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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.
slide19
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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