Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-27T00:07:05.850Z Has data issue: false hasContentIssue false

Chapter 6 - Nutrition and Aging

from Section I - General Approach to the Care of the Elderly

Published online by Cambridge University Press:  30 June 2022

By
Diane Villanyi  and
B. Lynn Beattie
Edited by
Jan Busby-Whitehead ,
Samuel C. Durso ,
Christine Arenson ,
Rebecca Elon ,
Mary H. Palmer  and
William Reichel
Jan Busby-Whitehead
Affiliation:
University of North Carolina, Chapel Hill
Samuel C. Durso
Affiliation:
The Johns Hopkins University, Maryland
Christine Arenson
Affiliation:
Thomas Jefferson University, Philadelphia
Rebecca Elon
Affiliation:
The Johns Hopkins University School of Medicine
Mary H. Palmer
Affiliation:
University of North Carolina, Chapel Hill
William Reichel
Affiliation:
Georgetown University Medical Center
Get access

Summary

Optimizing nutrition in the elderly is paramount to help maintain good health and quality of life. There are many factors leading to nutritional frailty in the elderly, including physiologic causes such as age-related changes in smell and taste, altered absorption in the gastrointestinal tract, changes in the neuroendocrine pathway, and cytokine-related adverse effects on nutrition. The burden of comorbidity, including cognitive decline, directly impacts an older adult’s nutritional status. Social factors such as limited access to fresh food, social isolation, and lower socioeconomic status can compromise an elderly individual’s nutritional status. It is important to screen the elderly for malnutrition in both the inpatient and outpatient setting using validated nutrition screening tools. The nutritional requirements of older adults are outlined in the U.S. Department of Agriculture (USDA) and the U.S. Departments of Health and Human Services (HHS) updated 2015-2020 Dietary Guidelines for Americans. The elderly in long-term care may face additional nutritional challenges including dysphagia due to a neurodegenerative process and perceived restrictions in mealtimes and menus. Nutritional frailty in the elderly is multifactorial and thus requires a multipronged approach to identification and management.

Keywords

nutritional frailtymalnutrition in the elderlymalnutrition syndromesnutrition screening toolsnutritional requirementslong-term care
Type
Chapter
Information
Reichel's Care of the Elderly
Clinical Aspects of Aging
 , pp. 54 - 63
Publisher: Cambridge University Press
Print publication year: 2022

