What role does nutrition play?

THE PROCESS OF AGING

In 2040, 25% of the Dutch population is 65 + We are getting older

Therefore it is essential to gain an insight in the nutritional needs of elderly.

Because: optimal nutrition contributes to the quality of life in the last years

WHY DO WE GET OLD?

Telomere

AGING Aging is not a homogenous process.

Organs in the same person age at different rates influenced by

Genetic-make up Lifestyle choices Environmental choices

AGING

AGING AND GASTRO INTESTINAL SYSTEMWhat does it affect?

Swallowing and chewing aspiration Decline in taste and smell Increased rates of gastritis and increased

sensitivity to medication Changes in intestine structure; less effective

uptake of micronutrients (Vit B12) Less vitamin D receptors lower efficiency of

calcium absorption. Reduced propulsive motility obstipation Reduced anal sphincter tone fecal incontinence

HOMEOSTENOSIS

MALNUTRITION

Risk of

malnutrition

Loss of appetite----------

Lower Energy requirement

Decline in Energy intake

Increase in fat massDecline in muscle mass

↓ Exercise

WHO IS AT RISK OF MALNUTRITION? Elderly Chronic disease

Cancer COPD Heart failure Kidney failure

WHAT ARE THE CONSEQUENCES OF MALNUTRITION?

HOW LARGE IS THIS GROUP? < 1500 Kcal/day ; High risk of micronutrient

deficiency.

20 % of people > 75 year who living independently

40% of elderly living in a nursing home

HOW DO RECOGNIZE SOMEONE AT RISK? By weighing!

Weight loss: > 5% in 1 month (3 kg/month) > 10% in 6 months (6 kg/month)(independent of the initial weight)

< 65 year: BMI < 18,5 kg/m2 > 65 year: BMI < 20,0 kg/m2

MAJOR BOTTLENECKSVitamin D deficiency! (sunlight)

Water Proteins Vitamin A Vitamin B6, Folic acid, Vitamin B12 (due to

malabsorption) Vitamin C Calcium (diuretics) Iron Iodine

CLINICAL RELEVANCE

Bone Muscle Other consequences

Osteomalacia Muscle weakness Autoimmune disease

Rachitis Muscle cramps Cancer

Osteoporosis Astma

Cardiovascular disease

Population Criterium serum calcidiol

Percentage in total year

Percentage summer

Percentage winter

Independent elderly < 50 nmol/l 50% 35% 50%

Nursery home < 50 nmol/l 0 – 85%

SENIOR FRIENDLY HOSPITAL30-60% of the elderly experience a decline in health while admitted to the hospital

Hospitals should become senior friendly:‘Look beyond the reason of admission’

4 year project to a. identify the needs and

requirements of elderly when it comes to hospital admission / visits

b. Identify each hospital policyc. Reward positive results with the

label ‘’senior friendly hospital “d. Advising hospitals on senior

friendliness

Goal: At the end of 2015 everyone in Holland knows where to find a senior friendly hospital

Thank you for listening.

Are there any questions?