Nutrition and Quality of Life in the Elderly Presenter : John Orta, Professor of Nutritional Sciences, California State University, Los Angeles, CA August 7, 2007 Oxford Roundtable: Successful Aging: Enhancing the Quality of Life
Jul 03, 2015
Nutrition and Quality of Life in the Elderly Presenter: John Orta, Professor of Nutritional Sciences,
California State University, Los Angeles, CA August 7, 2007
Oxford Roundtable: Successful Aging: Enhancing the Quality of Life
Successful Aging: Enhancing the Quality of LifeAn interdisciplinary perspective
Harris Manchester CollegeOxford, England
Tuesday, August 7, 2007
Nutrition and Quality of Life in the Elderly Presenter: Dr. John Orta, R.D. FADA
Professor of Nutritional Sciences, California State University, Los Angeles, CA, USA
Nutrition & Quality of LifeIn general, subjective estimates of the individual’s health statusdo not correlate closely with objective assessment of health status as measured by laboratory tests and physical assessments.
Indicators of Well-Being
Diet of CentenariansCharacteristic Dietary Habits:
• The intake of most nutrients were similar among 60-, 80-, and 100-year old community-dwelling groups with few exceptions .
Centenarians
• Consumed about 20 – 30% more carotenoids and vitamin A from foods.
• Consumed breakfast more regularly than most people. • Avoided weight loss diets and large fluctuations in body weight.
• Lastly, centenarians tended to consume more whole milk, less 2% milk and yogurt, and were less likely to avoid dietary cholesterol.
(Fischer et al., 1995; Williams, Johnson, Poon, & Martin, 1995; Johnson, Brown, Poon, Martin, & Clayton, 1992).
What are indicators of nutritional risk among the elderly?
Top 10 Risks of Malnutrition in the Elderly
1. The food I eat doesn't taste as good to me as it did. 2. Most of the time I eat by myself. 3. I eat fewer than two meals a day. 4. It is hard for me to prepare meals. 5. I have tooth pain or mouth pain that makes it difficult for me to
eat. 6. No teeth or ill-fitting dentures.7. I take more than three prescribed or over-the-counter drugs
daily. 8. Without trying, I have lost ten pounds or more in the last six months. 10. I don't have enough money to buy food throughout the month.11. I usually “drink my meals.” 12. I have a health-related illness or disease that makes it hard for
me to eat properly.
D.E.T.E.R.M.I.N.E• The DETERMINE checklist is the NSI* tool used by physicians, registered dietitians,
other health care providers and social service agencies to assess the impact of various dietary, medical, or physical and social problems:
DiseaseEating poorlyTooth loss/mouth painEconomic hardshipReduced social contactMultiple medicationsInvoluntary weight loss/gainNeeds assistance in self careElder years above age 80
Recognizing the risk posed by these factors can result in interventions to improve the
quality of life and the ability to perform activities of daily living.____________________________
* Nutrition Screening Initiative
Disease
Disease
Alzheimer’s Disease
Can make it difficult to remember what you eat potentially affecting nutritional status.
Elderly DepressionCan Cause changes in appetite, digestion,
weight and well-being.
D.E.T.E.R.M.I.N.E• The DETERMINE checklist is the NSI* tool used by physicians, registered dietitians,
other health care providers and social service agencies to assess the impact of various dietary, medical, or physical and social problems:
DiseaseEating poorlyTooth loss/mouth painEconomic hardshipReduced social contactMultiple medicationsInvoluntary weight loss/gainNeeds assistance in self careElder years above age 80
Recognizing the risk posed by these factors can result in interventions to improve the
quality of life and the ability to perform activities of daily living.____________________________
* Nutrition Screening Initiative
Eating Poorly
Eating PoorlyCompromises Nutritional Health
Eating Poorly & SentarinessCompromises Nutritional Health
Alcohol Displaces Nutritious Meals & Disposes of Income
D.E.T.E.R.M.I.N.E• The DETERMINE checklist is the NSI* tool used by physicians, registered dietitians,
other health care providers and social service agencies to assess the impact of various dietary, medical, or physical and social problems:
DiseaseEating poorlyTooth loss/mouth painEconomic hardshipReduced social contactMultiple medicationsInvoluntary weight loss/gainNeeds assistance in self careElder years above age 80
Recognizing the risk posed by these factors can result in interventions to improve the
quality of life and the ability to perform activities of daily living.____________________________
* Nutrition Screening Initiative
Healthy Mouth,Teeth, & Gums, are Needed To Eat Properly
Health Care Reform?
