Nutrition in the age-related disablement process

Abstract

The transition from independence to disability in older adults is characterized by detectable changes in body composition and physical function. Epidemiologic studies have shown that weight loss, reduced caloric intake and the reduced intake of specific nutrients are associated with such changes. The mechanisms underlying these associations remain unclear, and different hypotheses have been suggested, including the reduction of the antioxidant effects of some nutrients. Changes in muscle mass and quality might play a central role in the pathway linking malnutrition, its biological and molecular consequences, and function. A different approach aims at assessing diets by dietary patterns, which capture intercorrelations of nutrients within a diet, rather than by selective foods or nutrients: epidemiologic evidence suggests that some types of diet, such as the Mediterranean diet, might prevent negative functional outcomes in older adults. However, despite a theoretical and empirical basis, intervention studies using nutritional supplementation have shown inconclusive results in preventing functional impairment and disability. The present work is the result of a review and consensus effort of a European task force on nutrition in the elderly, promoted by the International Association of Gerontology and Geriatrics (IAGG) European Region. After the critical review of different aspects related to the role of nutrition in the transition from independence to disability, we propose future lines for research, including the determination of levels of inadequacy and target doses of supplements, the study of interactions (between nutrients within a diet and with other lifestyle aspects), and the association with functional outcomes.

Qualidade da dieta e fatores associados entre idosos: estudo de base populacional em Campinas, São Paulo, Brasil

“…Mas, além do sobrepeso, parcela significativa dos idosos é acometida por carências nutricionais e mesmo por desnutrição. No idoso, ocorrem alterações na ingestão alimentar provocadas por perda de apetite, diminuição da capacidade gustativa e olfativa, distúrbios de deglutição, o que conduz a menor absorção de vitaminas, minerais e outros nutrientes 2 . Entre os fatores que podem resultar em menor ingestão alimentar, destacam-se ainda o isolamento social, a depressão, a viuvez e as incapacidades 3 .…”

“…Entre os fatores que podem resultar em menor ingestão alimentar, destacam-se ainda o isolamento social, a depressão, a viuvez e as incapacidades 3 . Em decorrência do reduzido consumo de alimentos ou da adoção de uma dieta monótona, o idoso pode apresentar depleção de nutrientes essenciais para a manutenção da saúde e controle das doenças 2 .…”

Avaliação nutricional de idosos: desafios da atualidade

“…It is important to consider a complex network of direct and indirect determining factors that are inherent to the aging process, such as: social isolation; diseases; disabilities; physiological and biological abnormalities. 5 In addition to these specificities, the methods of nutritional assessment and the context of modern life demand the adoption of a wider perspective.…”

Dietary availability in elderly Portuguese households

“…Due to its potential to modulate the transition from vulnerability to frailty and dependence, nutrition is an important determinant of the quality of ageing (6,7) . Examination and monitoring of the dietary characteristics of the elderly is important in identifying subgroups at risk of malnutrition or disease (8)(9)(10) .…”