Handbook of Clinical Nutrition and Aging PDF
Preview Handbook of Clinical Nutrition and Aging
Nutrition and Health Series Editor: Adrianne Bendich Connie Watkins Bales Julie L. Locher Edward Saltzman Editors Handbook of Clinical Nutrition and Aging Third Edition N H UTRITION AND EALTH Adrianne Bendich, Ph.D., FASN, FACN, SERIES EDITOR For further volumes: http://www.springer.com/series/7659 Connie Watkins Bales (cid:129) Julie L. Locher Edward Saltzman Editors Handbook of Clinical Nutrition and Aging Third Edition Editors Connie Watkins Bales Julie L. Locher Geriatric Research, Education, and Clinical Center Departments of Medicine and Health Care Durham VA Medical Center Organization and Policy and Translational Nutrition and Aging Program Department of Medicine University of Alabama at Birmingham Duke University Medical Center Birmingham , AL , USA Durham , NC , USA Edward Saltzman Jean Mayer USDA Human Nutrition Research Center on Aging Tufts University Boston , MA , USA ISBN 978-1-4939-1928-4 ISBN 978-1-4939-1929-1 (eBook) DOI 10.1007/978-1-4939-1929-1 Springer New York Heidelberg Dordrecht London Library of Congress Control Number: 2014953584 © Springer Science+Business Media New York 2004, 2009, 2015 T his work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfi lms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. Exempted from this legal reservation are brief excerpts in connection with reviews or scholarly analysis or material supplied specifi cally for the purpose of being entered and executed on a computer system, for exclusive use by the purchaser of the work. Duplication of this publication or parts thereof is permitted only under the provisions of the Copyright Law of the Publisher’s location, in its current version, and permission for use must always be obtained from Springer. Permissions for use may be obtained through RightsLink at the Copyright Clearance Center. Violations are liable to prosecution under the respective Copyright Law. T he use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specifi c statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. Printed on acid-free paper Humana Press is a brand of Springer Springer is part of Springer Science+Business Media (www.springer.com) Dr. Bales dedicates this book in honor of her brand new grandchildren, Ada Elizabeth and William Thomas Britton. Thank you for reminding us that tomorrow brings new life, fresh beginnings, and hope for a better world! Dr. Locher dedicates this work to those in health care and community settings who are working together to comprehensively address nutrition risk and food insecurity among older adults. Dr. Saltzman: To my mentors and those who have served as role models, whose contributions to my success have been incalculably great and for which I am more grateful than words can express. Foreword This new edition of the Handbook of Clinical Nutrition and Aging , edited by Connie Bales, Edward Saltzman, and Julie Locher, is a most timely comprehensive overview of relevant new fi ndings for practitioners, investigators, and policy makers. The individual chapters share knowledge and expertise from authors who are preeminent leaders in the fi eld. As the twenty-fi rst century unfolds, the world will confront many challenges in caring for aged adults that far exceed any ever experienced previously. The US population aged 65 years and older has increased by 21 % over the past two decades. In the coming years, it will grow even more rapidly, increasing more than twofold by 2060. Even more rapid change is projected for the oldest-old; those 85 years and older are expected to triple between 2012 and 2040. Such unprecedented increases in the numbers of adults reaching old age will produce major changes in population age distributions, not only in the Western world but around the globe, i.e., in developed as well as developing nations. These dramatic changes will have an indelible impact on health care and the practice of clinical nutrition. To some extent, this is old news. These predictions have been on the radar for at least two decades, prompting efforts to consider new comprehensive systems of healthcare delivery for older persons. However, as we now engage the aging cohort of the “baby boomer” generation, the future has arrived, and we must face the realities of shifting demographics and limited resources. What it means to be an older person has also continued to evolve. Who imagined even 100 years ago that life expectancies would rise to the current degree? Who imagined that, for some, age 70 would functionally become the new age 60? Who imagined that so many older persons would have such active, rich, and fulfi lling lives? Unfortunately a substantial number of older persons will not have these opportunities because they suffer aging- associated conditions like chronic disease, depression, dementia, poor oral health, sarcopenia, functional decline, and frailty. Malnutrition is associated with many of these conditions, both as a precipitating factor and as an adverse outcome that blunts the success of medical therapies and contributes to decline. Obesity has also become common among older persons and is strongly associated with disease burden and functional limitation. Sarcopenic obesity is especially common and may contribute to functional impairment. Paradoxically, many obese older persons consume poor quality diets