Download - Immunity elderly
NUTRITION, IMMUNITY AND INFECTIONSIN THE ELDERLY
Prepared By:Bhavya Dhir L-2013-HSC-04-BNDGarima Goyal L-2013-HSC-09-BNDKritika Gupta L-2013-HSC-20-BND
HIGHLIGHTS The proportion of elderly individuals is increasing in both
developed and developing countries.Major Consequence –
• Significant increase in age related illness and disease• Increase in health related expenditure
Factors affecting ageing process –• Genetic• Environmental
i. Nutritional factorsii. Exposure to antigens throughout life
Immunological and Nutritional
Status of the elderly
Physiological Changes
Social Factors
Economic Factors
Psychological Changes
PRIMARY AGEING IMMUNE DEFICIENCY
The immune function changes seen in very
healthy elderly individuals with no other underlying
causes are referred as Primary Ageing Immune
Deficiency.
MAIN CHANGES
CHANGES IN
CYTOKINES
CHANGES IN CELL MEDIATED IMMUNITY AND
T LYMPHOCYTES
CHANGES IN B
LYMPHOCYTES
CHANGES IN MACROPHAGE
S AND NK CELLS
>Immature T cells>Memory T cells
>Thymic function>Mature T lymphocytes>Native T & Cytotoxic T cells>Lyphocyte proliferation in response to stimulation>Functional ability of T cells>Effectiveness of CD4+ Th cells & CD8+ T suppressor cells>Cell mediated immunity & DCH responses
INCR
EASE
DDECREASED
Changes in cell-mediated immunity & T lymphocytes
>Plasma levels of IgA & IgG>Production of autoantibodies>B-lymphocytes responses unaltered
>IgM production>Antibody response to vaccines
INCR
EASE
D
DECREASED
Changes in B lymphocytes
Function well preserved
Phagocytosis & lysosomal activity maintained
Macrocytes produce more prostaglandins & free radicles
Changes in macrophages & NK cells
>Th2 cytokine secretions>Production of interleukins (IL-3. IL-4) >During infections IL-1, IL-6 & TNF-α secretions increases
IL-2 secretion as young adults
INCR
EASE
D COM
PARABLE
Changes in cytokines
Diabetes
ALS
COPDDysphagia
Cancer
Palliative CareCeliac Disease
Constipation
SuperbugsCongestive
HeartFailure
PressureUlcers
MultipleSclerosis
Parkinson’sDisease
MalabsorptionSyndromes
Osteoporsis
GERD
Pneumonia
Falls
AlcoholAbuseStroke
Osteoarthritis
Anemia
Family RelatedIssues
Renal Disease
Nutrition Issues For Elderly
System Issues
Dementia
Mental Illness
Obesity
Malnutrition
Nutrition and Quality of Life
Healthy food choices positively influence quality of life of older adults.
Older adults are at risk for inadequate dietary intakes which may lead to:
Poor nutritional statusDecreased quality of lifeFunctional disabilityIncreased health care costsGreater risk for morbidity and
mortality
Factors Affecting Nutrition Status OF ELDERLY
• Declining digestion and absorption• Reduced sensory perception• visual, olfactory, taste acuity, thirst• Anorexia of Aging
(1)Physiological
• Chewing and swallowing difficulty• Affects on body systems : Integumentary (skin),
renal, musculoskeletal, cardiovascular(2)Physical
• Depression• Loneliness• Dementia• Food likes/dislikes
(3)Psychological
• Poverty• Lack of knowledge of nutrition• Inadequate cooking knowledge (men)• Decreased Social support
(4)Social and Economical
• Provision of culturally appropriate food and setting are both important(5)Cultural
beliefs
PHYSIOLOGICAL CHANGES ASSOSCIATED WITH AGEING
System Affected Physiological Change
Body Structure A decline in bone density can cause fractures and result in a period of decreased physical activity and social interaction.
GI tract Older adults have an increased risk of GERD, which can affect swallowing and foods consumed. It might impair digestion and absorption.
Mouth Missing teeth and deterioration of gums can affect chewing and swallowing and can reduce food intake.
Neurologic Decline in cognition, steadiness, reactions, and coordination can decline, potentially affecting food and beverage intake.
Sensory changes Taste perception (dysgeusia) or smell perception (hyposmia) may be altered with aging and/or chronic disease.
Nutritional deficiencies in elderly
Nutritional deficiency in
elderly is multi-
nutrient deficiency.
Inadequate intakes of
macro nutrients such as energy and
protein as well as of
micro nutrients.
Both intakes &
plasma levels of a wide range of vitamins
and minerals
are lower.
Micro nutrients such as
vitamin E, C,B6 ,Se and
Zn were reported to
be below two-thirds of
recomme-nded levels.
EFFECT OF AGEING ON NUTRITION
Submitted to – Dr Harpreet Kaur