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16 Cards in this Set

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List some physiologic changes that happen as people get older.

Body composition changes?
Decreased muscle mass
Decreased neuronal mass
Gastric atrophy
Reduced absorption of iron, folate, B12
Slowed intestinal transit time
Reduced calcium absorption
Reduced kidney function

fat mass increases, visceral fat increases, lean muscle mass decreases (sarcopenia).
What is sarcopenia?
- cause of morbidity and mortality?
- causes?
- how to slow progression?
involuntary loss of muscle mass, strength, and function that occurs with aging
- yes.
- undernutrition and inactivity... also age-typical hormonal decline.
- Encourage elderly to stay active
Strength training!
Increase protein intake (across 3 meals)
age>80
inadequate food intake
poverty
social isolation
...these are risk factors for what?

weight loss >10lbs
low serum albumin
poor oral/dental status
dehydration
polypharmacy
risk factors for poor nutrition

indicators of poor nutrition.
What is the DETERMINE check list?
- lvl 1? lvl 2?
A home checklist for nutritional deficiency
- lvl 1 and 2 are for physician use.
Vit D synth does what with age?

North of 40 degrees latitude, sunlight is too weak to synth D during which months? 42 degrees?
declines

jan&feb

late october thru early March.
What are the main effects of Vitamin D deficiency?
hyperC and enhanced bone reabsorption.
What are the functions of Vitamin K?
- sources?
- UL toxicity?
blood clotting, bone formation.
- Green leafy vegetables, plant oils, and margarine
- none known
What are the B-complex vitamins?
- fx?
- absorption is influenced by what in older people?
- sources?
B12 (corrinoids)
B6 (Pyridoxine, pyridoxal, and pyridoxamine)
Folate (numerous forms, including: polyglutamate derivatives, pteroylmonoglutamic acid)
- coenzymes:
+ blood formation, neurologic fx, involved in amino acid metabolism --> function as co-enzymes of one-carbon units and homcysteine.
- normal aging changes of the gut and common disorders of older adults.

- B12 = mainly animal sources and fortified foods
- B6 = variety of foods
- Folate = liver, leafy greens, fortified grains, citrus fruits.
Walk through B-cmplx vitamin absorption.
salivary glands produce R-protein --> stomach releases IF --> B12 b/ R i/ stomach --> pancreatic enzymes degrade R, releasing B12 which b/ IF --> absorbed in the ileum w/ IF.
Are b6 and folate abs affected by aging?
B6 isn't, folate may or may not be.
Fortification of grains is mandated w/ what? This can mask deficiency of what?

Deficiency of B12 is caused mainly by what?

Do vit B6 requirements increase w/ age?
folate.

B12; malabsorption.

yes.
What is folate toxicity associated with?
- Associated with faster rate of cognitive decline of older adults
- Large amounts may mask neurologic damage of Vitamin B12 deficiency
What does the risk of neg. Ca balance increase w/ age? (4)
Absorption of less calcium
Vitamin D deficiency
Excess phosphates
Lack of exercise
Skin ulcers have which two sorts of causes?

Decubitus ulcer (bed ulcers) patients often lack what? (4)
mechanical and nutritional causes.

protein/energy
ascorbate
omega-3 fatty acids
zinc
What are the critical minerals for older adults?

Which mineral decreases mortality? Howso / from what causes?
Ca, Mg, and Zn

Zn: \mortality from non-CV/circulatory dz or cancer.... also improves immunity and resistance to infection.
Should WL be the goal for older people? Do they need dietary supplements to get enough D, B12, and other micronutrients?

How often should detailed questions about diet and supplement use be asked?
no, improved body composition should be the aim.

yes.

every visit.