Elderly Nutrition

1.

Course

code: 4301510-1 English name: Elderly Nutrition Hebrew name: Faculty: School of Health Sciences Department: Nutritional Sciences Degree : Bachelor of science (B.Sc.) in nutrition semester and year: second semester 2011

2. 3.

Schedule

Tuesdays 9:00-10:30 location room 11.3.14 Lecturer

Osnat Stone room 11.3.9 Phone no. 054-4686510 email: osnatst@gmail.com Tuesday 10:30-11:30

4.

Course goal

Development of knowledge and positive attitudes towards ageing and the elderly population. Understanding the special nutritional requirements of the elderly population, and the nutritional therapy for common conditions among the elderly.

5.
6.

Prerequisites Method of instruction

Human nutrition course no.4021510-01 Frontal lecture

7.
1

Course plan
Title Introduction to ageing Main topics Demographics in Israel, USA, & Europe The health system structure in Israel Important organizations & services for the elderly
General concept, in health systems, among dietitians.

Date 15.2.11

Recommended reading
.2008 . Elderly in Israel Statistical Annual 2008. Seung-Yeon et al. (2008). Nutrition Students Improve Attitudes after a Guided Experiential Assignment with Older Adults. Journal of Nutrition Education Behavior, 40:279-287. Kaempfer et al. (2002). Dietetics students low knowledge, attitudes and work preferences toward older adults indicate need for improved education about aging, Journal of the American Dietetic Association, 102:197-202. ONeill, et al. (2005). Aging in community nutrition, diet therapy, and nutrition and aging textbooks. Gerontology and Geriatric Education, 25(3):65-83. Bodner, E. & Lazar, A. (2008). Ageism among Israeli students: Structure and demographic influences. International Psychogeriatrics, 20:10461058. Butler, R. (1995). Ageism. In G. Maddox (Ed.). Encyclopedia of aging. New York: Springer. Exploring the anatomy and physiology of ageing. Parts 1-11. (2008). Retrieved from http://www.nursingtimes.net Wellman, N.S. & Kamp, B.J. (2007). Nutrition in aging. In Mahan, K. & Escott-Stump, S. (eds.). Krouses food and nutrition therapy (pp. 286307). St. Louis, Missouri: Saunders Elsevier. Nieuwenhuizen et al. (2010). Older adults and patients in need of nutritional support: Review of current treatment options and factors influencing nutritional intake. Clinical Nutrition, 29(2):160-169. Kondrup J, Allison SP, Elia M et al. (2003). ESPEN guidelines for nutrition screening 2002. Clinical Nutrition, 22:415-421. NICE (2006). Nutrition Support for Adults Oral Nutrition Support, Enteral Tube Feeding and Parenteral Nutrition. Retrieved from http://guidance.nice.org.uk/CG32/Guidance/pdf/English Saka et al. (2010). Malnutrition in the elderly and its relationship with other geriatric syndromes. Clinical Nutrition. Article in Press, Corrected Proof. Guigoz Y. (2006). The Mini Nutritional Assessment (MNA) review of the literature--What does it tell us? Journal of Nutrition Health and Ageing, 10(6):466-485. Milne et al. (2009). Protein and energy supplementation in elderly people at risk from malnutrition. Cochrane Database Syst Rev. 2009 Apr 15; (2):CD003288. Ahmed, T. & Haboubi, N. (2010). Assessment and management of nutrition in older people and its importance to health. Clin Interv Aging, 9(5):207-216.

Ageism

22.2.11

Physiology of ageing

The physiology of normal ageing: shanges in body composition, cardio vascular, gastrointestinal, urinary system changes

1.3.11

Malnutrition

Prevalence, risk factors, consequences, screening tools (MNA, MUST, NRS)

15.3.11

Malnutrition

Nutritional assessment: Mini Nutritional Assessment Nutritional intervention

22.3.11

obesity

Correlation with mortality and morbidity in the elderly vs. the adults, assessment, and treatment

29.3.11

Metabolic syndrome cardio vascular disease

and

Metabolic syndrome, Diabetes, HTN, Hyperlipidemia- same goals of treatment?!

