Health Promotion and Disease Prevention in the Older Adult

Chapter 22

Healthy Aging

• Health– “A state of complete

physical, mental, and social well-being and not merely the absence of disease or infirmity”

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Healthy Aging• Aging

– Chronological aging• Number of years a person has lived

– Biological aging• Changes in anatomy and physiology that affect

all body systems and occurs over time– Social aging

• Social habits and roles with respect to culture– Psychological aging

• Interchanges between the person and the psychological or social environments

Pathological Aging

• Unhealthy or “disease” state• Consider all individuals along the continuum

of aging

Health Promotion Versus Disease Prevention

• To achieve optimal level of wellness– Incorporates the spiritual, social, emotional,

intellectual, and physical dimensions to obtaining quality of life

• Health Promotion– Actions that are deliberately taken with the intent

of moving an individual to a higher level of wellness

Health Promotion Versus Disease Prevention

• Disease Prevention– Those activities that an individual deliberately

takes part in to prevent illness or disease

Frailty and Disability inPathological Aging

• Frailty– “Multidimensional syndrome of loss of reserves

that gives rise to vulnerability”• Disability

– A decline in physical ability or mental capacity to the extent that the individual cannot perform the usual activities of daily living without great difficulty

Factors that Influence Quality of Life

Quality of Life

• Encompasses many dimensions– Physical, emotional, psychological, and spiritual

• Health-related quality of life– A person or group’s perceived physical and mental

health over time– Can identify subgroups with poor physical or

mental health and can help guide policies or interventions to improve their health

Successful Aging as the Product of Health Promotion and Disease

Prevention• Consider successful aging to be the product of

effective health promotion activities coupled with evidence-based disease prevention strategies aimed at the promotion of optimal levels of health and well-being.

Heart Disease

• Conditions affecting the heart– Hypertension– Coronary artery disease– Myocardial infarction– Heart failure

• Risk factors– Modifiable– Nonmodifiable

Heart Disease

• Health Promotion and Disease Prevention in Heart Disease– Primary prevention activities– Secondary prevention – Tertiary prevention

• Cholesterol and Dietary Fat– Hypercholesterolemia

Heart Disease

• Exercise– Accumulate at least 30

minutes of exercise on most, but preferably all, days of the week

• Smoking Cessation– If necessary, encourage

older adult to quit© Noam Armonn/Dreamstime.com

Diabetes

• A disorder resulting from deficiency of or resistance to the hormone insulin

• A generalized disorder of carbohydrate, fat, and protein metabolism

• Can results in vascular complications • Primary prevention

– Maintain a healthy weight and engage in regular physical activity

• Secondary prevention– Screening for diabetes

Diabetes

• Diabetes and Exercise– Exercise improves insulin sensitivity– Aerobic activity, weight lifting or progressive

resistance training

Pulmonary Disease

• Diseases that affect the lungs– Chronic obstructive pulmonary disease

• Most common pulmonary disorder• Cigarette smoking is the single most important

risk factor for development of COPD• COPD in nonsmokers

Pulmonary Disease

• Nutritional interventions– Nutrition Screening Initiative (2002)– Pharmacologic interventions

• Smoking Cessation– Considered one of the most essential parts of

therapy in the treatment of COPD– Appropriate nutritional counseling

• Weight Control– Malnutrition

Osteoporosis• Nutritional Intervention in Patients with

Osteoporosis– Primary prevention begins in childhood and

adolescence• Adequate diet• Regular activity

– Recommendations for older adults• 1,000 - 1,200 mg of calcium per day• 200 to 400 IU of Vitamin D• Adequate sunlight exposure

Osteoporosis

• Weight-Bearing Exercise– Walking, mild-to moderate-impact aerobics, and

resistance exercise– Regular exercise

• Increases muscle mass and strength• Improves balance and coordination• Has been shown to reduce the risk of falls in

frail elderly persons

Drugs That May Worsen Osteoporosis

• Many medications used to treat other chronic conditions may worsen osteoporosis– Steroids– Anticonvulsants– Some antineoplastic agents

Obesity

• A public health epidemic• Obesity-related disability is of greater concern

than obesity-related death in older adults• Responsible for billions of dollars in direct

costs to the U. S. health care system

Obesity

• Obesity and Diet– Overall number of calories required decreases

with age• Obesity and Exercise

– Exercise is essential to weight loss and to the long-term maintenance of weight loss

Nutritional Products and Dietary Supplements

• Appropriate use of alternative nutrition therapies and nutritional supplementation

• Complementary and Alternative Medicine– It is likely that many older adults are taking some

type of nontraditional supplementation– Caution interactions with other medications

Food Safety

• Older adults at risk of foodborne illnesses– Comorbidities– Immunosenescence

• Potential hazards to food safety– Biological hazards from bacteria and other

microorganisms– Chemical hazards– Physical hazards

Food Safety

• Biological Hazards– Viruses

• Unable to replicate independently, require a host (food)

–Transmitted via poor food handling–Biological threats

»Time-temperature»Cross-contamination»Poor personal hygiene by food handlers

Food Safety

• Preventing Foodborne Illness– Food Handling and Preparation

• Hand washing!– Food Storage

• Hot food should be kept hot• Cold food should be kept cold• “Danger zone”

–Temperature between 40 and 140 degrees F

Food Safety

• Preventing Foodborne Illness– Food Storage

• Refrigerate or freeze perishables within two hours of purchase or preparation

• Marinate food in refrigerator• Cook to appropriate internal temperature

Specific Strategies for Disease Prevention and Health Promotion

• American Diabetes Association– Careful attention given to reduce the likelihood of

medical consequences of diabetes– Recommendations for choosing healthy foods and

recipes and exercise guidelines• National Cancer Institute and the American

Institutes for Cancer Research– Guidelines generated toward cancer prevention– Consistent with the USDA’s Dietary Guidelines for

Americans

Specific Strategies for Disease Prevention and Health Promotion

• American Heart Association– Use at least as many calories as you take in– Eat a variety of nutritious foods from all the food

groups– Eat fewer nutrient-poor foods– Do not smoke tobacco, and stay away from

tobacco smoke

Specific Strategies for Disease Prevention and Health Promotion

• National Cholesterol Education Program by NHLBI– Reduce the risk of illness and death from coronary

heart disease by reducing the percentage of Americans with high blood cholesterol

• Exercise Guidelines– Effective method for minimizing the functional

declines commonly associated with aging

Specific Strategies for Disease Prevention and Health Promotion

• Medical Nutrition Therapy– To prevent or reduce complications from

conditions that can be modifiable• Initial assessment of nutrition and lifestyle• Nutritional counseling• Information regarding managing lifestyle

factors that affect diet• Follow-up visit to monitor progress of diet

Specific Strategies for Disease Prevention and Health Promotion

• Other Nutritional Interventions– State and local governments as well as private

sources provide a large number of programs and resources.

Conclusion

• A nutritionist is part of the health care team responsible for assessing and implementing those activities aimed at health promotion and disease prevention.