successful aging
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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 - PowerPoint PPT PresentationTRANSCRIPT
Successful AgingSuccessful AgingSorosh Roshan, MD, Sorosh Roshan, MD,
MPHMPH
International Health International Health Awareness NetworkAwareness Network
www.ihan.orgwww.ihan.org
Who is Old?Who is Old? Second childhood - Shakespeare late Second childhood - Shakespeare late
1616thth century “sans teeth, sans eyes, century “sans teeth, sans eyes, sans taste, sans everything”sans taste, sans everything”
The United Nations defines older The United Nations defines older people as those 60 years of age and people as those 60 years of age and over, andover, and
The oldest old as those over 80 years The oldest old as those over 80 years of ageof age
The Human Rights of Older The Human Rights of Older WomenWomen
Equal access to health and social servicesEqual access to health and social services Eliminate gender, age, race and income related Eliminate gender, age, race and income related
inequalitiesinequalities Life long training opportunityLife long training opportunity Involving older workers right across the Involving older workers right across the
company’s activities e.g., training, worker company’s activities e.g., training, worker involvement in redesigning the work place, etc.involvement in redesigning the work place, etc.
Access to the labor marketAccess to the labor market Elimination of elder abuseElimination of elder abuse
AgingAging ““A process of gradual and A process of gradual and
spontaneous change, resulting in spontaneous change, resulting in maturation through childhood, maturation through childhood, puberty and young adulthood and puberty and young adulthood and then decline through middle and late then decline through middle and late age”age”
Senescence Senescence ““The process by which the capacity The process by which the capacity
for cell division, growth, and function for cell division, growth, and function is lost over times, ultimately leading is lost over times, ultimately leading to an incompatibility with life; i.e., to an incompatibility with life; i.e., the process of senescence the process of senescence terminates in death” terminates in death”
Successful AgingSuccessful Aging A process by which deleterious A process by which deleterious
effects are minimizedeffects are minimized Healthy lifestyle from preconception Healthy lifestyle from preconception
though out life cyclethough out life cycle Nutrition and an active physical, Nutrition and an active physical,
mental and spiritual lifemental and spiritual life
Accelerated AgingAccelerated Aging Progeroid syndromeProgeroid syndrome Warner syndromeWarner syndrome Wiedmann-Rautenstrauch syndrome Wiedmann-Rautenstrauch syndrome
and Hutchinson-Gilford syndromeand Hutchinson-Gilford syndrome Down syndromeDown syndrome
Physiology of AgingPhysiology of Aging Aging is a normal process in which Aging is a normal process in which
the rate of catabolic changes the rate of catabolic changes become greater than the rate of become greater than the rate of anabolic cell regeneration.anabolic cell regeneration.
Loss of cells and body mass can lead Loss of cells and body mass can lead to varying degree of decreased to varying degree of decreased efficiency and impaired organ efficiency and impaired organ function.function.
Physiological ChangesPhysiological Changes
Sensory lossesSensory losses Oral health problemsOral health problems Gastrointestinal and metabolic Gastrointestinal and metabolic
abnormalitiesabnormalities Cardiovascular diseasesCardiovascular diseases
Physiological Changes Physiological Changes (con’t)(con’t)
Reduction of pleasure of eating due to Reduction of pleasure of eating due to hyposmia (the ability to taste and smell hyposmia (the ability to taste and smell reduced) and dysgeusia (the capability reduced) and dysgeusia (the capability to digest foods is reduced)to digest foods is reduced)
Reduced ability to detect odor can Reduced ability to detect odor can cause cause
food poisoningfood poisoning Dry mouth (xerostomia), hyposalivation; Dry mouth (xerostomia), hyposalivation;
difficulties in chewing and swallowing; difficulties in chewing and swallowing; constipation constipation
Gastrointestinal ChangesGastrointestinal Changes Constipation due to inadequate intake Constipation due to inadequate intake
of fiber, fluid, sedentary life styleof fiber, fluid, sedentary life style Glucose intolerance Glucose intolerance Increase in plasma levels of 1.5mg/dl Increase in plasma levels of 1.5mg/dl
per decadeper decade Deficient insulin production or functionDeficient insulin production or function Diet modification and exercise are the Diet modification and exercise are the
treatment of choicetreatment of choice
Gastrointestinal Changes Gastrointestinal Changes (con’t)(con’t)
Hypochlorhydria (Lower levels of Hypochlorhydria (Lower levels of digestive enzymes)digestive enzymes)
Diminished absorption of nutrients such Diminished absorption of nutrients such as B12, iron and calciumas B12, iron and calcium
Metabolism of calcium and vitamin D is Metabolism of calcium and vitamin D is altered during agingaltered during aging
These factors and poor dietary intake These factors and poor dietary intake will accelerate bone loss and will accelerate bone loss and osteoporosisosteoporosis
Nutritional RequirementsNutritional Requirements
Age, gender, level of activity, food Age, gender, level of activity, food allergies, environment and medical allergies, environment and medical conditionsconditions
Caloric requirements begin to decline from Caloric requirements begin to decline from 55-60, (500kcal per for men and 300 kcal 55-60, (500kcal per for men and 300 kcal for women)for women)
Protein requirements increase slightlyProtein requirements increase slightly 20-30 kcal per kg of body weight-20-30 kcal per kg of body weight-
depending on the person’s weight. depending on the person’s weight.
