Nutrition and Aging

Today we had a guest lecturer for our Occupation-Centered Practice in Older Adults class who was a Registered Dietitian. It was a really interesting and informative lecture on the importance of proper nutrition in the aging population. It was really crazy to think about the fact that at age 30, a person is at the peak of our muscle mass. At age 40, muscle mass decreases by about 8% per decade and after age 70, muscle loss accelerates to about 15% per decade. The loss of lean body mass can lead to a whole host of complications ranging from decreased immunity and increased infections to death from pneumonia. This is something that can be prevented but is so often neglected in medical care. Most people do not know that they are malnourished or losing lean body mass, and they do not understand how to prevent it. In order to prevent or treat sarcopenia, the age-related loss of muscle, one must have a high protein diet and engage in strength training regularly. 

People who are highly at risk for malnutrition include older adults, people living with chronic diseases, patients in a hospital, and long-term care residents. All of these individuals are people that occupational therapists see regularly, so proper nutrition needs to become an issue at the forefront of an OT’s brain in order to prevent the many complications that can occur from malnutrition. One easy way for an OT to detect malnutrition is from a weak grip strength, another is edema (usually in the lower extremities). These are areas of an individual’s evaluation that OTs are already addressing. With proper education and training, this information can then be given to the patient’s dietitian to hopefully prevent further malnutrition and get the patient back to being well nourished. The information may also need to be given to the patient’s doctors, caregivers, and the patient themselves.

Often times, malnutrition can be treated with nutrient supplements, Ensure. This can really increase the patient’s caloric intake, and most importantly, their protein intake. This is such a vital aspect of a person’s lean body mass that is typically deficient or lacking. This can be from lack of education, or it could be from food insecurity. If an individual has food insecurity, they are 50% more likely to develop diabetes and 3x more likely to be depressed. Both of these diagnoses have a major impact on ADLs and occupational performance. Nutrition is such a vital aspect of an individual’s life, and it is far too often overlooked. We as occupational therapists need to understand the role that an individual’s nutrition plays on their occupational performance and work on advocating for proper nutrition for our clients.

An individual treatment idea could be to make a dietary discharge plan with someone who is in an acute care facility in order to educate the patient and caregiver on proper nutrition, as well as a way to provide proper local resources to supplement for any food insecurity. A group intervention to address nutrition could be an ice cream social in which residents engage in social participation, while receiving the proper nutrition they need from an Ensure mixed with their ice cream. Another intervention that could be applied to a population is educating caregivers and LTC residents about the effects of a sedentary lifestyle coupled with malnutrition.