Nutrition Concerns

"Dietary choices can help improve health during this life stage and address some of the nutritional concerns that many older adults face. Medical problems, such as disability and disease, can impact diet and activity level. Dental problems can lead to difficulties with chewing and swallowing, which in turn can make it hard to maintain a healthy diet. The use of dentures or the preparation of pureed or chopped foods can help solve this problem. There also is a decreased thirst response in the elderly, and the kidneys have a decreased ability to concentrate urine, both of which can lead to dehydration. At about age sixty, taste buds begin to decrease in size and number. As a result, the taste threshold is higher in older adults, meaning that more of the same flavor must be present to detect the taste. Many elderly people lose the ability to distinguish between salty, sour, sweet, and bitter flavors. This can make food seem less appealing and decrease the appetite. An intake of foods high in sugar and sodium can increase due to an inability to discern those tastes. The sense of smell also decreases, which impacts attitudes toward food. Sensory issues may also affect digestion because the taste and smell of food stimulates the secretion of digestive enzymes in the mouth, stomach, and pancreas. Some older adults have difficulty getting adequate nutrition because of dysphagia, which impairs the ability to swallow. Any damage to the parts of the brain that control swallowing can result in dysphagia, therefore stroke is a common cause. Dysphagia is also associated with advanced dementia because of overall brain function impairment. To assist older adults suffering from dysphagia, it can be helpful to alter food consistency. Solid foods can be pureed, ground, or chopped to allow more successful and safe swallowing. This decreases the risk of aspiration, which occurs when food flows into the respiratory tract and can result in pneumonia. Typically, speech therapists, physicians, and dietitians work together to determine the appropriate diet for dysphagia patients. Obesity is also a concern for the elderly. Adults over age sixty are more likely to be obese than young or middle-aged adults. Being overweight or obese increases the risk for potentially fatal conditions that can afflict the elderly, including cardiovascular disease and Type 2 diabetes. Obesity is also a contributing factor for a number of other conditions, including arthritis. For older adults who are overweight or obese, dietary changes to promote weight loss should be combined with an exercise program to protect muscle mass. This is because dieting reduces muscle as well as fat, which can exacerbate the loss of muscle mass due to aging. Although weight loss among the elderly can be beneficial, it is best to be cautious and consult with a healthcare professional before beginning a weight-loss program. A condition known as the anorexia of aging is characterized by poor food intake, which results in dangerous weight loss. This major health problem among the elderly leads to a higher risk for immune deficiency, frequent falls, muscle loss, and cognitive deficits. Reduced muscle mass and physical activity mean that older adults need fewer calories per day to maintain a normal weight. Decreased intake may be due to disability or the lack of a motivation to eat. Many older adults skip at least one meal each day, and some elderly people are unable to meet even reduced energy needs. Nutritional interventions should focus primarily on a healthy diet. Remedies can include increasing the frequency of meals and adding healthy, high-calorie foods, such as nuts, potatoes, whole-grain pasta, and avocados, to the diet. Liquid supplements between meals may help to improve caloric intake. Health care professionals should consider a patient’s habits and preferences when developing a nutritional treatment plan. After a plan is in place, patients should be weighed on a weekly basis until they show improvement."