Geriatrics 3rd Exam

• Dietetics


  Healthcare field, science of how food & nutrition affects the human health
• Registered Dietitian (R.D.)


  Not a nutritionist, requires a degree
• You are what you ingest
• Food intake, illegal substance, medicine all impact health status
• Addressing food, substance, medicine with PT

  In order to prevent major health risks
• Malnutrition


  Common diagnosis with older adult PT
• Symptoms of malnutrition in older adults

  • Insufficient caloric intake
  • Weight loss (ongoing)
  • Muscle loss
  • Loss of subcutaneous fat
  • Localized fluid accumulation (edema)
  • Diminished functional status measured by hand grip strength
• Dynamometer


  Piece of equipment to measure hand grip strength
• Focusing around the edges of a grocery store


  Good diagram to use with PT
• Middle of grocery store

  Has a lot of preservatives
• Ultra-processed foods


  Contain a lot of preservatives, no need for refrigeration, have unknown ingredients
• Ultra-processed foods use a lot of fats, oils, sugars
• Nebulous term


  Ingredients in ultra-processed foods are selected by food manufacturers to be profitable
• Chemicals in ultra-processed foods contribute to various cancers
• Sugar is a component to many chronic diseases
• The population's average sugar intake has increased from 40 lbs to 80 lbs per year over time
• There has been an increased rate of 20-30 year olds being diagnosed with cancer
• Pills with dyes are carcinogens and can cause cancer
• Older patients depend on others

  To take them grocery shopping due to limited mobility and financial means
• Dysphagia


  Impairs ability to swallow, so diet becomes limited to soft foods like yogurt and applesauce
• Dementia


  Impacts dietary intake as patients don't understand how to view their foods cognitively
• Sarcopenia


  Loss of muscle mass in older adults, prevented by maintaining physical activity and movement
• Celiac disease


  Individuals have sensitivity to the gluten protein gliadin, which damages the intestinal villi and causes malabsorption of vitamins and minerals
• The aging process changes the sense of thirst, leading to dehydration in older adults
• Symptoms of dehydration in older adults

  • Dry lips to the point of cracking
  • Deep sunken eyes
  • Swollen tongue
  • Increased body temperature
  • Decreased blood pressure
  • Constipation
  • Decreased urine output
  • Nausea
  • Confusion
• There is a misconception in the US about how much movement is needed to burn calories, leading to weight gain from excess calorie intake
• Excess calories consumed by older adults

  Are composed of sugar, saturated fats, cholesterol and salt
• Nutrient deficiencies in older adults

  • Calcium
  • Fiber
  • Magnesium
  • Potassium
  • Vitamins A, C, E
• Electrolyte imbalance


  In older adults due to intake of medications and inability to flush out toxins
• Long-term care facilities are required by law to contract Registered Dietitians to develop diet menus for patients
• The population consumes too many calories without burning them off, leading to excessive weight gain and high rates of cancer
• A 10-year study of 755,000 people found that greater physical activity greatly reduces the risk of 7 types of cancer
• Increased physical activity of at least 1 hour per day has a drastic impact in lowering cancer risk
• Increased physical activity


  Decreases the risk of glaucoma due to greater oxygen intake
• Nutrient deficiencies common in older adults


  • Vitamin B12 (green-leafy veggies & fish), A, C, E, D
• Overnutrition


  Polite documentation of obesity, taking in too many calories leading to conditions like type 2 diabetes
• Alcohol abuse


  Alcoholics replace a nutritional diet with alcohol, which has a lot of empty calories but no nutrients
• High alcohol intake interferes with the normal absorption of vitamin B12, folic acid, and vitamin C
• Periodontal disease


  Inflammatory reaction of the gums and dissolution of the bony structures holding the teeth, resulting from lack of dental hygiene
• 23% of adults aged 65-74 have periodontal disease