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Weight Problems of Older Adults: Weight Loss and Obesity - Chapter 14
 

Weight Problems of Older Adults: Weight Loss and Obesity - Chapter 14

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Malnutrition ...

Malnutrition
Undernutrition
Overnutrition
Specific nutrient deficiencies
Protein-energy malnutrition
Assessing nutrition status
Combination of laboratory measures, assessment of nutrition intake, and anthropometric measurements

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    Weight Problems of Older Adults: Weight Loss and Obesity - Chapter 14 Weight Problems of Older Adults: Weight Loss and Obesity - Chapter 14 Presentation Transcript

    • Weight Problems of OlderAdults: Weight Loss and ObesityChapter 14
    • Introduction• Malnutrition– Undernutrition– Overnutrition– Specific nutrient deficiencies– Protein-energy malnutrition• Assessing nutrition status– Combination of laboratory measures, assessmentof nutrition intake, and anthropometricmeasurements
    • Introduction• Anthropometric methods– Body Mass Index (BMI)• Biochemical indicators– Serum albumin– Prealbumin– Serum cholesterol– Total lymphocyte count
    • Introduction• Signs and symptoms– Weight– Skin– Hair
    • Importance of Undernutritionand Weight Loss• Unintentional weight loss• Skilled nursing facility patients– Weight loss is a predictor of earlyinstitutionalization– Malnutrition or high risk of undernutrition• Hospitalized older patients– Weight loss and hypoalbuminemia often followhospitalization
    • Factors Contributing to Poor Nutrition• Physiological Changes of Aging– Reduction in Height and Weight Distribution• BMI• Height decreases with age• Reduction in muscle mass• Increase in adipose tissue in trunk andabdomen• Subcutaneous fat decreases, especially in limbs• Calorie requirements decrease• Required nutrients do not diminish
    • Factors Contributing to Poor Nutrition• Physiological Changes of Aging– Reduction in Taste and Smell• Taste sensory threshold increases• Sense of smell decreases
    • Factors Contributing to Poor Nutrition• Physiological Changes of Aging– Decrease in Appetite and Anorexia• Contributes to weight loss• Anorexia of aging• Medication side effects• Decoupling of hunger and nutrient ingestion• May be associated with illness, drugs,dementia, or mood disorders• Polypharmacy may indicate malnutrition
    • Factors Contributing to Poor Nutrition• Mechanical Barriers Contributing to PoorNutrition– Poor oral health– Physical activity may become more difficult– Declined mobility– Pain from arthritis– Restrictive diets– Unrecognized feeding problems
    • Factors Contributing to Poor Nutrition• Medical Conditions Contributing to PoorNutrition– Increased metabolic requirements– Healing increases need for nutrients– Multiple medical conditions with unique nutrition-related issues– Chronic disease can result in difficulties
    • Factors Contributing to Poor Nutrition• Psychological Factors Contributing to PoorNutritional Status– Depression– Dementia– Malnutrition is prevalent in older adults with mildcognitive impairments
    • Social Factors Associated WithUndernutrition• Older adults living in poverty– Insufficient funds to purchase food– Inadequate consumption of fruits and vegetables– Low intake of multiple vitamins/minerals– Social isolation– Loneliness– Rural older adults are vulnerable to nutritionalinadequacies– Culture
    • Consequences of Weight Lossin Older Adult• Often leads to death• Suggests a loss of lean body mass• May follow the development of disease• Can predispose older adults to increased riskfor community-acquired pneumonia• Associated with bone loss and hip fractures• Medication side effects decrease food intake
    • Consequences of Weight Lossin Older Adult• Interventions– Multiple possible interventions that increasecaloric intake– Nutritional education and healthy hints forhealthy eating
    • Obesity• Defined as BMI of 30 kg/m2 or greater• BMI between 25 and 30– Protective for mortality• Physiological Changes– Prevalence of obesity peaks– Loss of lean tissue– Intra abdominal and intramuscular fat increasewith age– Visceral body fat increases with age
    • Obesity• Physiological Changes– Factors that contribute to obesity• Inactivity• Reduced hormone levels• Poor nutrition
    • Obesity• Problems Associated with Obesity– Association between obesity and disability– High body fat is predictive of mobility loss– More likely to experience functional impairment
    • Obesity• Other Consequences of Obesity– Associated with numerous diseases and problems– Metabolic syndrome– Increase likelihood of osteoarthritis in knees– Depression– Favorable aspects• Protective for falls and mortality• Increased muscle strength• Decreased risk of pressure ulcers• May be protective against dementia in women
    • To Lose or Not to Lose Weight• Effective weight loss interventions include– Nutrition education– Diet– Exercise counseling– Behavioral strategies
    • To Lose or Not to Lose Weight• Losing Weight– Nutrition guidelines for older adults
    • To Lose or Not to Lose Weight• Losing Weight– Popular diets (trends)– Mediterranean diet– Counseling by a dietitian– Pharmaceutical agents
    • Conclusion• Exercise should be an integral part of anyresearch about diet therapy in those withundernutrition as well for obese individuals.