Tooth Loss--Edentulousness
A healthy mouth, teeth and gums are needed to eat properly.
Dentures
Missing, loose or rotten teeth or dentures which don’t
fit well or cause mouth sores make it hard to eat.
Mouth Pain
Chronic mouth pain makes it hard to eat.
D.E.T.E.R.M.I.N.E• The DETERMINE checklist is the NSI* tool used by physicians, registered dietitians,
other health care providers and social service agencies to assess the impact of various dietary, medical, or physical and social problems:
DiseaseEating poorlyTooth loss/mouth painEconomic hardshipReduced social contactMultiple medicationsInvoluntary weight loss/gainNeeds assistance in self careElder years above age 80
Recognizing the risk posed by these factors can result in interventions to improve the
quality of life and the ability to perform activities of daily living.____________________________
* Nutrition Screening Initiative
Economic Hardship
D.E.T.E.R.M.I.N.E• The DETERMINE checklist is the NSI* tool used by physicians, registered dietitians,
other health care providers and social service agencies to assess the impact of various dietary, medical, or physical and social problems:
DiseaseEating poorlyTooth loss/mouth painEconomic hardshipReduced social contactMultiple medicationsInvoluntary weight loss/gainNeeds assistance in self careElder years above age 80
Recognizing the risk posed by these factors can result in interventions to improve the
quality of life and the ability to perform activities of daily living.____________________________
* Nutrition Screening Initiative
Reduced Social Contact
Reduced Social Contact
Vienna has the largest elderly population of any metropolis inthe world – fully 36 per cent of its 1.6 million inhabitants are overage 60.
Reduced Social Contact? Not in Vienna
The Aged In Vienna: A Gerontocracy When asked what is important in his life now, the retiree typically replies unhesitatingly,
"Health and good appetite."
www.aliciapatterson.org/.../Skerly05.html
D.E.T.E.R.M.I.N.E• The DETERMINE checklist is the NSI* tool used by physicians, registered dietitians,
other health care providers and social service agencies to assess the impact of various dietary, medical, or physical and social problems:
DiseaseEating poorlyTooth loss/mouth painEconomic hardshipReduced social contactMultiple medications Involuntary weight loss/gainNeeds assistance in self careElder years above age 80
Recognizing the risk posed by these factors can result in interventions to improve the
quality of life and the ability to perform activities of daily living.____________________________
* Nutrition Screening Initiative
Multiple Medications:Polypharmacy
Polypharmacy Polypharmacy, or the concurrent use of many drugs, has been associated with increased rates of potentiallyinappropriate medication (PIM) use anddangerous drug interactions.
PolypharmacyWarning!
Increases the potential for adverse drug-nutrient interactions.
Multiple Medications:Polypharmacy
Multiple Medications: Polypharmacy
Polypharmacy and Potentially Inappropriate Medication in the Elderly.US Pharm. 2006;10:112-116.
Involuntary Weight Loss May Have Serious Health Concerns in the
Elderly—i.e. Sarcopenia
Involuntary Weight Loss
Involuntary Weight Loss/Gain
Body Mass Index
Involuntary Weight Loss/Gain• Body Mass Index
Involuntary Weight Loss/Gain
Body Mass Index
Optimal body mass index (BMI) values of 21 to 25.
The risks increase slightly when BMI values are between 25 and 27.
They are significant in BMIs between 27 and 30.
They are dramatic over 30.
