Chapter 6 Nutrition Assessment of Older Adults

TABLE 6.9 Diseases and Drugs That Alter Olfaction and Taste Olfaction

Central nervous system

Alzheimer’s disease Head trauma Multiple sclerosis Neoplasia Parkinson’s disease

Endocrine

Diabetes mellitus Hypothyroidism

Adrenocortical insufficiency Kallmann syndrome

Systemic diseases Nutritional Local infections

Cirrhosis of liver Renal failure

Vitamin B-12 deficiency

Influenza Allergic rhinitis Sinusitis Sjögren’s syndrome Dental problems

Iatrogenic Drugs

Laryngectomy Opiates

Streptomycin Diltiazem

85

Taste

Head trauma Multiple sclerosis Bell’s palsy

Diabetes mellitus Hypothyroidism

Adrenocortical insufficiency Panhypopituitarism

Cirrhosis of liver Renal failure Cancer

Zinc deficiency Niacin deficiency

Influenza Glossitis Sjögren’s syndrome

Radiation therapy

Antihistamines Allopurinol Metronidazole Amiloride

Captopril/enalapril Nifedipine/diltiazem Carbamazepine Lithium Phenytoin Metformin

Source: Reprinted with permission from Morley JE, Thomas DR, Wilson MM; Council for Nutritional Clinical Strategies in Long-Term Care. Appetite and orexigenic drugs. Ann Long-Term Care. 2001;9(suppl):6. http://www.annalsoflongtermcare.com/ attachments/1057151324-Orexigenic.pdf. Accessed September 9, 2015.

may be a variety of diseases and drugs that alter taste (see Table 6.9) (56).

Skin

The older adult’s skin should be observed for signs of dehydration, edema, and ascites, which may indicate protein deficiency, renal disease, or hepatic disease. All have potential nutritional significance. Loose skin may be evidence of weight loss; the interviewer should question the older adult about his or her usual weight. Make a visual scan for dry, flaky skin; for skin

that tents, which can indicate dehydration; or for a nonhealing wound, purpura, or bruise. As a person ages, dramatic changes in the skin occur. Sweat glands diminish in number. There is atrophy and thinning of the epithelial and fatty layers of tissue. Both collagen and elastic components of the dermis undergo degen- erative changes. Collagen content of the skin decreases about 1% throughout adult life. The result is thin, dry, and inelastic skin (57). The loss of subcuta- neous fat in older clients results in frequent complaints of being cold. Refer to Table 6.8 (see pages 98–100)