Food and nutrition.pdf

Nutrition Disorder Related to Food 145Dental problems, common in old age, decrease the ability to chewcertain foods. Physical disabilities such as diminution of vision may makeeating less pleasant. The decreases in basal metabolic rate and physicalactivity noted with increasing age reduce nutrient needs, however, theintake of calories and essential nlltrients may be even lower than theseneeds. Decreased physical activity also may predispose individuals to thedevelopment of osteoporosis.Changes such as osteoarthritis can affect mobility and decrease anolder person's ability to purchase and prepare food. Another possiblehinderance to adequate nutrition in the aged is malabsorption, which canbe caused by decrease or absence of gastric acid secretion and byinteraction with medications commonly prescribed for older persons.The most common psychologic factor affecting nutrition is depression.Of all psychiatric diagnoses, depression is most strongly correlated withincreased mortality, regardless of the age of the subjects, and is most oftenrelated to chronic disease and to poverty, which are common among olderpersons. Neither institutionalization nor solitary living necessarily inducesdepression, but such life changes may be associated with poor self-esteem,which in tum, can lead to significant changes in eating patterns.Older people as a group have a lower economic status than otheradults. Although the percentage of older individuals living below thepoverty .level has decreased substantially over the past two decades andis now less than the percentage of those under 65 living in poverty, povertycontinues to be too high. The decline in income most often results fromretirement from the workforce, the effects of inflation on fixed incomes,death of wage-earning spouse, or failing health. Income and health statushave been found to be important determinants of life satisfaction in theolder population. Low income is also a major risk factor for inadequatenutrition in older individuals.Most older people do not live in institutions, although institutionalfood is likely to meet minimal standards for nutrient content, factors suchas lack of choice or limited day-to-day variety may increase the risk ofinadequate consumption. Many residents of nursing homes consume atherapeutic diet that may further discourage adequate intake. Animportant issue for demented institutionalized individuals is that theymay not consume the food, not that the menu is inadequate.Clinical and dietary standards for younger adults may not beappropriate for older persons, yet few data are available on nutritionalrequirements or recommended intakes of older adults. The RDA's forexample, were developed from research on the nutrient needs of youngerhealthy people. The present standards for adults over the age 50 are, forthe most part, identical to those for people aged 23 to 50. Because these