Involuntary Weight GainMay Lead to or Aggravate Serious
Health Problems
Involuntary Weight Gain
Waist to Hip Ratio
Do Look Fat?
Cartoons often ridicule fat people
D.E.T.E.R.M.I.N.E• The DETERMINE checklist is the NSI* tool used by physicians, registered dietitians,
other health care providers and social service agencies to assess the impact of various dietary, medical, or physical and social problems:
DiseaseEating poorlyTooth loss/mouth painEconomic hardshipReduced social contactMultiple medications Involuntary weight loss/gainNeeds assistance in self careElder years above age 80
Recognizing the risk posed by these factors can result in interventions to improve the
quality of life and the ability to perform activities of daily living.____________________________
* Nutrition Screening Initiative
Needing Assistance in Health Care
Needs Assistance in Health Care
D.E.T.E.R.M.I.N.E• The DETERMINE checklist is the NSI* tool used by physicians, registered dietitians,
other health care providers and social service agencies to assess the impact of various dietary, medical, or physical and social problems:
DiseaseEating poorlyTooth loss/mouth painEconomic hardshipReduced social contactMultiple medications Involuntary weight loss/gainNeeds assistance in self careElder years above age 80
Recognizing the risk posed by these factors can result in interventions to improve the
quality of life and the ability to perform activities of daily living.____________________________
* Nutrition Screening Initiative
Elder Years Above 80 Years Old
Nutrition Screening Initiative (NSI)• CONTEXT OF USE
Instrument for assessing nutritional risk in elderly patients in any setting.
• STRENGTHS
Quick and easy to administer 10 item questionnaire to patient or proxy. The checklist identifies patients who may benefit from nutritional counseling or home delivered meals as well as, evaluation of activities of daily living, depression, poor oral health, polypharmacy or status of underlying chronic conditions
• LIMITATIONS
The instrument is dependent on the patient or proxy having the information and being forthright.
Check Up On Your Nutritional Health
Circle the number in the "yes" column if the statement applies to you. Total the "yes" numbers to get your nutritional score.
TOTAL
2I am not always physically able to shop, cook and/or feed myself.
2Without wanting to, I have lost or gained 10 pounds in the last six months.
1I take three or more different prescribed or over-the counter drugs a day.
1I eat alone most of the time.
4I don't always have enough money to buy the food I need.
2I have tooth or mouth problems that make it hard for me to eat.
2I have three or more drinks of beer, liquor or wine almost every day.
2I eat few fruits or vegetables, or milk products.
3I eat fewer than two meals per day.
2I have an illness or condition that made me change the kind and/or amount of food I eat.
YES
Check Up On Your Nutritional Health
Circle the number in the "yes" column if the statement applies to you. Total the "yes" numbers to get your nutritional score.
TOTAL
2I am not always physically able to shop, cook and/or feed myself.
2Without wanting to, I have lost or gained 10 pounds in the last six months.
1I take three or more different prescribed or over-the counter drugs a day.
1I eat alone most of the time.
4I don't always have enough money to buy the food I need.
2I have tooth or mouth problems that make it hard for me to eat.
2I have three or more drinks of beer, liquor or wine almost every day.
2I eat few fruits or vegetables, or milk products.
3I eat fewer than two meals per day.
2I have an illness or condition that made me change the kind and/or amount of food I eat.
YES
What Your Nutritional Score Means
3-5 You are at moderate nutritional risk! See what can be done to improve your eating habits and lifestyle. A local office on aging, congregate meal sites, health department or cooperative Extension Office can help. Recheck your nutritional score in three months.
6 or more You are at high nutritional risk! Take this checklist with your the next time you see your doctor, dietitian or other health or social service professional. Talk with them about any problems you may have. Ask for help to improve your nutritional health. These warning signs suggest risk
but do not represent a diagnosis of any condition.
0-2 Good! Recheck your nutritional score in six months.
www.ext.vt.edu/.../348-020/348-020.html
Conclusion
Optimal NutritionIs important and
necessary for health Quality of Life in the
Elderly
The End