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Shlisky, J, Bloom, DE, Beaudreault, AR, et al. Nutritional considerations for healthy aging and reduction in age-related chronic disease. Adv Nutr. 2017; 8: 17–26.Google Scholar
Bernstein, M, Munoz, N. Position of the academy of nutrition and dietetics: Food and nutrition for older adults – Promoting health and wellness. Journal of the Academy of Nutrition and Dietetics. 2012; 112(8):1255–1277.Google Scholar
Sobotka, L, ed. Basics in Clinical Nutrition. 4th edition. Somerville, NJ:Galen, 2012.Google Scholar
What is malnutrition? www.who.int/features/qa/malnutrition/en. Accessed on 7/10/2020.Google Scholar
White, JV, Guenter, P, Jensen, G, Malone, A, Schofield, M. Consensus statement: Academy of Nutrition and Dietetics and American Society for Parenteral and Enteral Nutrition – Characteristics recommended for the identification and documentation of adult malnutrition (undernutrition). J Parenter Enteral Nutr. 2012; 36(3):275–283.Google Scholar
Jensen, GL, Cederhol, T, Correia, MI, et al. J Parenter Enteral Nutr. 2019; 43(1):32. Epub 2018 (Sep. 2).Google Scholar
Visvanathan, R, Chapman, I. Undernutrition and anorexia in the older person. Gastroenterol Clin N Am. 2009; 38:393–409.Google Scholar
Donini, LM, Poggiogalle, E, Molfino, A, et al. Mini-nutritional assessment, malnutrition Universal screening tool, and nutrition risk screening tool for the nutritional evaluation of older nursing home residents. J Am Med Dir Assoc. 2016; 17(10):959. e11–18.Google Scholar
Robbins, LJ. Evaluation of weight loss in the elderly. Geriatrics 1989; 44:31–37.Google Scholar
Westenhoefer, J. Age and gender dependent profile of food choice. Forum Nutr. 2005(57):44–51.Google Scholar
Feldman, M, Cryer, B, McArthur, KE, et al. Effects of aging and gastritis on gastric acid and pepsin secretion in humans: A prospective study. Gastroenterology. 1996; 110(4):1043–1052.Google Scholar
Bhutto, A, Morley, JE. The clinical significance of gastrointestinal changes with aging. Curr Opin Clin Nutr Metab Care. 2008; 11(5):651–660.Google Scholar
Nordin, S, Bamerson, A, Bringlov, E, et al. Substance and tongue-specific loss in specific taste quality identification in elderly adults. Eur Arch Otorhinolaryngol. 2007; 264:285–289.Google Scholar
Walls, AW, Steele, JG. The relationship between oral health and nutrition in older people. Mech Ageing Dev. 2004; 125(12):853–857.Google Scholar
Bulut, EA, Khoury, R, Lee, H, et al. Eating disturbances in the elderly: A geriatric-psychiatric perspective. Nutrition and Healthy Aging. 2019; 5(3):185–198.Google Scholar
Donini, LM, Poggiogalle, E, Piredda, M, et al. Anorexia and eating patterns in the elderly. PLoS One 2013; 8:e63539.Google Scholar
Evans, WJ, Morley, JE, Argiles, J, et al. Cachexia: A new definition. Clin Nutr. 2008; 27:793–799.Google Scholar
Von Haehling, S, Anker, SD. Cachexia as a major underestimated and unmet medical need: Facts and numbers. J Cachex Sarcopenia Muscle. 2010; 1(1):1–5.Google Scholar
Krasnow, SM, Marks, DL. Neuropeptides in the pathophysiology and treatment of cachexia. Curr Opin Support Palliat Care. 2010; 4(4):266–271.Google Scholar
Tisdale, MJ. Cancer cachexia. Curr Opin Gastroenterol. 2010: 26(2):146–151.Google Scholar
Muscaritoli, M, Lucia, S, Molfino, A, et al. Muscle atrophy in aging and chronic diseases: Is it sarcopenia or cachexia? Internal and Emergency Medicine. 2013; 8:553–560.Google Scholar
Morely, JE, Abbatecola, AM, Argiles, JM, Society on Sarcopenia, Cachexia and Wasting Disorders Trialist Workshop, et al. Sarcopenia with limited mobility: An international consensus. J Am Med Dir Assoc. 2011; 12(6):403–409.Google Scholar
Evans, WJ. Skeletal muscle loss: Cachexia, sarcopenia, and inactivity. Am J Clin Nutr. 2010; 91:1123 S–1127 S.Google Scholar
Goodpaster, BH, Park, SW, Harris, TB, et al. The loss of skeletal muscle strength, mass, and quality in older adults: The health, aging and body composition study. J Geront A Biol Med Sci. 2006; 61:1059–1064.Google Scholar
Muller, MJ, Geisler, C, Pourhassan, M, et al. Assessment and definition of lean body mass deficiency in the elderly. European Journal of Clinical Nutrition. 2014; 68:1220–1227. doi: 10.1038/ejcn.2014.169.Google Scholar
Santilli, V, Bernetti, A, Mangone, M, et al. Clinical definition of sarcopenia. Clin Cases Miner Bone Metab. 2014; 11(3):177–180.Google Scholar
Stenholm, S, Harris, TB, Rantanen, T, et al. Sarcopenic obesity: Definition, etiology, and consequences. Curr Opin Clin Nutr Metab Care. 2008; 11(6):693–700.Google Scholar
Kohara, K. Sarcopenic obesity in aging population: Current status and future directions for research. Endocrine. 2014; 45(1):15–25.Google Scholar
Morley, JE. Undernutrition in older adults. Family Practice. 2012; 29:i89–i93.Google Scholar
