Bradley Hilltopics Online

Keys to a long life

By DR. G. KEVIN RANDALL

As members of Bradley's family and consumer sciences department, Dr. Jeannette Davidson and I are engaged in research with older adults. Our work highlights that at the end of the life span, just as at the beginning, good nutrition and a proper mental perspective are critical to maximizing all that life has to offer.

Dr. Davidson, director of Bradley's didactic program in dietetics, and Marjorie Getz, coordinator of the Turning Point retirement project, have investigated nutritional questions related to older adults in the Bradley Health and Aging Study since 1992. Research shows the current obesity crisis in the U.S. starts in childhood and is a challenge throughout the life cycle. However, in adults 80 years and older, malnutrition is sometimes more of a challenge than obesity. In fact, in our Health and Aging study, moderate obesity was associated with a positive quality of life outcome.

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Visit bradley.edu/hilltopics/go/nutrition for more information on the Mini-Nutritional Assessment.

Mini-Nutritional Assessment

I have worked with Dr. Davidson and other colleagues around the country, focusing on psychosocial predictors of successful aging. She and Marjorie found that a substantial number of community-dwelling (private homes or assisted-living facilities, not necessarily nursing homes), older adults were at risk for malnutrition.

Assessment of older adults' nutritional risk is significant, as it is a key marker for increased risk of illness and death. They recommended the Mini-Nutritional Assessment (MNA) as an inexpensive, quick instrument to use in the field. A follow-up study focused on nutrition screening and assessment of older nursing home residents. Nutrition screening was found to be critical for early detection of malnutrition risk and to monitor the effectiveness of nutritional interventions.

Factors such as depression, declining mental status, isolation, lack of funds, and physical disability all play into poor diet quality in many older adults. Maintaining physical activity, being part of a group, using available resources such as congregate meal sites or home-meal delivery services, and social support are problematic in older adults, especially those living in the community, but are critical to maintaining adequate nutrition. Dietitians work with older adults to ensure proper hydration, intake of sufficient calories, and especially when dealing with declining appetites, intake of high-quality proteins. Adequate intake of fruits, vegetables, and whole grains is recommended for all age groups.

Focusing on individuals over the age of 70, the Modified MyPyramid for Older Adults from Tufts University emphasizes nutrient-dense foods and increased fluid intake. (Note the drinking glasses on the second row.) The bottom row shows physical activity such as walking, swimming, and yard work.

Belle Boone Beard, a pioneer gerontologist, wrote in her book, Centenarians: The New Generation, "Ninety years is old, and 100 is news." Centenarians, those who have lived to 100 years and beyond, have survived, on average, 20 years beyond their birth-year peers, and as such are often referred to as "expert survivors." Scientists who study this venerable population report that 20 to 25 percent of centenarians live in community-dwelling situations, are cognitively intact, vibrant, and living life to its fullest. What we all want — added years of life and added life to those years — is what these survivors have achieved. Thus, the challenge is to learn from them about survival, disease, frailty, and independence with the goal that such findings can be used to promote healthy independence for all who hope, as one sage quipped, " … to die young, but as late in life as possible."

As we age, limitations are normal and to be expected; bodies wear out and friends and family members pass on. The critical piece found in research, over and above all others, tends to be our mental health or outlook on life that is typically associated with people. We can't age successfully without close, meaningful, interpersonal relationships that provide the type of support needed at the right time and in the appropriate manner. We need to learn to do well in our relationships, as they constantly change over our lifetime. And with such a key resource in place (i.e., close, supportive relationships), the other resources — adequate and appropriate nutrition, economic resources, and personality strengths — will only maximize our well-being.