fat. Much of this results from
minimal physical activity. Some researchers feel that some extra fat stores in the elderly may
be fine, while others recommend against fat gain through adulthood. However, obesity is
undesirable, especially in android distribution, because it can raise blood pressure and blood
glucose, as well as make it more difficult to walk and to perform daily tasks.
Cardiovascular health
The heart often pumps blood less efficiently in elderly people, usually because of a
longstanding history of insufficient physical activity. Poor heart conditioning allows fatty and connective tissue to infiltrate the heart's muscular wall. This decline in cardiac output is not inevitable with aging and does not occur to as great an extent among elderly people who
remain physically active.
Heart attack and stroke, the major causes of death in all adults, are caused primarily by
atherosclerosis and high blood pressure. With age, atherosclerosis plaques accumulate in the
arteries, reducing their elasticity, constricting blood flow and consequently elevating blood
pressure. The main way to limit the buildup of atherosclerotic plaque is to keep Low Density
Lipoproteins (LDL) and the total cholesterol to High Density Lipoproteins cholesterol ratio in
the desirable range. Consuming adequate vitamin B6, folate, and vitamin B12 is also important
to avoid elevated blood homocysteine, an additional risk factor for the heart disease.
Bone health
Decline in bone density is associated with aging. Bone loss in women occurs especially after
menopause. Bone loss in men is slow and steady from middle age throughout the elderly
years. Estrogen replacement at menopause is the most reliable treatment to lessen bone loss
in women. For elderly women not taking estrogen, increasing calcium intake to 1500 mg/day
helps maintain bone density in some types of bones, such as hip. The same was advised for
elderly men on optimal calcium intake. Currently many elderly people fail; to meet this
recommendation. Other measures to prevent bone loss can be started earlier and continued
throughout life. Maintaining adequate vitamin D intake, not smoking, and drinking alcohol
moderately or not at al. It should be noted that underweight women are at especially high risk
for developing osteoroposis. Performing weight bearing exercises also helps sustain bone.
For adult women at menopause who are at high risk or who may have osteoroposis, medical
treatment should be considered. Estrogen replacement therapy, active vitamin D hormone
(calcitriol) therapy, biphosphonate, or calcitonin therapy-administered with a physician’s
guidance. Very severe osteoroposis limits the ability of elderly people to exercise, shop,
prepare food, and live normally. They eat less and fewer nutrients.
Titany answered the question on November 8, 2021 at 07:59