The nutritional status of old people is affected by many factors. The person’s socioeconomic, cultural and psychological conditions have an effect. Lack of adequate money would affect what an elderly person can eat. In the same vein, wrong beliefs and superstitions regarding food and dietary habits, social isolation, depression and loneliness from loss of spouse, family members and friends can decrease the quantity and quality of the diet.
Taste buds decrease in number and size as we grow, affecting sweet and salty tastes in particular. About 30% of people 80 years or older appear to have difficulty identifying common substances by smell. Due to loss of bone and diseases of the mouth, many over 65 years people have lost many of their teeth leading to difficulty in chewing. This makes them select easy-to-chew foods, leading to reduced consumption of fresh fruits and vegetables high in dietary fiber. For those wearing dentures, it should be made to fit them so as not to give chewing problems.
Aging is also associated with a decrease in muscle mass and an increase in body fat. This leads to a decrease in energy spent during rest, and hence the need for reduced calories. Aging comes with reduced ability of the stomach to digest food. This is because the stomach cells are less able to secrete digestive juices. There is also a decrease in the secretion of gastric acid which may interfere with protein digestion. The small intestine becomes less capable of absorbing some nutrients, including protein, carbohydrate, fat, some vitamins and minerals. Some older people may suffer from cramps and diarrhea after eating dairy foods containing lactose because they lack the enzyme lactase. Constipation may be a result of altered movement of the intestines, inadequate fluid intake, and inactivity.
Some medical conditions such as obesity, accidents, heart disease, cancer, arthritis, osteoporosis, diabetes, senile dementia, and the use of prescription drugs can result in the health team making changes in the diet or a decrease in strength and ability to shop or cook. This can affect the nutritional status of the person. Alcohol when substituted for nutritious foods, may interfere with absorption of some nutrients, particularly folic acid. The elderly have a decreased ability to absorb, distribute, metabolize, and excrete both prescription and nonprescription drugs. Long-term use of certain therapeutic drugs that interfere with absorption and metabolism of nutrients is also an important cause of malnutrition in the elderly.
The size and function of the liver and kidneys reduce steadily with aging. Alcohol becomes more toxic to the liver as its ability to detoxify alcohol decreases. The ability of various substances to pass through the kidney is reduced making the aged kidney inefficient in the removal of metabolic waste products. The older individual may also be susceptible to dehydration, resulting from a diminished thirst mechanism.
Caregivers therefore have a crucial role to play to ensure that these normal changes do not compromise the nutritional status of their elderly relatives. Understanding these changes is the first step in planning appropriate care, so read this article again.
By Dzidor Sackey
Reviewed by Laurene Boateng