and also suffer micronutrient defi ciencies. Therefore, as highlighted in this book, practi- tioners will confront a complex spectrum of nutritional concerns among older persons, everything from malnutrition in the setting of classic starvation to malnutrition in the setting of disease or injury to malnutrition in the setting of obesity. In most Western countries, including the United States, diet-related chronic diseases are the single largest cause of morbidity and mortality. Optimally implemented, preventive nutrition and medical nutrition therapies have the potential to be major determinants of the ultimate impact of aging on world populations. Sound nutrition offers opportunities to favorably alter health-related quality of life as well as healthcare resource use by older persons. With respect to related aging policies, we are vii viii Foreword witnessing two evolving trends that bring nutritional concerns of older persons to the forefront. First, there is a growing movement to shift the emphasis of long-term care from institutional settings to home- and community-based settings. Central to this movement is the provision of nutrition services to older adults residing in the community who are at nutritional risk, especially those lacking resources (both fi nancial and social), and those who experience chronic disease burden and functional decline that increase their likelihood of being hospitalized or placed in a skilled nursing facility. Second, there are increasing fi nancial penalties to hospitals and healthcare providers when patients experience adverse outcomes like premature hospital readmission. Malnutrition is strongly associated with increased risk for such undesirable outcomes. Connecting medical and social services that address nutritional needs is vital in caring for older persons. An important new feature of this edition of this book is a focus on elders residing in the community and how best, both effectively and effi ciently, to meet their nutritional needs. Gordon L. Jensen, M.D., Ph.D. Pref ace It has been a decade since the fi rst edition of this H andbook was created. The intervening time has indeed brought a mixture of blessings and concerns. Rapid scientifi c progress and advances in infor- mation transfer have fostered medical discoveries and dissemination of health-related information at an unprecedented rate. Consumers are more aware of the value of health- promoting behaviors than ever before, and older adults are paying close attention. For example, older persons are the greatest consumers of dietary supplements. Many employers have introduced wellness in the workplace initia- tives, including to their retirees. Yet, the stark economic diffi culties of the past few years have added unanticipated challenges for many individuals and families, often making it diffi cult to take advantage of these advances. The stress of limited time and resources and the confusion resulting from mixed messages in the media can be particularly challenging for older adults. Many are living on a fi xed income and coping with a number of comorbidities as they make choices about health-related behav- iors, including nutrition. As a result, they may not rank nutrition highly amongst the complex array of health-related recommendations they are offered, but we believe that they should! In later life, as at any age, a poor diet and related factors like inactivity and obesity increase the risk of developing a long list of chronic conditions, such as cardiovascular disease, type 2 diabetes, meta- bolic syndrome, gallbladder disease, and cancer. Conversely, adherence to medical nutrition therapies for age-associated conditions such as renal disease and chronic heart failure can foster important improvements in health-related quality of life by preserving organ function and reducing problematic symptoms. With this in mind, we sought in this third edition of the H andbook to emphasize newer topics that have received limited attention heretofore, as well as mainstay topics for which assessment and therapies have continued to evolve and improve. For example, the increased recognition of physi- cal function as a determinant of independence and well-being in later life is supported by three rele- vant chapters (Chaps. 6 , 7 , and 2 2) . Two chapters (Chaps. 8 and 1 8) deal with aspects of diet and cognition, a current “hot topic” in geriatric nutrition. Chapters on food insecurity (Chap. 9 ), pressure ulcers (Chap. 1 4) , feeding in late dementia (again, Chap. 1 8) , and end of life issues (Chap. 1 9 ) high- light nutritional concerns in highly vulnerable populations. As in past editions, our “menu” of chap- ters on clinical conditions includes obesity, diabetes, heart failure, cancer, kidney disease, and osteoporosis. We are also pleased to include a new chapter on nutrition and anti-aging (Chap. 2 0 ) and the latest information on the ever-challenging topic of dietary supplements (Chap. 2 2 ), as well as a number of additional chapters relating to new knowledge about the role of nutrition in aging on a broader scope. The contents of these chapters refl ect an optimistic outlook. Clearly, the authors con- tributing chapters to the Handbook support the idea that optimal nutrition benefi ts all older adults and they offer specifi c suggestions for accomplishing these benefi ts. ix
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