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Healthy Aging
Assistant Professor Cindy Gross
Professor Margaret Huang- Saddleback College Aging
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▶ Aging is not a disease
“The best treatment of disease is its
prevention.”
Most causes of death and disability in
older people are partially to fully
preventable. Prevention
▶ Primary Prevention:
▶ ▶ Secondary Prevention:
▶ ▶ Preventing occurrence of disease, e.g. nutrition,
exercise, stress management, immunization, injury
prevention.
Early diagnosis and treatment to prevent
complications, e.g. screening for hypertension,
diabetes, cancer. Tertiary Prevention:
▶ Focuses on rehabilitation, control of pain,
caretaker support. Goal of Prevention To maintain active
healthy
and
independent lives Illness
Acute illnesses
▶ has been in control with the
development of immunizations and
antibiotics
▶ Chronic illnesses
▶ ▶ Majority of 65+ year olds have chronic
illness defined by ‘a condition where
there is no cure and the patient is
alive.’ Risk Factors for Disease
Poor Nutrition
▶ Lack of Exercise
▶ Poor Stress Mangement
▶ Smoking
▶ Alcohol
▶ Healthy Aging
is
a personal
responsibility Nutrition and Aging
Follow the food pyramid
▶ Need less calories – more
nutrient dense food in less
calories
▶ Need more Calcium, Vitamin D,
Vitamin B-12, C, E, Fiber, Folate,
Zinc
▶ Nutrients for Optimum Health
Protein
▶ Fat
▶ Carbohydrates
▶ Vitamins
▶ Minerals
▶ Water
▶ Food Sources
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▶ Protein Intake 15%
Fat Intake 30%
Carbohydrate Intake 55-60% Protein Requirement
Young adults – 0.8 gram/kg of body weight
Older adults – 1 gram/kg of body weight
Robnett, Regula, and Chop, Walter, Gerontology for Health Care Professional 2 nd ed., 2010. Nutrition
The kind of nourishment we
provide our bodies throughout
life can trigger or delay the
onset of the diseases of old age
and may help slow down the
aging process. 10 Recommendations to Reduce
Cancer Risk
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▶ Be lean – within the range of normal body weight
Be physically active everyday
Limit intake of red meat and avoid processed meat
Eat mostly foods of plant origin
Limit alcoholic drinks
Limit intake of energy dense foods
Limit consumption of salt, avoid moldy cereals (grains) or
legumes
Aim to meet nutritional needs through diet alone
Mothers to breastfeed; children to be breastfed
For cancer survivors, follow the recommendations for cancer
prevention
Food, Nutrition, Physical Activity and the Prevention of Cancer: A global Perspective,”
www.dietaandcancerreport.org. Tufts University Health and Nutrition Letter, 2/08 Risk Factors
▶ Family History ▶ Being Thin/Small Frame ▶ Alcohol/Smoking ▶ Low Calcium intake ▶ Low Sun Exposure ▶ Lack of Exercise ▶ Menopause Prevention
▶ Diet Rich in Calcium and Vitamin D
▶ Weight-Bearing Exercise
▶ No Smoking or Excess Alcohol
▶ Bone Density Testing Daily Calcium Recommendation
Stage Age RDA (milligrams) Infants Birth to 6 months 360 Children
Adolescents
Adults
Pregnant or
Breastfeeding
Post-Menopausal 1 to 10 years
11-18 years
10 and older
Under 19 years
Over 19 years
Age varies 1,000
1,200
1,000
1,600
1,200
1,500 Calcium
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▶ Yogurt, low fat / fat free / plain or fruit
Fat free milk
Fortified juice
Canned sardines
Oatmeal, instant
Calcium fortified product; cereal, rice, bread, others
Tofu, process with calcium
Soy milk
Green vegetables such as broccoli
Nellie G. Hedstrom, M.S., R.D., “Good Nutrition From Maine”. University of Main. June 9, 2003. Sarcopenia
Loss of skeletal muscle mass and
strength, leads to muscle weakness
▶ It is associated with normal aging
▶ A loss of 1% to 2% per year after age 50
▶ By age 50, an average of 15 pounds lost
and 30 pounds of fat gained
▶ Risk Factors
Malnutrition
▶ Sedentary lifestyle
▶ Hormonal secretion declines
▶ Estrogen
▶ Testosterone
▶ Growth hormone
▶ ▶ Medications
Steroids
▶ Statins
▶ muscle relaxants
▶ ▶ Medical Conditions
Hypothyroidism
▶ osteoarthritis
▶ Prevention
▶ Exercise
▶ Resistance training ▶ Strength training ▶ Nutrition
▶ RDA recommendation for protein Obesity
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▶ Approximately 108 million adults are
overweight or obese
Increase risk of:
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▶ Hypertension
Type 2 Diabetes
Coronary Heart Disease
Gallbladder Disease
Certain Cancers
Dyslipidemia
Stroke
Osteoarthritis
Sleep apnea
Nellie G. Hedstrom, M.S., R.D., “Good Nutrition From Maine”. University of Main. June 9, 2003. How can diets of older adults
be improved?
▶ ▶ ▶ The Federal Older Americans Act of
1973
▶ Provides funding thru the California Office on Aging for
Project TLC (Transportation, Lunch, Counseling) ▶ A hot lunch, 5 days per week, at community centers Meals on Wheels
▶ A nonprofit, volunteer organization, customer pay program
in which a hot lunch and a cold dinner are delivered 5 days a
week be a volunteer driver. ▶ Physician authorization is required for special diets Exercise Exercise
Exercise is important as eating
properly
▶ Maintaining physical conditioning is
imperative with aging
▶ “If exercise could be packed into a
pill, it would be the single most
widely prescribed and beneficial
medicine in the nation.”
