CD Week 30

Nutrition & Dementia in the Elderly

Dietary Guidelines: http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/n33.pdf

- See Wk 9: Diet and Nutrition.

- Particularly :

http://moritzcycling.com/eer.cgi

Measures• Height weight tables• BMI body weight(kg)/height (m2)• Waist / Waist to Hip Ratio • Body Fat– Skinfolds– Electrical Impedance– Buoyancy– DEXA (Dual Energy X-Ray Absortiometry Scan)

Where do older Australians live?

Australia’s Welfare 2009 , pg88

http://blackboard.nd.edu.au/webapps/portal/frameset.jsp?tab_id=_2_1&url=%2Fwebapps%2Fblackboard%2Fexecute%2Flauncher%3Ftype%3DCourse%26id%3D_4124_1%26url%3D

• 92% private Family, group or lone-person household 27% of these live alone 66% of these live in family households (mostly single family)

84% of people with dementia in the community sometimes or always require assistance with core activities. 93% receive some type of assistance with the condition.

• 8% non-private:

Hotel/motel, guest house, cared accommodation (hospital, aged care home, supported care at retirement village)

Proportion increases with age

1 in 2 residents with dementia (50%) needed high-level care with the ADLs compared with 30% of residents without dementia

Likelihood of living in cared accommodation increases with age

• 5% of ALL older people

• 31% of 85+

• 2008 – 60% of residents were 85+

What assists or impedes the ability for older Australians meeting the recommended dietaryguidelines?

• Assist – community services (Meals On Wheels), deliveries, family/friends, A.C Facility, supplements.

• Challenge- poverty, remoteness, mobility, access,

laziness, reversion to ethnic food patterns of consumption, dentition/swallowing, diseases re eating/digestion, cognitive decline, hand function, inability to physically prepare food, living alone/loneliness.

Disease states associated with poor nutrition include:

• Cardiovascular disease Elevated blood pressureElevated cholesterol levels

• Diabetes • Some cancers • Musculoskeletal and arthritis

To reduce falls/fractures important for good muscle mass and reduced osteoporotic fractures.

Demographic changes occurring in Australia and other demographic changes:

Dementia in Australia•More females 63% than males 37% have dementia (AIHW 2011).

•222,100 Australians (1.0%) had dementia in 2011.

• By 2031 expected to project more than 464,000 (1.6%)

•From 2000-2009, dementia rose from 7th to 3rd leading cause of death in Australia

•Dementia is already the single greatest cause of disability in older Australians.

•It is one of the fastest growing sources of major disease burden, overtaking coronary heart disease in its total wellbeing cost by 2023.

•Australia faces a shortage of more than 150,000 paid and unpaid carers for people with dementia by 2029.

Dementia internationally Fun Facts

• The dementia epidemic is worldwide, more prevalent in developed countries

• The total estimated worldwide costs of dementia were US$604 billion in 2010

• These costs account for about 1% of the world’s GDP (gross domestic product)

• If dementia were a country, it would be the world’s 18th largest economy

• If it were a company, it would be the world’s largest, exceeding Wal-Mart (US$414 billion)

Important features in the design of an aged care facility for dementia residents?

• Falls prevention:Rails, steps, even surfaces, rugs, slippery/wet, footwear, obstacles/clutter. Chairs for rest. Avoid sharp corners/edges. Shower chairs/hoses. Toilet commodes/raised seat/ alert system.

• Staff awareness

Important features in the design of an aged care facility for dementia residents?

• Monitors/technology – contained area, microchipping, identification

• Physical condition – skills – balance retraining & maintenance. Ex classes. Chairs for rest

• Cognitive maintenance – games, skills, etc –puzzles/papers/ipads

• Social interaction – common rooms, personal belongings & familiarity, visitor friendly,

Fall Prevention Strategies in people with dementia

From week 26, the risk factors for falls in elderly:

• History of previous falls • Psychoactive medications• Cognitive or functional impairment • Environment impairment • Balance or gait problems • Loss of muscle strength • Impaired vision

V: Alzheimers /Dementia Wimo, A., Prince, M. (2010) World Alzheimer Report 2010: The Global Economic Impact of Dementia. London : Alzheimer’s Disease International (ADI ) www.alz.co.uk/research/files/WorldAlzheimerReport2010ExecutiveSummary.pdf