Key Words
appetite, chewing, constipation, dehydration, diet, dysphasia,
eating, liquid supplements, malnutrition, minced diet, nutrition,
nutritional deficiency, nutritional supplementation, pureed
diet, smell, special diets, swallowing, swallowing test, taste,
thickeners, thirst, tube feeding
Glossary
Dysphagia:
Difficulty in swallowing
Videofluoroscopic Swallow Study: A test to determine the degree of difficulty
a person has with swallowing. Also called a swallowing test
Good eating habits and proper nutrition are key ingredients
for healthy aging; however many seniors are at risk of malnutrition.
Key factors contributing to seniors' poor nutritional health
include:
- Loss of appetite
- Illness
- Medications
- Chewing and swallowing problems
- Ill-fitting dentures
- Loneliness
- Depression
- Decreased mobility
Healthy eating, at any age, raises energy levels, boosts the
immune system and protects the body against illnesses such
as hypertension (high blood pressure), diabetes and osteoporosis.
A healthy diet for seniors will provide high levels of nutrition
and an appropriate number of calories in small quantities
of food that can be easily digested. People in an advanced
stage of illness will require special nutritional attention.
See Special situations.
Things You Should Know
- More than 75% of adults over the age of 80 experience significant
loss of their sense of smell and taste
- Seniors are too often malnourished; physicians check vital signs
but can overlook asking what a patient is eating
- Eliminating too much fat from the diet may rob a senior of that "extra padding" which
can help fight disease.
- 50-75% of the elderly population has gastrointestinal problems leading to indigestion or reflux
- Saliva production decreases in the elderly causing a drier mouth, thicker saliva and poorer
natural cleansing of the mouth
- A weight loss of more than 5% in 1 month, 7.5% in 3 months or 10% in 6 months requires
immediate investigation
Things to Look For
- Weight change
Noticeable or sudden weight loss or weight gain could signal
a serious physical or psychological problem. Weight loss
and wasting can also signal severe nutritional deficiencies.
- Complaints of changes in taste and smell
Loss of taste and smell (which enhances taste) is a major
cause of weight loss in the elderly. Changes in taste and
smell are a normal part of aging but the situation can be
made worse by disease and medication.
- Loss of appetite/smaller appetite
An aging digestive system may not be able to tolerate certain
foods and spices. This may cause seniors to stop eating
a balanced diet and limit themselves to only a few foods
the "tea and toast" scenario. Illness and medication
can also adversely affect appetite. Chewing problems may
also cause a person to shy away from eating solid foods.
- Constipation
Food moves more slowly through an aging digestive tract.
Constipation can also be caused by certain medications and
not drinking enough fluids. An unbalanced diet (not enough
friuts and vegetables, too much meat, etc.) can also cause
constipation.
- Disease
Disease can interfere with the body's ability to absorb
and make use of nutrients. Seniors with illnesses such as
heart disease, hypertension, and diabetes may find it difficult
to switch or stick to low-cholesterol, low-sodium and other
prescribed diets. Neurological diseases, particularly, affect
a person's ability to chew and swallow.
- Medication
Medications can interfere with
the body's ability to absorb nutrients from food, and impair
the body's ability to excrete minerals.
- Level of physical activity/exercise
Strength training exercise combined with multivitamin supplements
can help increase muscle strength and energy levels in very
frail elderly people. Moderate activity and exercise help
stimulate appetite.
- Mobility/dexterity problems
A person who is not able to move around easily or have access
to transportation may have difficulty preparing meals and
shopping for groceries. Problems with handling eating utensils
may cause frustration and lessen the enjoyment of meals.
- Loneliness/depression
Eating is a social activity. Many people do not like to
eat alone and will not make the effort to cook for one.
The loss of a spouse or close friend may bring on feelings
of isolation that could escalate to depression. A person
who is depressed may lose interest in eating.
- Dining environment/food presentation
A pleasant environment and appetizing-looking food increases
a person's enjoyment of meals.
Medical conditions that affect the senses of taste or smell

Disorders affecting the nervous system
- Alzheimer's Disease
- Bell's palsy
- Damage to vocal chords
- Epilepsy
- Head trauma
- Korsakoff syndrome
- Multiple Sclerosis
- Parkinson Disease
Disorders affecting the nutritional system
- Tumours and lesions
- Cancer
- Chronic renal failure
- Liver disease including cirrhosis
- Niacin (vitamin B3) deficiency
- Vitamin B12 deficiency
- Zinc deficiency
Endocrine disorders
- Cushing syndrome
- Diabetes
- Hypothyroidism
- Kallman syndrome
- Turner syndrome
- Local disorders
- Allergic rhinitis, atopy and bronchial asthma
- Sinusitis and polyposis
- Xerostomic conditions, including Sjogren syndrome
Viral infections
- Acute viral hepatitis
- Influenza-like infections
Source:
"Taste and Smell Losses in Normal Aging and Disease," Susan
S. Schiffman, Ph.D. JAMA, The Journal of the American Medical
Association, October 22/29, 1997,Vol 278, No. 16.
Medications and medical treatments that alter taste and smell
- Lipid-lowering drugs
- Antimicrobials
- Antineoplastics
- Anti-inflammatory drugs
- Bronchodilators and other asthma medications
- Antihypertensives and cardiac medications
- Muscle relaxants and drugs for the treatment of Parkinson's Disease
- Antidepressants and anticonvulsant
- Radiation therapy
- Vasodilators
Source:
"Taste and Smell Losses in Normal Aging and Disease," Susan
S. Schiffman, Ph.D. JAMA, The Journal of the American Medical
Association, October 22/29, 1997,Vol 278, No. 16.
Medicines that may cause nutritional deficiencies
- Cardiac glycosides
- Lipid-lowering drugs
- Diuretics
- Anti-inflammatory drugs
- Antacids
- Laxatives
Source:
"Elder Care for the Millennium," Dr. Lisa Mienville and Dr.
Bonnie L. Robeson. Graphix III Productions, Columbia, MD.
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