▶ Dr. Robert N. Butler Types of Exercise
▶ Endurance
▶ Strength
▶ Balance
▶ Stretch Exercise for Older Adults
Walking
▶ Dancing
▶ Gardening and yard work
▶ Swimming
▶ Weight lifting
▶ Tai chi
▶ Benefits of Exercise in Aging
▶ Tufts University Study
People in their 70’s, 80’s, and 90’s can benefit
from lifting weights. Average age was 87.
▶ They exercised every other day for 10 weeks,
resulting in:
▶ ▶ ▶ Increased strength 113% ▶ Improved walking speed 12% ▶ Improved balance and health ▶ Preventing falls “You get old because you don’t move.”
New England Journal of Medicine, June 1994 Successful Aging
(MacArthur Foundation) Avoidance of disease and disability
▶ Maintenance of high physical and
cognitive function
▶ Engagement in social and
productive activities
▶ 7 Keys to Healthy Aging
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▶ Not smoking
The ability to take life’s ups and
downs
Absence of alcohol abuse
Healthy weight
A solid marriage
Physical activity
Years of education How to Live a Long Healthy Life
(Dr. R. Butler, 10/22/04) ▶ A real sense of purpose- do something to make a
difference ▶ Not to be impulsive- sensible behavior ▶ Close intimate relationship-giving to each other ▶ Be a high earner-better access to health care,
vacation- less stress ▶ Eat sweet-dark chocolate (antioxidant) ▶ Make friends of all ages-good for the mind ▶ Make the mind engaged Trends in Health Maintenance
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▶ Holistic concepts of health: mental and
physical health are equally important.
Community senior centers
Adult day health centers
Senior housing projects
Community health fairs
Hospitals and clinics Housing Alternatives for Older Adults
▶ Private home or apartment ▶ Mobile home parks ▶ Subsidized low-rent apartment ▶ Share a house ▶ Retirement center, e.g. Laguna Woods ▶ Single room occupancy (SRO) Hotel (room and meals) ▶ Echo home (home or apartment close to an adult child’s home) ▶ Board and care homes (some assistance provided) ▶ Adult foster care home ( live with a nonrelated family or person) ▶ Assisted living facility (ALF) ▶ Continuing care retirement community (CCRC)-independent living to skilled care ▶ Institutional living (nursing home) Housing Trends in the
New Retirement Aging in Place Strong Preference for Aging in Place
▶ Why?
▶ Psychological
▶ Familiarity
▶ Ties to neighborhood
▶ Avoid placing burden on family
Jon Pynoos, Prof. of Gerontology @ USC, 2009 Aging
90% of older Americans 60 years and
older prefer to remain in their own
home and never move.
Source: AARP (2006) “We know we can’t stop aging, but we
can prevent injury and increase safety.”
J.L. Mueller, adapted Jon Pynoos, Prof. of Gerontology @ USC, 2009 Environment Needs Modifications
To increase independence and safety
▶ To reduce falls
▶ ▶ Over 50% in homes
▶ Over 20% in the community Top Risk Factors for Falls
▶ Depression
▶ Balance problems
▶ Polypharmacy
Dr. Lawrence Katz, Univ. of N. Carolina at Chapel Hill, March 9, ASA/NCOA conference Accident-Proofing Checklist
▶ Stairs- dangerous for elderly
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▶ Adequate illumination on stairs and landings
Need light switches, top and bottom of stairs
Non-skid treads or carpet
Staircase handrails on both sides of stairs
Staircase handrails with end of rail shaped to
signify bottom of stairway
Wide steps – 18 inches
Rails and steps need clear color contrast
markings Accident-Proofing Checklist
▶ Carpets
▶ Edges tacked down completely ▶ Wall-to-wall with pads ▶ Medium to short pile ▶ No throw rugs Accident-Proofing Checklist
▶ Floors
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▶ No highly polished floor surfaces
Non-skid wax
Thresholds removed
No extension cords or wiring
Access pathways free of low-lying furniture
or clutter
No level changes
Free of wet areas Accident-Proofing Checklist
▶ Bathroom
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▶ Non-skid rubber mat in shower or bath
Handrails in bath and by commode
Adequate lighting in bath and night light on access
path
Water temperature regulated at 100 degrees
Fahrenheit or less
Clear markings hot and cold faucets
Easy to reach and manipulate faucet handles
Seat in tub or shower
Easy access to toilet paper Accident-Proofing Checklist
▶ Kitchen
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▶ Adequate illumination
Stove controls large and clearly marked
Pots and pans with large, easily grasped, protected
handles
Lightweight pots and pans
Pocket magnifier for small prints on labels
Large numbers on telephone
Timer
Smoke detector
Avoid kitchen stool Accident-Proofing Checklist
▶ Bedroom
▶ Guard-rail on side of bed to aid in rising ▶ Light source beside bed- for reading ▶ Night light ▶ Bed low enough to roll in and out with ease Accident-Proofing Checklist
▶ Other
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▶ Furniture or chairs need to be stationary
Sturdy furniture of proper height for ease in getting up and down
Shelving designed low enough so use of stools is
minimized-especially kitchen
Telephone jacks placed to allow easy moving of
telephones-telephone amplifier
Smoke alarms with sound or light emergency system
Adequate access and escape doors and windows
Long handle dust pans or shoehorn to prevent falls
Microwave or toaster ovens are better than stoves
Wear proper clothing (loose, easily removed) and shoes, slippers
(low-heeled, rubber sole, no shoe laces, no open back) to
prevent fall or slip
(Margaret Huang, 2009)
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