Nutrition for Elderly

Tuesday, 12 May 2015


The population has grown modestly with people over 60 years old. This shows that the population ages are increasing and people seek for healthy lifestyle. Most study defines elderly as more than 60 years old. Their physiologies are not similar to the younger age. Elderly might suffer with the different production or amount of hormones and changes in body compositions.

Source: http://www.jkm.gov.my
In body composition, it can be divided into two; fat mass and fat free mass. Elderly with sarcopenia or frail or loss of independence might have a depletion of fat free mass. This is due to decline in muscle mass and the aging process. At the same time, the percentage of fat mass is increasing with age. Besides, elderly have high possibility to have problems in getting sufficient nutrients. The chemosensory loss and decrease ability to identify odors and taste. Most frequent problems, their sensitivity towards sweet, sour, salty and bitter are changed. Part of that, they might suffer dysgeusia or bitter or metallic taste after eating. If not being treated, they have high risk of malnutrition.

Over the age of 65 years old, the energy intake decreases since the physical activity decline. However, the energy requirement of critically ill elderly patients might higher than normal or 1.3 times the estimated basal metabolic rate in order to maintain weight. Most elderly patients, the recommended energy is 30-35 kcal/kg of body weight per day. 

The recommended protein intake is similar to normal adults, 0.8-1.0 g/kg of body weight. However, it can be up to 1.5 g/kg if elderly have severe medical conditions that need higher protein. It is account for 12-15% of total energy intake. However, there are certain conditions such as burn injury, trauma and severe traumatic brain injury which allow protein up to 2 g/kg per day. The protein requirement can change once patients’ medical conditions resolved and depends on medical judgment. 

For the water, elderly with 65 years old and above may need 30 ml/kg of body weight. There is a study which shows the benefits of taking 1800 ml per day for elderly with more than 86 years old. Dehydration should be avoided because it can lead to hypernatremia and decreased elimination of urea. By the age of 85, the kidney functions are depleted by approximately 30%. Aging also increases the secretion of rennin and less aldosterone resulting increased the reabsorption of sodium which increases the risk of hypertension. Thus, ensure elderly get sufficient water and make it as part of treatment.


References:
Bozzetti, F. (2003). Nutritional issues in the care of the elderly patient. Critical Reviews in Oncology/hematology, 48(2), 113–121. doi:10.1016/j.critrevonc.2003.08.001

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