This document discusses nutrition and well-being in later life. It notes that malnutrition increases sharply after age 70 and older adults account for most malnutrition in hospitals. Good nutrition can help manage chronic disease and weight, while undernutrition increases disease risk and negatively impacts mood and quality of life. Specific nutrients like vitamins and fatty acids affect well-being and cognition. Towards the end of life, the document questions whether individual needs and preferences of older adults are adequately considered regarding food, which can impact dignity, anxiety and quality of life.
5. Malnutrition
The Nutrition Screening Week surveys
(BAPEN 2013) indicated that the proportion
of underweight individuals (BMI < 20 kg/m2)
admitted to hospital rises steeply above the
age of 70 years..
Older people
accounted for
most of the
malnutrition
in hospital
(62%)
6. In older years chronic disease and ill health
can create dietary challenges
7.
8.
9. Psychological and Social Well Being
Psychological well-being
How happy or content we feel with life
Social well-being
A sense of involvement with other people and
with our communities
10. Diet quality can play a central role in
maintaining cognition and well-being
Shatenstein et al, 2012
Experimental Gerontology.
Haveman-Nies et al,
SENECA study Age and
Ageing 2003.
HALCyon Programme
11. Specific nutrients affect our
well being and function
Folate
Zinc
Vitamins B12
Omega 3 Fatty Acids
Selenium
(Abouh-Saleh and Cooper, 2006, Levitan et al, 2000, Nowak et al, 2005,
Williams et al, 2005,Bodnar and Wisner, 2005, Bamber et al, 2007)
Vitamin B6
CHO
Energy
12. Preservation of cognitive abilities is central to
the maintenance of independence and quality
of life among older adults
Shatenstein et al,
2012 Experimental
Gerontology
13. Kuh et al, HALCyon Programme Public Health 2012
HALCyon Programme
Crucial elements of ageing well
Feeling Useful Being socially
engaged
Being productive
16. Conclusion - one size does not fit all
• Good nutrition can help to combat chronic
disease, manage weight and function
• Under-nutrition predisposes to disease and
adversely affects its outcome. This has
important economic implications but can
adversely affect mood, happiness, comfort.
• Older people and partner agencies with a remit
for older people’s health should be provided with
consistent and appropriate messages
concerning nutrition in later life.
17. Do we listen to our clients?
• Do we know what is good for older people?
• In chronic disease and life limiting
conditions we need to be aware that food can
create considerable anxiety,
misunderstandings, become a battle ground.
• Do we take into consideration all the
challenges around food?
• Do we address beliefs and values?
• Do we aim to improve QoL or nutritional
status?
18. Malnutrition, dignity and later life.
•Do we really cater for the
individual needs of our ageing
population?
•If diet is a habit of a lifetime - are
individuals able to enjoy what they
have habitually eaten when in a
care home, nursing home?
•Do individuals feel engaged in the
preparation and choice of meals?
There are differences in obesity prevalence by both age and sex.
Obesity prevalence appears to increase with age (in the age range 16 to 74 years), but then decreases above age 75 years.
When broken down by age group, differences in obesity prevalence by sex are most noticeable in the 16-24 years and 75+ age groups. Here obesity prevalence is higher for women than for men. However between the ages of 45 and 64 years obesity prevalence appears to be higher among men than women.
The published Health Survey for England data used to produce this chart are available from:
http://www.hscic.gov.uk/catalogue/PUB13219
What are we trying to achieve through nutrition???
Maintaining a sense of psychological wellbeing and continuing to be socially engaged in later life is an important part of growing older in a healthy way. During this presentation I will highlight how specific nutrients, food itself, the eating experience, individual needs and challenges might influence our state of well being and happiness.
The connection between food and depressive disorders has been established through epidemiological studies. Much of the research into biochemical causes of depression have focussed on neurotransmitters such as serotonin. Nutrients that affect neurotransmitters are believed to be important in treating depression and augmenting the effect of medication.
Not just the nutrients it is the environment
All these factors will affect dignity and well being (comfort)