Ritchie, C, Yukawa, M. Geriatric nutrition: Nutritional issues in older adults. UpToDate. 2020. www.uptodate.com/contents/geriatric-nutrition-nutritional-issues-in-older-adults. Accessed on 10/11/2021.Google Scholar
Kaiser, M, Bauer, J, Ramsch, C, et al. Validation of the Nutritional Assessment Short-Form (MNA-SF): A practical tool for identification of nutritional status. J Nutr Health Aging. 2009 (Nov.); 13(9):782–788.Google Scholar
Isenring, EA, Bauer, JD, Banks, MD, et al. The malnutrition screening tool is a useful tool for identifying malnutrition risk in residential aged care. Journal of Human Nutrition and Dietetics. 22(6):545–550.Google Scholar
Poulia, KA, Yannakoulia, M, Karageorgou, D, et al. Evaluation of the efficacy of six nutritional screening tools to predict malnutrition in the elderly. Clin Nutr. 2012 (Jun.); 31(3):378–385.Google Scholar
Kortebein, P, Ferrando, A, Lombeida, J, et al. Effect of 10 days bedrest on skeletal muscle in healthy older adults. JAMA. 2007; 297:1772–1774.Google Scholar
Flegal, KM, Kit, BK, Orpana, H, et al. Association of all-cause mortality with overweight and obesity using standard body mass index categories: A systematic review and meta-analysis. JAMA. 2013; 309(1):71–82.Google Scholar
Fontana, L, Hu, F. Optimal body weight for health and longevity: Bridging basic, clinical, and population research. Aging Cell. 2014; 13:391–400.Google Scholar
Sujino, Y, Tanno, J, Nakano, S, et al. Impact of hypoalbuminemia, frailty, and body mass index on early prognosis in older patients (>/= 85 years) with ST-elevation myocardial infarction. Journal of Cardiology. 2014; 66(3):263–268.Google Scholar
US Department of Agriculture. Dietary Guidelines for Americans 2015–2020. 8th edition. https://health.gov/our-work/food-nutrition/2015–2020-dietary-guidelines/guidelines. Accessed on 7/13/2020.Google Scholar
Physical Activity Guidelines for Americans. 2nd edition. https://health.gov/sites/default/files/2019–09/Physical_Activity_Guidelines_2nd_edition.pdf. Accessed on 7/13/2020.Google Scholar
Canada’s Food Guide/Dietary Guidelines, 2019. https://food-guide.canada.ca/en/guidelines. Accessed on 7/10/2020.Google Scholar
Institute of Medicine. Dietary Reference Intakes Tables and Application. https://ods.od.nih.gov/HealthInformation/Dietary_Reference_Intakes.aspx. Accessed on 5/28/2020.Google Scholar
Health Canada. The DRI values: Definitions. www.hc-sc.gc.ca/fn-an/nutrition/reference/dri_ques-ques_anref-eng.php#a5a. Accessed on 6/10/2020.Google Scholar
Elmafa, I, Meyer, AL. Body composition, changing physiological functions and nutrient requirements of the elderly. Ann Nutr Metab. 2008; 52(1):2–5.Google Scholar
Pennypacker, LC, Allen, RH, Kelly, JP, et al. High prevalence of cobalamin deficiency in elderly outpatients. J Am Geriatr Soc. 1992; 40(12):1997–1204.Google Scholar
Van Asselt, DZ, de Groot, LC, van Staveren, WA, et al. Role of cobalamin intake and atrophic gastritis in mild cobalamin deficiency in older Dutch subjects. Am J Clin Nutr. 1998; 68:328–334.Google Scholar
Walters, JR, Balesaria, S, Chavele, KM, et al. Calcium channel TRPV6 expression in human duodenum: Different relationships to the vitamin D system and aging in men and women. J Bone Miner Res. 2006; 21:1770–1777.Google Scholar
Bischoff-Ferrari, HA, Dawson-Hughes, B, Willett, WC, et al. Effect of Vitamin D on falls: A meta-analysis. JAMA. 2004; 291(16):1999–2006.Google Scholar
Anderson, JL, May, HT, Horne, BD, et al. Relation of vitamin D deficiency to cardiovascular risk factors, disease status, and incident events in a general healthcare population. Am J Cardiol 2010. 106(7):963–968.Google Scholar
Bolland, MJ, Avenell, A, Baron, JA, et al. Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis. BMJ. 2010; 341:c3691.Google Scholar
Bolland, MJ, Grey, A, Avenell, A, et al. Calcium supplements with or without vitamin D and risk of cardiovascular events: Reanalysis of the Women’s Health Initiative limited access dataset and meta-analysis. BMJ. 2011; 342:d2040.Google Scholar
Sloane, PD, Ivey, J, Helton, M, et al. Nutritional issues in long-term care. J Am Med Dir Assoc. 2008 (Sep.); 9(7):476–485.Google Scholar
Lowndes, R, Daly, T, Armstrong, P. “Leisurely dining”: Exploring how work organization, informal care, and dining spaces shape residents’ experiences of eating in long-term residential care. Qual. Health Res. 2018; 28(1):126–144.Google Scholar
Abbey, KL, Wright, OR, Capra, S. Menu planning in residential aged care: The level of choice and quality of planning of meals available to residents. Nutrients. 2015; 7(9):7580–7592.Google Scholar
Milne, AC, Potter, J, Vivanti, A, et al. Protein and energy supplementation in elderly people at risk from malnutrition. Cochrane Database Syst Rev. 2009 (Apr. 15); (2):CD 003288.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×