NEW Geriatrics 3rd Exam

• Dietetics

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

  requires a bachelor's degree or masters, internship, credential exam & maintain license ; more training than nutritionists
• Nutritionist


  Does not require a degree
• Patient's diet is a huge part of health status
• What you ingest (food, illegal substances, medicine) impacts health status
• Healthcare providers must address these factors with patients to prevent major health risks
• Malnutrition


  A common diagnosis made in older adult patients
• Symptoms of malnutrition in older adults

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


  Piece of equipment used to measure hand grip strength
• The middle of the grocery store has a lot of preservatives and ultra-processed foods
• Ultra-processed foods

  Foods with a lot of preservatives, no need for refrigeration, and unknown ingredients
• Ultra-processed foods use a lot of fats, oils, and sugars
• Ingredients in ultra-processed foods are selected by manufacturers to be profitable, not nutritious
• Chemicals in ultra-processed foods contribute to various cancers
• Sugar is a component in many chronic diseases
• The average American sugar intake 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 carcinogenic and can cause cancer
• Inadequate dietary intake

  Older patients depend on others to take them grocery shopping, live on limited financial means, and may have to choose between food, bills, or medications
• Dysphagia


  Impaired ability to swallow, leading to a limited diet of soft foods
• Dementia


  Impacts dietary intake as patients do not understand how to view their foods
• Sarcopenia


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

  Individuals have sensitivity to the gluten protein, gliadin, which damages the intestinal villi and causes malabsorption of vitamins & minerals
• Aging process


  Diminishes sense of thirst in older adults
• Symptoms of dehydration in older adults

  • Dry, cracked lips
  • 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 often composed of sugar, saturated fats, cholesterol, and salt, with deficiencies in calcium, fiber, magnesium, potassium, and vitamins A, C, and E
• Electrolyte imbalance


  Common in older adults due to medication intake and inability to flush out toxins
• Long-term care facilities must contract Registered Dietitians by law to develop diet menus for their residents
• The population in long-term care facilities consumes too many calories without enough physical activity, leading to excessive weight gain and high cancer rates
• A study found that greater physical activity greatly reduces the risk of 7 types of cancer
• Increased physical activity also decreases the risk of glaucoma due to greater oxygen intake
• Nutrient deficiencies common in older adults

  • Vitamin B12, A,C,E,D
  • Calcium, Magnesium, Potassium, & Fiber
• Overnutrition

  Polite term for obesity, caused by taking in too many calories
• Alcohol abuse leads to replacing a nutritional diet, interferes with absorption of vitamins B12, folic acid, and C
• Periodontal disease


  Inflammatory reaction of the gums leading to dissolution of the bony structures holding the teeth
• Lack of dental hygiene and not seeing a dentist can lead to periodontal disease, causing pain, impaired chewing, and teeth loss</b>
• Bacteria from the mouth can travel to other parts of the body with untreated periodontal disease
• 23% of adults aged 65-74 have periodontal disease
• Dental plaque

  Accumulation of dental bacteria, can progress into periodontal disease