12.1 Age-Related Changes Affecting Nutritional Status

As we age, our bodies undergo significant changes that affect how we process and use nutrients. These shifts can lead to malnutrition risks in older adults. Understanding these age-related changes is crucial for maintaining good health and preventing nutritional deficiencies as we grow older.

From muscle loss to altered taste buds, aging impacts our bodies in ways that directly affect our nutritional needs. This intro explores how these changes influence nutrient absorption, body composition, and overall health in older adults, setting the stage for effective geriatric nutrition assessment.

Physiological Changes and Nutrition

Age-Related Decline in Physiological Function

Top images from around the web for Age-Related Decline in Physiological Function

• 

  Frontiers | Biochemical Pathways of Sarcopenia and Their Modulation by Physical Exercise: A ... View original

  Is this image relevant?

• 

  Frontiers | Sarcopenia: What Is the Origin of This Aging-Induced Disorder? View original

  Is this image relevant?

• 

  Frontiers | Biochemical Pathways of Sarcopenia and Their Modulation by Physical Exercise: A ... View original

  Is this image relevant?

• 

  Frontiers | Sarcopenia: What Is the Origin of This Aging-Induced Disorder? View original

  Is this image relevant?

1 of 2

Top images from around the web for Age-Related Decline in Physiological Function

• 

  Frontiers | Biochemical Pathways of Sarcopenia and Their Modulation by Physical Exercise: A ... View original

  Is this image relevant?

• 

  Frontiers | Sarcopenia: What Is the Origin of This Aging-Induced Disorder? View original

  Is this image relevant?

• 

  Frontiers | Biochemical Pathways of Sarcopenia and Their Modulation by Physical Exercise: A ... View original

  Is this image relevant?

• 

  Frontiers | Sarcopenia: What Is the Origin of This Aging-Induced Disorder? View original

  Is this image relevant?

1 of 2

• Aging is associated with a gradual decline in physiological function across various body systems which can affect nutritional status and increase the risk of malnutrition in older adults
• Sarcopenia, the progressive loss of muscle mass and strength, is a common age-related change that can lead to reduced mobility, increased risk of falls, and decreased energy expenditure
• Osteoporosis, characterized by a decrease in bone mineral density, is more prevalent in older adults and can increase the risk of fractures, which may impact nutritional status due to reduced mobility and increased energy requirements for healing
• Age-related changes in the endocrine system, such as decreased production of growth hormone and testosterone, can contribute to reduced muscle mass and increased fat mass

Immunosenescence and Nutritional Status

• Immunosenescence, the gradual deterioration of the immune system with age, can increase the risk of infections and chronic inflammation which may negatively impact nutritional status
• Chronic inflammation associated with immunosenescence can lead to increased catabolism and muscle wasting, further exacerbating sarcopenia and increasing the risk of malnutrition
• Age-related changes in the immune system may also affect the gut microbiome, potentially altering nutrient absorption and increasing the risk of gastrointestinal disorders that can impact nutritional status
• Adequate nutrition, particularly sufficient intake of protein, vitamins (vitamin D), and minerals (zinc), is crucial for supporting immune function and reducing the risk of infections and chronic inflammation in older adults

Body Composition Changes in Older Adults

Alterations in Lean Body Mass and Body Fat

• With aging, there is a progressive decrease in lean body mass, particularly skeletal muscle, and an increase in body fat, especially visceral fat
• The loss of muscle mass and strength (sarcopenia) can lead to reduced physical function, increased risk of falls and fractures, and a decrease in resting metabolic rate, which may contribute to weight gain if energy intake is not adjusted accordingly
• The increase in body fat, particularly visceral fat, is associated with a higher risk of metabolic disorders such as insulin resistance, type 2 diabetes, and cardiovascular disease in older adults
• Changes in body composition can also affect the distribution and metabolism of medications, potentially leading to altered drug responses and increased risk of adverse effects

Maintaining Healthy Body Composition

• Maintaining a healthy body composition through adequate nutrition and regular physical activity is crucial for preserving functional independence and reducing the risk of chronic diseases in older adults
• Consuming a balanced diet with sufficient protein intake (1.0-1.2 g/kg body weight/day) can help preserve muscle mass and prevent sarcopenia
• Engaging in regular resistance exercise and weight-bearing activities can stimulate muscle protein synthesis, maintain bone mineral density, and reduce the risk of falls and fractures
• Monitoring body composition changes through regular assessments (bioelectrical impedance analysis, dual-energy X-ray absorptiometry) can help identify individuals at risk of sarcopenia or obesity and guide appropriate interventions

Sensory Changes and Food Intake

Decline in Taste and Smell Sensitivity

• Aging is associated with a decline in taste and smell sensitivity which can alter the perception of food flavors and reduce the enjoyment of eating
• Decreased sensitivity to sweet, salty, and umami tastes may lead to a preference for more intensely flavored foods or the addition of extra salt or sugar to compensate for the diminished taste experience
• Impaired sense of smell can reduce the ability to detect food aromas, which play a significant role in stimulating appetite and enhancing the pleasure of eating
• Strategies to enhance the sensory appeal of food, such as using a variety of colors, textures, and flavors (herbs, spices), can help stimulate appetite and promote adequate nutritional intake in older adults

Impact of Visual Changes on Nutrition

• Age-related changes in vision, such as decreased visual acuity and contrast sensitivity, may affect the ability to read food labels, portion sizes, and expiration dates potentially leading to inadequate or imbalanced nutrient intake
• Poor vision can also impact the ability to prepare meals safely and effectively, increasing the risk of malnutrition and foodborne illnesses
• Ensuring adequate lighting in food preparation areas, using high-contrast labels and measuring tools, and seeking assistance with meal preparation when needed can help mitigate the impact of visual changes on nutrition in older adults
• Regular eye examinations and appropriate treatment for age-related vision problems (cataracts, macular degeneration) can help maintain visual function and support optimal nutritional status

Gastrointestinal Changes and Nutrient Absorption

Structural and Functional Changes in the Gastrointestinal Tract

• The aging process can lead to structural and functional changes in the gastrointestinal tract that may affect nutrient absorption and overall nutritional status
• Atrophic gastritis, a condition characterized by chronic inflammation and thinning of the stomach lining, is more common in older adults and can lead to decreased production of hydrochloric acid and intrinsic factor impairing the absorption of vitamin B12 and increasing the risk of pernicious anemia
• Age-related changes in the small intestine, such as reduced surface area and decreased motility, can impair the absorption of nutrients like calcium, iron, and fat-soluble vitamins (vitamin D, vitamin A)
• Decreased production of digestive enzymes, such as lactase and pancreatic enzymes, can lead to maldigestion and malabsorption of certain nutrients (lactose, fat)

Strategies to Support Gastrointestinal Health

• Changes in the gut microbiome with age, including a decrease in beneficial bacteria (Bifidobacterium, Lactobacillus) and an increase in potentially harmful bacteria, may influence nutrient absorption and immune function
• Medications commonly used by older adults, such as proton pump inhibitors and antibiotics, can further disrupt the gastrointestinal environment and affect nutrient absorption
• Strategies to support gastrointestinal health in older adults include consuming a balanced diet rich in fiber, probiotics (yogurt, kefir), and nutrient-dense foods, as well as regular monitoring for nutrient deficiencies and appropriate supplementation when necessary
• Encouraging the consumption of fermented foods (sauerkraut, kimchi) and prebiotic-rich foods (garlic, onions, leeks) can help promote a healthy gut microbiome and support optimal nutrient absorption in older adults