Oreopoulos A. (2009). The obesity paradox in the elderly: potential mechanisms and clinical implications. Clinical Geriatric Medicine, 25(4):643-659. Villareal, D. T., Apovian, C. M., Kushner, R. F., Klein, S., American Society for Nutrition, & NAASO, T. O. S. (2005). Obesity in older adults: Technical review and position statement of the american society for nutrition and NAASO, the obesity society. The American Journal of Clinical Nutrition, 82(5), 923-934. Yermilov et al. (2009). Appropriateness criteria for bariatric surgery: beyond the NIH guidelines. Obesity,17(8):1521-1527. Wittert (2007). Obesity in older adults. In: Geriatric Nutrition. Morley (ed.). chapter 4. Ray et al. (2010). Mechanisms of association between obesity and chronic pain in the elderly. Pain, in press, corrected proof. Lechleitner M. (2008). Obesity and the metabolic syndrome in the elderly--a mini-review. Gerontology, 54(5):253-259. DPP research group. (2009). 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Lancet, 374(9702):1677-1686. Chen et al. (2010). Care of elderly patients with diabetes mellitus: A focus on frailty. Ageing Research Reviews, 9(Suppl 1):S18-S22. Mellen, et al. (2008). Deteriorating dietary habits among adults with hypertension: DASH dietary accordance, NHANES 1988-1994 and 1999-2004. Archives of Internal Medicine, 168(3):308-314. Akbaraly, et al. (2010). Metabolic syndrome, its components, and mortality in the elderly. J Clin Endocrinol Metab, 95(11):E327-E332. Kim et al. (2010). Relation between nutritional risk and metabolic syndrome in the elderly. Archives of Gerontology and Geriatrics, May 5. [Epub ahead of print]. ADA (2008). Nutrition Recommendations and Interventions for Diabetes: A position statement of the American Diabetes Association. Diabetes Care, 31(s1):s61-s78. Skyler et al. (2009). Intensive glycemic control and the prevention of cardiovascular events: implications of the ACCORD, ADVANCE, and VA diabetes trials: a position statement of the American Diabetes Association and a scientific statement of the American College of Cardiology Foundation and the American Heart Association. Circulation, 119(2):351-357. Abbatecola et al. 2008. New approaches to treating type 2 diabetes mellitus in the elderly: role of incretin therapies. Drugs & Aging. 25(11):913-25 Cea-Calvo et al. (2009). Prevalence of low HDL cholesterol, and relationship between serum HDL and cardiovascular disease in elderly Spanish population: the PREV-ICTUS study. Int J Clin Pract. 63(1):7181. Ali & Alexander. (2007). Statins for the primary prevention of cardiovascular events in older adults: a review of the evidence.

5.4.11

Neurological diseases

Alzheimer & dementia; Parkinson; Risk factors and nutritional issues

American Journal of Geriatric Pharmacotherapy, 5(1):52-63. Djousse et al. (2009). Egg consumption and risk of type 2 diabetes in men and women. Diabetes Care, 32:295-300. Aronow. (2008). Treatment of hypertension in the elderly. Geratrics, 63(10):21-25. McDonald et al. (2006). Clinical inquiries. What lifestyle changes should we recommend for the patient with newly diagnosed hypertension? Journal of Family Practice, 55(11):991-993 Appel et al. (2003). Effects of comprehensive lifestyle modification on blood pressure control: main results of the PREMIER clinical trial. Journal of the American Medical Association, 289(16):2083-2093. Scarmeas et al. (2009). Mediterranean diet and mild cognitive impairment. Archives of Neurology, 66(2):216-225. Aderinwale, et al. (2010). Current therapies and new strategies for the management of Alzheimer's disease. American Journal of Alzheimers Disease and Other Dementias, 25(5):414-424. Morillas-Ruiz, et al. (2010). Effect of an antioxidant drink on homocysteine levels in Alzheimer's patients. Journal of Neurological Science, Epub ahead of print. Retrieved November 2010. Ousset et al. (2008). Nutritional status is associated with disease progression in very mild Alzheimer disease. Alzheimer Disease & Associated Disorders, 22(1):66-71. von Arnim CA, Gola U, Biesalski HK. (2010). More than the sum of its parts? Nutrition in Alzheimer's disease. Nutrition, 26(7-8):694-700. Gaenslen A, Gasser T, Berg D. (2008). Nutrition and the risk for Parkinson's disease: review of the literature. J Neural Transm, 115(5):703-713. Kones R. (2010). Parkinson's disease: mitochondrial molecular pathology, inflammation, statins, and therapeutic neuroprotective nutrition. Nutr Clin Pract. 2010 Aug;25(4):371-89. Littarru GP, Tiano L. (2010). Clinical aspects of coenzyme Q10: an update. Nutrition, 26(3):250-254.

12.4.11

Swallowing difficulties

The intact and the damaged swallowing mechanism, etiology, population at risk, screening, identification and diagnosis, nutritional treatment.

26.4.11

Enteral feeding; pressure sores

Feeding program, feeding tolerance, complications, and ethical aspects. Definitions, factors and pathology, population at risk, the connection between pressure sores and nutrition, nutritional support. Types of anemia, prevalence, treatment.

10

3.5.11

Anemia and gastrointestinal issues

11

17.5.11

osteoporosis

Risk factors, prevention and treatment (medical, nutritional, supplements)

12

24.5.11

Supplements

Multivitamins, vitamins (D, B12), minerals (Ca), the Israeli committee regarding supplements for geriatric institutions.

