CLINICAL DIETETICS
CONTENTS I TRENDS IN NUTRITION AND HEALTH IN OLDER ADULTS 1 GLOBAL GRAYING AND NUTRITIONAL TRENDS IN THE NEW MILLENNIUM A CROSS CULTURAL PERSPECTIVE 3 2 CREATING A CONTINUUM OF NUTRITION SERVICES FOR THE OLDER POPULATION 23 3 THE PROGRESSION FROM PHYSIOLOGICAL AGING TO DISEASE THE IMPACT OF NUTRITION 49 4 THE STATUS OF NUTRITION IN OLDER ADULTS A EUROPEAN PERSPECTIVE 63 II FUNDAMENTALS OF GERIATRIC NUTRITION 5 NUTRITIONAL ASSESSMENT AND SUPPORT IN CHRONIC DISEASE MANAGEMENT 77 6 COMMON NUTRIENT DEFICIENCIES IN OLDER ADULTS 103 7 DIETARY SUPPLEMENTS FOR HEALTH MAINTENANCE AND RISK FACTOR REDUCTION 127 III GERIATRIC SYNDROMES NUTRITIONAL CONSEQUENCES AND POTENTIAL OPPORTUNITIES 8 NUTRITION AND THE AGING EYE 193 9 LOSS OF TASTE SMELL AND OTHER SENSES WITH AGE EFFECTS OF MEDICATION 211 10 HEARING LOSS AND NUTRITION IN OLDER ADULTS 291 11 SARCOPENIA AND NUTRITIONAL FRAILTY DIAGNOSIS AND INTERVENTION 309 12 THE RELATIONSHIP OF NUTRITION AND PRESSURE ULCERS 335 TRENDS IN NUTRITION AND HEALTH IN OLDER ADULTS I 1 GLOBAL GRAYING AND NUTRITIONAL TRENDS IN THE NEW MILLENNIUM 1 1 INTRODUCTION WHY ARE WE LEADING OFF THIS BOOK ON CLINICAL NUTRITION AND AGING DISCUSSING GLOBAL GRAYING IT IS BECAUSE WE RECOGNIZE THAT THE POPULATION OF THE WORLD IS CHANGING IN A WAY THAT WILL DRAMATICALLY ALTER HEALTH CARE AND THEREFORE NUTRITIONAL CARE IN THE NEAR FUTURE DURING THE FIRST HALF OF THE 21ST CENTURY THE PROPORTION OF THE POPULATION THAT IS OLDER OR ELDERLY 65 YR AND UP WILL REACH AN ALL TIME HIGH THIS DEMOGRAPHIC SHIFT TOWARD AN OLDER POPULATION WILL INEVITABLY CREATE A GREATER DEMAND FOR HEALTH CARE SERVICES CALLING OUR ATTENTION TO THE APPLICATION OF NUTRITIONAL PREVENTION AND INTERVENTION AS ILLUSTRATED IN SUBSEQUENT CHAPTERS OF THIS VOLUME HEALTH PROBLEMS THAT ARE NOT THWARTED BY PRIMARY PREVENTION STRATEGIES MAY EVENTUALLY PRESENT THEMSELVES AS DISEASES AND DISORDERS THAT REQUIRE NUTRITIONAL INTERVENTION LATER IN LIFE THE PRESENT DAY WORLD FACES POPULATION AGE SHIFTS TOWARD GRAY THAT ARE COMPLETELY UNPRECEDENTED IN TERMS OF HEALTH CARE POLICY THERE IS NO MODEL TO FOLLOW OR PREVIOUS EXPERIENCE TO SERVE AS A GUIDE IN FACT IT IS EVIDENT THAT THE MODERN HEALTH CARE SYSTEM WILL EXPERIENCE AN INCREASE IN DEMAND THAT COULD EXCEED ITS CAPACITY UNLESS CAREFUL PLANNING FOR THE FUTURE IS IMPLEMENTED THIS BOOK REINFORCES THE OPTIMISTIC VIEW THAT NUTRITIONAL INTERVENTIONS HAVE THE POTENTIAL TO IMPROVE HEALTH CARE SCENARIOS FOR THE ELDERLY NOT ONLY WHEN IMPLEMENTED AT AN EARLY STAGE BUT ALSO WHEN APPLIED DURING MORE ADVANCED ILLNESS SECONDARY AND TERTIARY PREVENTION AND INTERVENTION SEE TABLE 1 WHEN OPTIMALLY IMPLE MENTED THESE INTERVENTIONS COULD REDUCE HEALTH CARE NEEDS AND COSTS AND ENHANCE THE QUALITY OF LIFE 1 FOR THE ELDER CITIZENS OF THE WORLD IN THE FOLLOWING SECTIONS DEMOGRAPHIC PROJECTIONS FOR THE FUTURE OF THE WORLD S ELDERLY POPULATION WILL BE BRIEFLY REVIEWED EMPHASIZING SPECIFIC IMPLICATIONS FOR HEALTH AND NUTRITION THE READER IS ALSO REFERRED TO CHAPTER 2 WHICH PROVIDES ADDITIONAL DETAILED INFORMATION ON THE DEMOGRAPHICS OF AGING AS AN ILLUSTRATION OF THE POTENT INTERACTION OF AGING TRENDS WITH NUTRITION AND PUBLIC HEALTH WE THEN EXPLORE THE IMPLICATIONS OF EXPECTED 3