Nutritional Requirements Nutritional Requirements (con’t)(con’t)
1.25g of protein per kilogram of body 1.25g of protein per kilogram of body weight is appropriate for the elderly (12 weight is appropriate for the elderly (12 - 16% of total daily calories).- 16% of total daily calories).
The US RDA for adults is .8g of protein The US RDA for adults is .8g of protein per kilogram of body weight.per kilogram of body weight.
Need varies depending on illness, stress,Need varies depending on illness, stress,open wounds, burns, vigorous exercise,open wounds, burns, vigorous exercise,infection and altered GI function.infection and altered GI function.
Carbohydrate IntakeCarbohydrate Intake Limited to 55% of total daily calories.Limited to 55% of total daily calories. 40% of it from complex 40% of it from complex
carbohydrate, whole grains, carbohydrate, whole grains, vegetables and fibers.vegetables and fibers.
Fibers help reduce cholesterol and Fibers help reduce cholesterol and plasma plasma
glucose level.glucose level.
Dietary FatDietary Fat 30% of daily calories.30% of daily calories. Reduce saturated fats.Reduce saturated fats. Increase intake of monounsaturated Increase intake of monounsaturated
and and polyunsaturated sources including polyunsaturated sources including
Omega 3 fatty acids (salmon, tuna Omega 3 fatty acids (salmon, tuna fish, walnuts and flaxseed powder)fish, walnuts and flaxseed powder)
Nutrients and VitaminsNutrients and Vitamins– Calcium intake 800-1200mg/day Calcium intake 800-1200mg/day – Phosphorus intake to be reduced to Phosphorus intake to be reduced to
700mg/day.700mg/day.– Vitamin D for the homebound with Vitamin D for the homebound with
limited sun exposure.limited sun exposure.– Iron store tends to increase with age. Iron store tends to increase with age.
The recommended dose is 10mg/ day The recommended dose is 10mg/ day for men and women. (50% of the for men and women. (50% of the required dose for under the age of 50)required dose for under the age of 50)
Anemia in the ElderlyAnemia in the Elderly Is due gastrointestinal bleeding and Is due gastrointestinal bleeding and
malignant disease.malignant disease.
Zinc Zinc
Zinc deficiency causes: Zinc deficiency causes: – Impaired immune functionImpaired immune function– anorexiaanorexia– dysgeusia dysgeusia – delayed wound healing delayed wound healing – development of pressure ulcersdevelopment of pressure ulcers
Treat with Zinc supplementsTreat with Zinc supplements
AntioxidantsAntioxidants Vitamin E enhances immune function.Vitamin E enhances immune function. 400 IU daily.400 IU daily. Vitamin C may help to protect against Vitamin C may help to protect against
cataract, 150-250 mg/day.cataract, 150-250 mg/day. B12, B6 and folate may help to improve B12, B6 and folate may help to improve
nutritional status and energy, protects nutritional status and energy, protects against elevated serum homocysteine, a against elevated serum homocysteine, a risk factor for depression, risk factor for depression, cardiovascular and neurological deficits.cardiovascular and neurological deficits.
Hydration and Fluid IntakeHydration and Fluid Intake Dehydration is the most important Dehydration is the most important
cause of fluid and electrolyte cause of fluid and electrolyte disturbances in the elderly.disturbances in the elderly.
A daily fluid intake of 30-35 ml per A daily fluid intake of 30-35 ml per kilogram of body weight, or a kilogram of body weight, or a minimum of 1.0-1.5 ml per kilogram's minimum of 1.0-1.5 ml per kilogram's necessary.necessary.
Daily Fluid RequirementsDaily Fluid Requirements Fluid requirements increase with:Fluid requirements increase with:
– ExerciseExercise– Use of laxative or diureticsUse of laxative or diuretics– Hot environmentHot environment– Increase protein or fiber intakeIncrease protein or fiber intake– FeverFever
The elderly often experience reduced The elderly often experience reduced thirst sensationthirst sensation
The MenuThe Menu The food should be prepared for the The food should be prepared for the
individual needs.individual needs. Good presentation, fresh, nutritious, Good presentation, fresh, nutritious,
tasty tasty and nutrient dense. Be considerate of and nutrient dense. Be considerate of
those who wear dentures or suffer from those who wear dentures or suffer from dysphasia. Add supplements if you must.dysphasia. Add supplements if you must.
Serve the food with bouquet of tender Serve the food with bouquet of tender loving care.loving care.
Special ThanksSpecial Thanks Azi Ahmadi, MS NutritionAzi Ahmadi, MS Nutrition Laura DiClementi, MS Health Laura DiClementi, MS Health
EducationEducation Courtney Essary, MBACourtney Essary, MBA Hewitt Simon, Age in Action-S. Africa Hewitt Simon, Age in Action-S. Africa
Council for the AgedCouncil for the Aged