Author
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McCabe Sellers, Beverly |
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JOHNSTON, RUTH - AR VETERANS HEA SYS,UAMS |
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Submitted to: Book Chapter
Publication Type: Book / Chapter Publication Acceptance Date: 2/1/2005 Publication Date: 4/17/2006 Citation: McCabe Sellers, B.J., Johnston, R. 2006. Health promotion and disease prevention in the elderly. In: Chernoff, R., editor. Geriatric Nutrition: The Health Professional's Handbook. 3rd Edition. Sudbury, MA:Jones and Bartlett, Inc. p. 519-557. Interpretive Summary: Providing disease prevention and health promotion advice to older people presents a new challenge for health professionals. Recent research has begun to document the benefits of smoking cessation, diet modification, increased exercise (even in frail elderly), and limited intake of alcohol and drugs for older adults as well as younger adults. Health promotion strategies can improve function as well as reduce the risk of morbidity and premature death. Greater consideration of quality of life and lifestyle factors are important to nutritionists providing optimal nutrition care to older adults. For those over age 50, health promotion is less about preventing the symptoms of disease and more about preserving function and maintaining independence, productivity, and personal fulfillment. Reasons for geriatric health promotion and disease prevention include the following: Aging is a lifelong phenomenon consisting of physiological, psychological, and behavioral processes; aging occurs at different rates in different people, thus biological age may not be equal to chronological age; and most disabilities of old age are not inevitable, universal, or irreversible. Effective health promotion and disease prevention messages should be directed toward all older people when knowledge justifies such recommendations. Additional guidance and health interventions should be based on individual assessments of health status for those identified as being at high risk for disease or disability. A geriatric assessment should be included as a regular part of health monitoring of older people in addition to chronic disease screening. Nutrition screening and intervention can and should be a major part of any geriatric assessment. Technical Abstract: This book chapter provides an extensive review of the literature on the role of nutrition in health promotion and disease prevention in the elderly. Since 30% of each Medicare dollar is spent on end-of-life care, the promotion of health among this age group grows increasingly important in the American economy as the population grows increasingly older. Health promotion has shifted from a primary focus on the individual to a primary focus on the community, and from the expert biomedical model to the global health movement with the public or patient participation as central to health care. The promotion of health in older adults represents the best cost-benefit ratio. The Dietary Guidelines for Americans, National Cancer Institute Guidelines, Nutrition Screening Initiative, and the Dietary Reference Intakes all provide recommendations that can positively affect nutritionally responsive diseases such as hypertension, heart disease, diabetes, and obesity. The decline in the rate of morbidity and mortality from heart disease in older adults has been sharper than in other age groups. Hypertension remains a substantial problem, especially in African Americans and Hispanic elderly. Cancer and osteoporosis prevention and treatment represent significant investments for a longer and higher quality of life. Food safety issues are much greater among the elderly as among the very young due to their greater vulnerability to foodborne illnesses. Evidence is mounting that an active exercise program for older adults is highly beneficial, even among the frail elderly. Prevention of disability and falls represents very large quality of life and health care cost benefits. Successful aging means not only a longer life but also a longer productive and independent life. |
