Nutritional considerations

Nutritional considerations

Adequate nutrition is important at any age, but is more important in the later years as when it is combined with the changes of ageing it can exacerbate or lead to compromises in health. Any interruption to the basic nutritional needs may trigger subclinical or chronic diseases. The energy requirements of older persons are slightly lower than those for younger people. Poor nutrition may play a role in the decline of many functions associated with aging and nutritional status is altered by many of the physiological process of aging. The nutritional status of older persons is also dependent on lifetime eating habits, social condition and can be significantly influenced by disease processes or the presence of mood disorders. Successful rehabilitation of older persons require adequate nutrition. Heath care workers need to be sensitive to the changes that occur with ageing and the ways that they affect nutrition and are affected by poor nutrition. There is a need for screening, evaluation and intervention for nutritional status of those older persons who are at risk.

Risk factors for nutritional status:
• social isolation
• poor or inappropriate food intake
• poverty
• disability
• acute or chronic diseases
• medication use

The dietary guidelines for older Australians developed by the NHMRC (2000) has a set of 12 recommendations to improve the nutrition of older persons:
1) Enjoy a wide variety of nutritious foods
2) Keep active to maintain muscle strength and a health body weight
3) Eat at least three meals every day
4) Care for your food: prepare and store it correctly
5) Eat plenty of vegetable (including legumes) and fruit
6) Eat plenty of cereals, beans and pastas
7) Eat a diet low in saturated fat
8) Drink adequate amounts of water and/or other fluids
9) If you drink alcohol, limit your intake
10) Choose food low in salt and use salt sparingly
11) Include foods high in calcium
12) Use added sugars in moderation

Malnutrition:
• deficient consumption of calories or nutrients; could affect up to 25% of those over 65 years in some form and up to 50% of those hospitalised
• often not recognised
• risk factors - poverty, ignorance, ‘finicky’ eaters; elder abuse & neglect, social isolation, psychiatric illness (especially depression), physical disability, chronic disease states (especially gastrointestinal disease), impaired appetite, poor dentition. reduced absorption, increased requirements (eg surgery, trauma), alcohol intake, drug therapy (eg neomycin affects iron absorption; steroid and vitamin C; metformin and vitamin B12)
• clinical features – weight loss, bruising and/or bleeding gums, poor wound healing, osteomalacia, anaemia, hypoalbuminaemia
• effects of malnutrition – poor wound healing, impaired immunity, prolonged hospital stays, increased mortality and morbidity risk

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