Lin et al. (2010). What is associated with low food intake in older people with dementia? Journal of clinical nursing, 19(1-2):5359. Watson (2006). Feeding and dementia: a systematic literature review. Journal of advanced nursing, 54(1):86-93. Amella, J & Lawrence, J.F. (2007). Eating and Feeding Issues in Older Adults with Dementia: retrieved from: Part I: Assessment http://consultgerirn.org/uploads/File/trythis/try_this_d11_1.pdf NICE (2006). Nutrition Support for Adults Oral Nutrition Support, Enteral Tube Feeding and Parenteral Nutrition. Retrieved from http://guidance.nice.org.uk/CG32/Guidance/pdf/English Langer et al. (2003). Nutritional interventions for preventing and treating pressure ulcers. Cochrane Database Syst Rev. 2003;(4):CD003216. Kheir, F. & Haddad, R. (2010). Anemia in the elderly. Dis Mon, 56(8):456-467. Tettamanti, M., et al. (2010). Prevalence, incidence and types of mild anemia in the elderly: the "Health and Anemia" population-based study. Haematologica, 95(11):1849-1856. Leandro-Merhi, et al. (2010). Dental and gastrointestinal changes as indicators of nutritional depletion in elderly inpatients. Journal of Evaluation in Clinical Practice, 16(5):873-877. Triantafyllou, etal. (2010). Gastrointestinal and liver side effects of drugs in elderly patients. Best Practice & Research Clinical Gastroenterology, 24: 203215. Goldacre (2009). Demography of aging and the epidemiology of gastrointestinal disorders in the elderly. Best Practice and Research Clinical Gastroenterology, 23(6):793-804. NOF. (2010). Clinicians Guide to Prevention and Treatment of Osteoporosis. Retrieved from http://www.nof.org/sites/default/files/pdfs/NOF_ClinicianGuide2009_v7 .pdf. Anderson, J.J.B. (2007). Nutrition and bone health. In Mahan, K. & Escott-Stump, S. (eds.). Krouses food and nutrition therapy (pp. 614635). St. Louis, Missouri: Saunders Elsevier. (. , . , .. '. ) .( ) 1062-1067 :.. 1002; 041; " Lichtenstein et al. (2008). Modified MyPyramid for Older Adults. Journal of Nutrition, 138 :78-82. Lappe et al. (2007). Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial. American Journal of Clinical Nutrition, 85:15861591. Goodwin, P.J. (2009). Vitamin D in cancer patients: above all, do no harm. Journal of Clinical Oncology, 27(13):2117-2119. Schwalfenberg. 2008. Vitamin D and diabetes: improvement of glycemic control with vitamin D3 repletion. Canadian Family Physician,

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31.5.11

Food and supplements -drug interactions

Popular medications among elderly that interact with food and should be considered by the dietitian.

54(6):864-866. Wang et al. (2010). Systematic review: Vitamin D and calcium supplementation in prevention of cardiovascular events. Hypertension, 51(4):1073-1079. Li Y et al. (2002). 1,25-Dihydroxyvitamin D(3) is a negative endocrine regulator of the renin-angiotensin system. Clinical Investigation, 110:229238. Oh, R.C. & Brown, D.L. (2003).Vitamin B12 Deficiency. American Journal of Family Physician, 67:979-986,993-994. Rajan et al. (2002). Screening for Cobalamin Deficiency in Geriatric Outpatients: Prevalence and Influence of Synthetic Cobalamin Intake. Journal of the American Geriatric Society, 50:624-630. Eussen et al. (2008). Changes in markers of cobalamin status after cessation of oral B-vitamin supplements in elderly people with mild cobalamin deficiency. European Journal of Clinical Nutrition, 62(10):1248-1251. Sampson, G. (2009). Weight loss and malnutrition in the elderly. Australian Family Physician, 38,( 7): 507-510. Gardiner et al. (2008). Herbal and dietary supplement-drug interactions in patients with chronic illnesses. American Family Physician, 77(1):7378. Boullata, J. (2005). Natural health product interactions with medication. Nutrition in Clinical Practice, 20(1):33-51.

8.

Course requirements:

Attendance- 80% Exam- score of 75

9.
3.7.11 11.7.11

Date of the examination:

10. 11.

Course grading

Grade of the exam Main textbook and additional text books

Morely, J.E. & Thomas, D.R. (2007). Geriatric Nutrition. Boca Raton: CRC Press. http://www.crcnetbase.com/isbn/9781420005493 Chernoff, R. (2006). Geriatric Nutrition: The Health Professional's Handbook. (Third edition). Sudbury: Jones & Barlett Learning. Wellman, N.S. & Kamp, B.J. (2007). Nutrition in aging. In Mahan, K. & EscottStump, S. (eds.). Krouses food and nutrition therapy (pp. 286-307). St. Louis, Missouri: Saunders Elsevier.
12. 13. None Reading list Required material for the examination See in course plan