Chapter 19: Nutrition and Older Adults: Conditions and Interventions

The material emphasizes how targeted nutritional strategies serve as cost-effective clinical tools that improve health outcomes and reduce hospitalizations in this vulnerable demographic. For cardiovascular disease management, the chapter details patient-centered approaches that incorporate cardio-protective dietary patterns, with particular focus on the DASH diet framework as a mechanism for lowering blood pressure and reducing intake of sodium, saturated fats, and dietary cholesterol. Stroke prevention and recovery are addressed through recognition of associated risk factors including hypertension, diabetes, and sedentary behavior, with specific attention to rehabilitation protocols that may include retraining of swallowing and feeding mechanics. Diabetes management in older adults requires individualized hemoglobin A1c targets that account for age-related functional decline and sensory changes while minimizing hyperglycemic episodes that pose particular risk in this population. The chapter identifies polypharmacy as a significant clinical challenge, explaining how concurrent medication use can suppress appetite, alter taste perception, impair nutrient bioavailability, and complicate therapeutic adherence. Gastrointestinal dysfunction, particularly constipation, is addressed through dietary modifications emphasizing increased fluid consumption and soluble fiber integration, with practical interventions such as structured high-fiber formulations. Cognitive impairment management focuses on preserving nutritional adequacy through provision of nutrient-dense, palatable foods in environments that minimize stimulation and distraction. For patients experiencing frailty or malnutrition, the chapter outlines refeeding protocols that gradually restore energy and protein intake, using medical food supplements strategically to optimize weight recovery and potentially reduce mortality risk in this compromised population.