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Successful Aging. Sorosh Roshan, MD, MPH International Health Awareness Network www.ihan.org. Who is Old?. Second childhood - Shakespeare late 16 th century “sans teeth, sans eyes, sans taste, sans everything” The United Nations defines older people as those 60 years of age and over, and

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Successful aging

Successful Aging

Sorosh Roshan, MD, MPH

International Health

Awareness Network

www.ihan.org


Who is old

Who is Old?

  • Second childhood - Shakespeare late 16th century “sans teeth, sans eyes, sans taste, sans everything”

  • The United Nations defines older people as those 60 years of age and over, and

  • The oldest old as those over 80 years of age


The human rights of older women

The Human Rights of Older Women

  • Equal access to health and social services

  • Eliminate gender, age, race and income related inequalities

  • Life long training opportunity

  • Involving older workers right across the company’s activities e.g., training, worker involvement in redesigning the work place, etc.

  • Access to the labor market

  • Elimination of elder abuse


Aging

Aging

  • “A process of gradual and spontaneous change, resulting in maturation through childhood, puberty and young adulthood and then decline through middle and late age”


Senescence

Senescence

  • “The process by which the capacity for cell division, growth, and function is lost over times, ultimately leading to an incompatibility with life; i.e., the process of senescence terminates in death”


Successful aging1

Successful Aging

  • A process by which deleterious effects are minimized

  • Healthy lifestyle from preconception though out life cycle

  • Nutrition and an active physical, mental and spiritual life


Accelerated aging

Accelerated Aging

  • Progeroid syndrome

  • Warner syndrome

  • Wiedmann-Rautenstrauch syndrome and Hutchinson-Gilford syndrome

  • Down syndrome


Physiology of aging

Physiology of Aging

  • Aging is a normal process in which the rate of catabolic changes become greater than the rate of anabolic cell regeneration.

  • Loss of cells and body mass can lead to varying degree of decreased efficiency and impaired organ function.


Physiological changes

Physiological Changes

  • Sensory losses

  • Oral health problems

  • Gastrointestinal and metabolic abnormalities

  • Cardiovascular diseases


Physiological changes con t

Physiological Changes (con’t)

  • Reduction of pleasure of eating due to hyposmia (the ability to taste and smell reduced) and dysgeusia (the capability to digest foods is reduced)

  • Reduced ability to detect odor can cause

    food poisoning

  • Dry mouth (xerostomia), hyposalivation; difficulties in chewing and swallowing; constipation


Gastrointestinal changes

Gastrointestinal Changes

  • Constipation due to inadequate intake of fiber, fluid, sedentary life style

  • Glucose intolerance

  • Increase in plasma levels of 1.5mg/dl per decade

  • Deficient insulin production or function

  • Diet modification and exercise are the treatment of choice


Gastrointestinal changes con t

Gastrointestinal Changes (con’t)

  • Hypochlorhydria (Lower levels of digestive enzymes)

  • Diminished absorption of nutrients such as B12, iron and calcium

  • Metabolism of calcium and vitamin D is altered during aging

  • These factors and poor dietary intake will accelerate bone loss and osteoporosis


Nutritional requirements

Nutritional Requirements

  • Age, gender, level of activity, food allergies, environment and medical conditions

  • Caloric requirements begin to decline from 55-60, (500kcal per for men and 300 kcal for women)

  • Protein requirements increase slightly

  • 20-30 kcal per kg of body weight-depending on the person’s weight.


Nutritional requirements con t

Nutritional Requirements (con’t)

  • 1.25g of protein per kilogram of body weight is appropriate for the elderly (12 - 16% of total daily calories).

  • The US RDA for adults is .8g of protein per kilogram of body weight.

  • Need varies depending on illness, stress,

    open wounds, burns, vigorous exercise,

    infection and altered GI function.


Carbohydrate intake

Carbohydrate Intake

  • Limited to 55% of total daily calories.

  • 40% of it from complex carbohydrate, whole grains, vegetables and fibers.

  • Fibers help reduce cholesterol and plasma

    glucose level.


Dietary fat

Dietary Fat

  • 30% of daily calories.

  • Reduce saturated fats.

  • Increase intake of monounsaturated and

    polyunsaturated sources including Omega 3 fatty acids (salmon, tuna fish, walnuts and flaxseed powder)


Nutrients and vitamins

Nutrients and Vitamins

  • Calcium intake 800-1200mg/day

  • Phosphorus intake to be reduced to 700mg/day.

  • Vitamin D for the homebound with limited sun exposure.

  • Iron store tends to increase with age. The recommended dose is 10mg/ day for men and women. (50% of the required dose for under the age of 50)


Anemia in the elderly

Anemia in the Elderly

  • Is due gastrointestinal bleeding and malignant disease.


Successful aging

Zinc

  • Zinc deficiency causes:

    • Impaired immune function

    • anorexia

    • dysgeusia

    • delayed wound healing

    • development of pressure ulcers

  • Treat with Zinc supplements


Antioxidants

Antioxidants

  • Vitamin E enhances immune function.

  • 400 IU daily.

  • Vitamin C may help to protect against cataract, 150-250 mg/day.

  • B12, B6 and folate may help to improve nutritional status and energy, protects against elevated serum homocysteine, a risk factor for depression, cardiovascular and neurological deficits.


Hydration and fluid intake

Hydration and Fluid Intake

  • Dehydration is the most important cause of fluid and electrolyte disturbances in the elderly.

  • A daily fluid intake of 30-35 ml per kilogram of body weight, or a minimum of 1.0-1.5 ml per kilogram's necessary.


Daily fluid requirements

Daily Fluid Requirements

  • Fluid requirements increase with:

    • Exercise

    • Use of laxative or diuretics

    • Hot environment

    • Increase protein or fiber intake

    • Fever

  • The elderly often experience reduced thirst sensation


The menu

The Menu

  • The food should be prepared for the individual needs.

  • Good presentation, fresh, nutritious, tasty

    and nutrient dense. Be considerate of those who wear dentures or suffer from dysphasia. Add supplements if you must.

  • Serve the food with bouquet of tender loving care.


Special thanks

Special Thanks

  • Azi Ahmadi, MS Nutrition

  • Laura DiClementi, MS Health Education

  • Courtney Essary, MBA

  • Hewitt Simon, Age in Action-S. Africa Council for the Aged


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