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Chapter 28. Nutrition and Physical Activity

Connie Watkins Bales, Ph.D., R.D.; Martha Elizabeth Payne, Ph.D., R.D., M.P.H.
DOI: 10.1176/appi.books.9781585623754.397375

Sections

Excerpt

The attainment of 65 years or more of living carries with it all the positive attributes (such as apparent resistance to early mortality) and negative consequences (including the effects of a lifetime of environmental exposures and health insults) of being an older adult. However, the quality and quantity of life from age 65 years onward remains very responsive to the impact of lifestyle factors, particularly the type of dietary and physical activity patterns maintained. In fact, with the onslaught of age-related decrements in physiological function and the concomitant onset of the chronic diseases of aging, it could be argued that this period in the life cycle offers one of the most important opportunities for lifestyle interventions to make a difference in health-related quality of life (Wellman 2007). This chapter provides a detailed discussion of the complex interactions of diet and physical activity with mental health and treatments for mental health disorders. In addition, the last section of this chapter provides a thorough discussion of assessment techniques and clinical guidelines for both nutrition and physical activity in the elderly.

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FIGURE 28–1. Determinants of quality of life in the elderly.Lifestyle factors including diet and physical activity are critical determinants of not only physical health but also mental health of older adults. Together, these components determine quality of life and the success of aging.

FIGURE 28–2. Example of a cascading problem.Excess food intake can lead to overweight and obesity that in turn can lead to physical impairment (e.g., mobility problems). Physical impairment may then promote psychiatric symptoms and even depression. To exacerbate the cycle, depression itself may lead to detrimental changes in dietary intake and physical fitness.

FIGURE 28–3. A dietary mechanism for late-life depression.Diet may promote (or prevent) depression by influencing one's risk of vascular diseases, including atherosclerosis and diabetes. These vascular diseases are known to promote late-life depression. In addition, diet may directly promote (or prevent) depression by altering neuronal health or neurotransmitter levels. Potential moderators of both pathways include ischemic brain lesions and inflammation.
Table Reference Number
Table 28–1. Dietary Reference Intakes for adults ages 51 years and older
Table Reference Number
Table 28–2. Dietary Reference Intakes for adults ages 51 years and older

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[PubMed]
 
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CME Activity

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Sample questions:
1.
Adherence to the Mediterranean diet has been associated with a reduced risk for cognitive decline. Which of the following is a component of the Mediterranean diet?
2.
There are three major components of nutritional assessment: dietary, biochemical, and clinical. The most commonly used biochemical assessment is for one or more markers of protein status. Which of the following markers has a very short half-life of 2–4 hours and a relatively small body pool, making it very sensitive to nutritional changes?
3.
Although most nutritional experts recommend that all older adults take a multivitamin/mineral supplement, specific nutrients have been associated with adverse outcomes. Excessive intake of which of the following nutrients can interfere with copper status and impair immune function?
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
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PubMed Articles
Adverse outcomes of frailty in the elderly: the Rotterdam Study. Eur J Epidemiol 2014;29(6):419-27.doi:10.1007/s10654-014-9924-1.
 
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