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t_Articles
The United Nations has declared 1999 as the year of the Elderly. In
this context, it's timely to look at the role of nutrition in the health
of elderly persons.
Most countries in Asia are experiencing a considerable rise in the
proportion of elderly people in the population and life expectancy is
higher today than ever before. Our ability to live longer is, in part,
attributable to better nutrition and improved health care. Educational
and economic improvements and social support systems also play a role.
But as we live longer, our dietary needs may change either due to the
process of aging or because of the onset of disease. Ensuring that the
elderly population is well nourished is of importance not just from an
individuals' perspective but also for the well being of society in
general.
The role of nutrition in improving both morbidity and mortality in
the elderly is an area of growing interest. According to Prof. Christine
Williams, Hugh Sinclair Professor of Human Nutrition, Reading
University, UK, "As we live longer, the emphasis in nutrition will shift
towards the definition of nutritional needs for prevention of
chronic disease. Nutrition in the acute care of elderly sick patients
has also been greatly under-emphasised and further research is needed in
relation to both acute and chronic nutritional needs of the elderly
person".
Changes with aging
Many physical, mental and social changes take place with aging.
Physiological problems are related to poor food intake that may be due
to a variety of with digestion, reduced perceptions of taste and smell
and impaired mental function. Chronic diseases and impairments such as
arthritis, hypertension and stroke, heart conditions, respiratory
problems, diabetes, cancers and osteoporosis can all affect the quality
of life.
Start young
The role of nutrition and a healthy lifestyle in preserving health
and wellbeing begins in youth and middle age. Poor lifestyle habits such
as smoking, lack of exercise and poor diets have an accumulative effect
as we age. In fact, the role of nutrition may start even earlier. Recent
studies suggest that the risk of chronic disease later in life may be
related to nutrition received in the womb.
While a healthy lifestyle can help to prevent the risk of chronic
disease, it also contributes to an older person's ability to recover
from illness. Whether older people are living in their own homes, in
hospitals or nursing homes, malnutrition is associated with
increased mortality, increased susceptibility to infection and reduced
quality of life. So what makes a healthy diet for an elderly person?
Same nutrients, different amounts
We all require the same nutrients regardless of our age but the
physiological changes that occur with aging may affect the amounts of
each nutrient needed. It is generally accepted that calorie needs
decline with age and that appetites tend to get smaller. Most people
tend to decrease their physical activity as they age. In order to avoid
becoming overweight, they need to lower their calorie intake. But to do
this safely requires eating foods that are nutrient-dense (high in
vitamins and minerals for relatively fewer calories). This can be
difficult unless care is taken in choosing the right foods.
Nutrients that are most likely to be lacking in elderly persons
include vitamins B6, B12, folate, vitamin D and calcium. This is
partly because aging is associated with less efficient processing of
essential nutrients. For example, the ability to synthesise vitamin D in
the skin declines with age and the gut is not as efficient in absorbing
nutrients. The actual intake of nutrients may be compromised if a person
is unwell, has problems chewing or is suffering from mild dementia.
Another problem that often goes unrecognised in the elderly is a poor
fluid intake. This can cause a range of problems from constipation to
dehydration and low blood pressure.
RISK FACTORS FOR POOR NUTRITION IN THE ELDERLY
Socio-environmental factors
Poor socioeconomic status or poverty
Problems getting to stores or markets to shop
Poor food preparation skills
Being institutionalised or hospitalised
Physiological factors
Deteriorating health/well-being
Decrease in taste and sense of smell
Problems with eyesight
Poor dentition
Chronic disease such as arthritis
Malabsorption of nutrients
Psychological factors
Depression
Dementia/senility
Food preferences
Other factors
Prescription drugs that may affect mood, appetite or nutrient
absorption
Unrecognised problem
Poor nutrition is a problem that often goes unrecognised in
the elderly. Ensuring adequate nutrient intake can affect both quality
of life and morbidity. A healthy diet contributes to a healthier immune
system and may also enhance a person's mood and feelings of wellness.
The future aims of science and medicine are not only to lengthen life
but also to reduce the amount of time that people spend diseased or
disabled. Healthy aging that incorporates a healthy diet, exercise and
avoidance of smoking, can enable people to fulfil their potential and
attain optimal health.
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