Deck 19: Nutrition and Older Adults: Conditions and Interventions

Question 1

What are the three most common chronic conditions affecting women over age 65?

Answer 1

The health professionals of public monitor the health of the population by measuring the leading causes of mortality and morbidity to design the interventions which improve the health of the population. Even though the deaths from cardiovascular and cerebrovascular diseases are reduced but these both are still the leading causes of death in older adults.
The percentage of women of age 65 who reported various selected chronic conditions in year 2009-2010 are heart disease (26%), hypertension (57%), stroke (8%), any cancer (21%), diabetes (18%) and arthritis (56%).
The three most common chronic conditions affecting men over age 65 are Hypertension, Arthritis and Heart Disease.

Question 2

Calculate her energy needs and suggest strategies she might use to regain some energy.

Answer 2

Even though there is a gain in weight of Ms. W, the energy needs are also decreased as functional status is declined. The strategies which can be used by her to regain some energy are as follows:
• doing physical activity like walking
• intake of dietary supplements which contains Vitamin D and ginseng
• intake of herbal therapies like avocado/soybean
• unsaponifiables (ASU) in pill form which improves the functional status
• intake of anti-inflammatory diets like DASH diet and Mediterranean diet
• reducing the intake of diet which is rich in saturated fats

Question 3

The DASH diet has been shown to reduce HBP; additional sodium restrictions have led to further reductions in blood pressure.

Answer 3

High Blood Pressure (HBP) or Hypertension is a chronic condition which has higher prevalence in older adults. It is defined as "untreated systolic pressure of 140 mm of Hg or higher, or diastolic pressure of 90 mm of Hg or higher or consuming any antihypertensive drugs.
The Dietary Approaches to Stop Hypertension (DASH) is very effective in decreasing the high blood pressure and the risk of stroke in adults below age 65. The life style modifications also has a greater benefit on blood pressure, hence researches recommend both DASH and life style as intervention focus in individuals around age 50.
Also the other non-drug interventions like restriction of sodium to 1500 to 1800 mg per day over 30 months and weight reduction also reduced the blood pressure. In DASH-sodium study, it was found that, with the strict intake of sodium limit to 1500 mg per day, the overall blood pressure has reduced to a great extent.
Hence it is true that, the DASH diet has reduced HBP and also further reductions in blood pressure with additional sodium restrictions.

Question 4

What other information would you want to know in order to counsel Ms. Wetter?

Question 5

BMI is a less effective predictor of morbidity and mortality in older than younger adults. Why is BMI a less reliable tool in older adults?

Question 6

Even a small loss of body weight can improve osteoarthritis, as can adequate intakes of vitamins C and D.

Question 7

Vitamin K levels present in dark green vegetables may interfere with warfarin (anti-coagulant) therapy.

Question 8

Eating a Mediterranean-style diet is associated with lower CVD mortality in older adults.

Question 9

Older adults who suffer from sarcopenia may benefit from high-protein diets. High protein intake will also help to keep their bones strong.

Question 10

Vitamin B 12 deficiency can cause irreversible neurological damage. List at least three reasons why an older adult might have low vitamin B 12 levels.

Question 11

Dehydration can result in confusion. List three or more strategies that can help to restore hydration and provide nutrients an older adult might be missing.

Question 12

Assessment
What nutritional parameters should be assessed and monitored now that Laura is back at Lenoir Manor?

Question 13

Diagnosis
What disciplines should be involved in Laura's care plan, and why?

Question 14

Diagnosis
The interdisciplinary care team wants to meet Laura's needs in a dignified and respectful manner. How can the care team address both clinical and ethical concerns?

Question 15

Diagnosis
What are strategies young adults can adopt to reduce their risk of stroke?

Question 16

Monitoring and Evaluation
How could Bridget ensure that Laura's nutritional needs are met?

Question 17

What are some of the nutritional issues faced by Ms. Wetter? (Hint: Calculate her current weight compared to her usual body weight as a percentage.)

Question 18

What are the three most common chronic conditions affecting men over age 65?

Question 19

How would you prioritize these in a nutritional care plan?