Roundup Record Tribune & Winnett Times -

By David Christianson, MD

Studies indicate that up to 70% of older adults hospitalized for acute care are at nutritional risk or are malnourished. Involuntary weight loss and malnutrition is associated with increased mortality.

Conditions associated with involuntary weight loss and malnutrition include depression, social isolation, finances, malignancy, new onset diabetes, thyroid disorders, gastrointestinal diseases, COPD, medication side effects, dental problems, neurologic problems including dementia, alcohol dependence, and nutritional deficiencies.

Nutritional deficiencies occur with increased frequency in older adults. B12 deficiency exists in up to 15% of people over the age of 65. People with low or low normal serum B12 levels may also benefit from further evaluation with serum methylmalonic acid and homocysteine testing, which if elevated may indicate B12 deficiency. B12 deficiency can result in anemia, weakness, neuropathy, gait disturbances, cognitive impairments, and mood impairments.

Inadequate calcium and vitamin D is associated with osteoporosis. In the United States 10 million people have osteoporosis and up to 1.5 million a year experience fractures secondary to osteoporosis. People over the age of 60 do not absorb as much calcium from their GI tract as younger adults. Some authorities recommend 1200 mg of calcium daily for people over the age of 51. Vitamin D deficiency is also associated with muscle weakness, depression, increased risk for falls.

An active lifestyle and exercise are associated with health benefits. An individualized exercise plan can be developed to accommodate underlying medical problems. Exercise programs should generally incorporate a combination of strengthening, flexibility, aerobic, and balance activities. When developing an exercise program, focus on what you can do, not what you cannot do, then try to advance from there. Benefits of exercise include increased strength, aerobic capacity, flexibility, and mobility. Exercise is also associated with reduction in blood pressure, improvement in lipid profile, treatment and possibly prevention of type 2 diabetes, and improvement in cardiovascular health.

A healthy diet, active lifestyle, and regular exercise can promote better health for people of all ages, and especially as people age.