Good nutrition and physical activity in the older population

The number of older people worldwide will dramatically increase over the next decades. In 2040 people in Finland over 65 years old will account for more than one quarter of the whole population. At the same time the oldest cohort (over 85 years) is increasing in numbers most rapidly.

Biological aging and disablement processes occur continuously and varies between individuals. Many factors affect individual aging and there is a large heterogeneity between individuals. Social, economic, physiological and psychological changes with aging have effects on eating patterns and nutritional status. On the other hand, the diet has an influence on the aging process as well.

The increasing number of elderly people is leading to an increased demand on health care. Aged individuals are: often vulnerable to many illnesses, they are frail, and they have disabilities in self-care tasks. The role of nutrition in the maintenance of aged individuals’ health, management of chronic conditions, treatment of serious illnesses, and rehabilitation of functional limitations has risen to the top of the agenda for public interest and research during the last decades.

Good nutrition and physical activity are health-promoting lifestyle approaches in the elderly population. An inadequate nutrition contributes to sarcopenia, frailty, loss of functions and the progression of diseases in elderly people. Nutritional status is influenced by medical, physiological, psychological and social variables. Encouraging better nutrition and physical exercise is a cost-effective way of decreasing progression of age-related diseases. As people age, adequate nutrition promotes the maintenance of health, physical performance and psycho-social well-being.

Malnutrition has been recognized as a common problem among aged residents living in institutional care facilities. Malnutrition is associated with certain diseases and impaired functioning, but less is known about its relationship with nutrition intake and nutritional care among aged residents. The assessment of the nutritional status of elderly people should be part of their care. There are many tools for identifying the nutritional risks, but the most extensively evaluated tool is the Mini Nutritional Assessment –test (MNA).

Nutritional advice for elderly residents and patients should focus on weight maintenance. Not all elderly individuals are the same with regard to appropriate nutritional interventions, however. The intervention for healthy elderly people should differ from those who are frail, from those with dementia, and from those who are at the end of their lives.

Nutritional treatment when carried out early enough seems to have a positive effect on energy and nutrient intake in frail elderly people. It can produce weight gain and increase physical activity. Oral nutritional supplements (ONS) have usually been the primary intervention when treating malnutrition. Studies with enriched food have also had positive outcomes in the energy intake of elderly hospital patients. Collective mealtimes in nursing homes and long term care hospitals provide an opportunity to integrate and implement good nutritional care. A pleasant and social environment during mealtimes may add a sense of security and satisfaction with life.

Nutrition in memory disorders

Older adults with memory disorders living at home alone or with their spouses are significant target groups of nutritional care and treatment. In these groups, the risk of malnutrition is increased as they have cognitive impairments and often older spouses may also have numerous diseases and functional defects. The possibilities of nutritional care and treatment remain largely unexploited. Nutritional information and support in nutritional problems are important methods in preventing and improving Alzheimer patients’ and their caregivers’ nutritional status and quality of life.

Nutritional interventions have had beneficial effects on the nutritional status and nutrient intake of AD patients. Several controlled studies have suggested that nutritional supplements increase body weight in AD patients at the risk of malnutrition. In an intervention study, the weight gain of AD patients was achieved when nutritional supplements were given to them for three months  A nutrition educational program directed to AD patients and their spouses had a positive effect on AD patients’ weights and their cognitive functions . However, further studies on the benefits of nutritional care and ways of implementing it are still needed. Nutritional care and tailored nutritional counselling are a highly valuable yet a largely unexplored method of maintaining AD patients’ and their caregivers´ health and quality of life. Moreover, the comprehensive intervention of the dietician time has promoted significant increase in body weight among people with memory disorders.

Read more: Nutrition and Dementia review 2014 (pdf)

Society for Gerontolological Nutrition in Finland