It seems that the older people get, the harder it is to categorise them in terms of lifestyle and general health needs. People in their eighties may be sprightly and fit, suffering from serious illness, or be somewhere in between. They may be living at home and fully independent, or living in a nursing home with full-time carers. Whatever the case, concerns about health and disease are bound to be important issues. For this reason, maintaining a healthy balanced diet is vital and including a daily multivitamin is recommended.
Maintaining a good diet may become more of a challenge, as the sense of taste tends to diminish as we age, although a loss of the sense of taste may also be associated with a deficiency in the mineral zinc. The commonest dietary deficiency in older persons is protein. Ensuring a daily intake of good quality protein foods is important for the repair of body tissues. Protein foods include meat, fish, eggs, nuts & seeds, and dairy produce. Protein can also be obtained from combining legumes (such as soy, lentils etc) with grains (such as rice, corn, wheat etc).
If maintaining a balanced diet becomes difficult, it may be necessary to ask for outside help. Enquire about the local community services by contacting your local community health centre, council, hospital, or doctor.
Supporting Immunity
Increasing susceptibility to infectious diseases occurs with increasing age. Hospital admissions for influenza and pneumonia are far more prevalent in older people, with the highest rate in those eighty-five years and over. Looking after the immune system and avoiding infection therefore takes on more importance. Vitamin C and zinc are important nutrients to assist immunity and are often not obtained at required levels from the diet. Forty-six per cent of older people in Australia reported that they commonly ate no fruit, and seventeen per cent reported no vegetables. This low intake of an important food group predisposes to nutrient deficiencies, particularly of vitamin C. Zinc is an important mineral in the diet of older people because of its role in wound healing as well as immune function.
Risks for Nutrient Deficiency
There are a number of factors that can increase the risk of developing nutrient deficiencies as we age. Aging is associated with a decrease in energy expenditure, which is often accompanied by reduced food intake. Another change that occurs with age is a reduction in the secretion of stomach acid. This decrease can lead to a decrease in the absorption of many nutrients including several minerals and vitamins. Many medications can affect appetite and the absorption of nutrients, whilst social isolation can result in less care being taken with nutritional requirements. The overall effect of these factors can have a profound effect on nutritional status.
Decreased intake and absorption of the B vitamins folate and B12 is reasonably common, and lowered blood levels of these two vitamins are associated with an increased risk for cardiovascular disease and dementias such as Alzheimer's disease. The average older Australian is likely to have borderline levels of the key minerals calcium, magnesium and zinc. These nutrients are essential for immunity, eye health, mental acuity, musculoskeletal health, heart health, and many other areas of health.
Preventing Falls
Falls can be responsible for a considerable amount of pain and suffering in older persons, with typical consequences being cuts, bruising, occasional burns and more serious conditions such as fractures. The risk of hospitalisation resulting from a fall increases with age. To reduce the risk of falls, have the home assessed, and modified if necessary. Installation of handrails and improved lighting can make a great deal of difference. More personal solutions such as walking aids, non-slip footwear, glasses and hearing aids will also help, as well as the assessment of medications and their potential to contribute to personal injury.
Exercise programs are operated by a range of government and non-government organizations to increase strength, agility and balance in older persons. These programs aim to improve a person’s ability to avoid falls, minimise the impact of falls or recover from them more quickly. These programs also have benefits, which extend to improving risks of other health conditions such as heart disease and osteoporosis.
Issues for carers
There will always be difficult decisions to make for carers of the aged, whether they are family members, friends, or professional carers. Dealing with dementia may be an issue, as after 85 years about 50% of people will be affected by some form of dementia, with Alzheimer’s disease being the most common cause. Dementia can cause personality changes and social withdrawal, making the person more difficult to communicate with. The sufferer may be aware that they have lost some degree of their mental faculties, causing frustration, depression and sometimes, aggressive behaviour.
Making a decision on the future care of a sick parent can be one of the most difficult decisions someone has to make. Whether someone is cared for at home or in residential care, support networks will be important for all parties. There are several ways in which a carer can be supported in their role. Services available range from community health centres that provide a number of services such as counselling and speech therapy, to home help, transportation assistance and home nursing. Commonwealth Carelink Centres provide information about the range of community care and other aged care services available in your local area.
REFERENCES
- Australia’s Health 2002. Australian Institute of Health and Welfare, 2002
- Savidge G et al. Agefit, fitness and nutrition for an independent future. Sydney: Pan Macmillan, 2001.
- Haas EM. Staying healthy with nutrition. Berkley, California: Celestial Arts, 1992
- Dietary Guidelines for Older Australians. National Health and Medical Research Council. November 1999.
- Porth, C.M. Pathophysiology, Concepts of Altered Health States. 6th Ed. Lippincott, Philadelphia, 2002.
- Carers Australia. www.carers.asn.au
