RespiteMatch.com Health Blog

Key Words
appetite, chewing, constipation, dehydration, diet, dysphasia, eating, liquid supplements, malnutrition, minced diet, nutrition, nutritional deficiency, nutritional supplementation, pureed diet, smell, special diets, swallowing, swallowing test, taste, thickeners, thirst, tube feeding
Glossary
Dysphagia: Difficulty in swallowing

Videofluoroscopic Swallow Study: A test to determine the degree of difficulty a person has with swallowing. Also called a swallowing test

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Good eating habits and proper nutrition are key ingredients for healthy aging; however many seniors are at risk of malnutrition. Key factors contributing to seniors’ poor nutritional health include:

Loss of appetite
Illness
Medications
Chewing and swallowing problems
Ill-fitting dentures
Loneliness
Depression
Decreased mobility
Healthy eating, at any age, raises energy levels, boosts the immune system and protects the body against illnesses such as hypertension (high blood pressure), diabetes and osteoporosis. A healthy diet for seniors will provide high levels of nutrition and an appropriate number of calories in small quantities of food that can be easily digested. People in an advanced stage of illness will require special nutritional attention. See Special situations.

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Things You Should Know

More than 75% of adults over the age of 80 experience significant loss of their sense of smell and taste
Seniors are too often malnourished; physicians check vital signs but can overlook asking what a patient is eating
Eliminating too much fat from the diet may rob a senior of that “extra padding” which can help fight disease.
50-75% of the elderly population has gastrointestinal problems leading to indigestion or reflux
Saliva production decreases in the elderly causing a drier mouth, thicker saliva and poorer natural cleansing of the mouth
A weight loss of more than 5% in 1 month, 7.5% in 3 months or 10% in 6 months requires immediate investigation
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Things to Look For

Weight change
Noticeable or sudden weight loss or weight gain could signal a serious physical or psychological problem. Weight loss and wasting can also signal severe nutritional deficiencies.
Complaints of changes in taste and smell
Loss of taste and smell (which enhances taste) is a major cause of weight loss in the elderly. Changes in taste and smell are a normal part of aging but the situation can be made worse by disease and medication.
Loss of appetite/smaller appetite
An aging digestive system may not be able to tolerate certain foods and spices. This may cause seniors to stop eating a balanced diet and limit themselves to only a few foods — the “tea and toast” scenario. Illness and medication can also adversely affect appetite. Chewing problems may also cause a person to shy away from eating solid foods.
Constipation
Food moves more slowly through an aging digestive tract. Constipation can also be caused by certain medications and not drinking enough fluids. An unbalanced diet (not enough friuts and vegetables, too much meat, etc.) can also cause constipation.
Disease
Disease can interfere with the body’s ability to absorb and make use of nutrients. Seniors with illnesses such as heart disease, hypertension, and diabetes may find it difficult to switch or stick to low-cholesterol, low-sodium and other prescribed diets. Neurological diseases, particularly, affect a person’s ability to chew and swallow.
Medication
Medications can interfere with the body’s ability to absorb nutrients from food, and impair the body’s ability to excrete minerals.
Level of physical activity/exercise
Strength training exercise combined with multivitamin supplements can help increase muscle strength and energy levels in very frail elderly people. Moderate activity and exercise help stimulate appetite.
Mobility/dexterity problems
A person who is not able to move around easily or have access to transportation may have difficulty preparing meals and shopping for groceries. Problems with handling eating utensils may cause frustration and lessen the enjoyment of meals.
Loneliness/depression
Eating is a social activity. Many people do not like to eat alone and will not make the effort to cook for one. The loss of a spouse or close friend may bring on feelings of isolation that could escalate to depression. A person who is depressed may lose interest in eating.
Dining environment/food presentation
A pleasant environment and appetizing-looking food increases a person’s enjoyment of meals.
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Medical conditions that affect the senses of taste or smell

Disorders affecting the nervous system
Alzheimer’s Disease
Bell’s palsy
Damage to vocal chords
Epilepsy
Head trauma
Korsakoff syndrome
Multiple Sclerosis
Parkinson Disease
Disorders affecting the nutritional system

Tumours and lesions
Cancer
Chronic renal failure
Liver disease including cirrhosis
Niacin (vitamin B3) deficiency
Vitamin B12 deficiency
Zinc deficiency
Endocrine disorders

Cushing syndrome
Diabetes
Hypothyroidism
Kallman syndrome
Turner syndrome
Local disorders
Allergic rhinitis, atopy and bronchial asthma
Sinusitis and polyposis
Xerostomic conditions, including Sjogren syndrome
Viral infections
Acute viral hepatitis
Influenza-like infections

Source: “Taste and Smell Losses in Normal Aging and Disease,” Susan S. Schiffman, Ph.D. JAMA, The Journal of the American Medical Association, October 22/29, 1997,Vol 278, No. 16.

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Medications and medical treatments that alter taste and smell

Lipid-lowering drugs
Antimicrobials
Antineoplastics
Anti-inflammatory drugs
Bronchodilators and other asthma medications
Antihypertensives and cardiac medications
Muscle relaxants and drugs for the treatment of Parkinson’s Disease
Antidepressants and anticonvulsant
Radiation therapy
Vasodilators
Source: “Taste and Smell Losses in Normal Aging and Disease,” Susan S. Schiffman, Ph.D. JAMA, The Journal of the American Medical Association, October 22/29, 1997,Vol 278, No. 16.

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Medicines that may cause nutritional deficiencies

Cardiac glycosides
Lipid-lowering drugs
Diuretics
Anti-inflammatory drugs
Antacids
Laxatives
Source: “Elder Care for the Millennium,” Dr. Lisa Mienville and Dr. Bonnie L. Robeson. Graphix III Productions, Columbia, MD.

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