Two inevitable consequences of getting older include changes in mental and physical function. Both of these changes contribute to an increased risk of falling. Consequently, the fear of falling naturally increases with age in most people. Many age-related changes contribute to an increased risk of falling, including decreased muscle strength, declining reflexes, vision limitations, mental challenges such as depression, and poor medication management — to mention a few.
Although many know that good nutrition is beneficial to long-term health, it is not always appreciated how much poor nutrition contributes to common changes that occur in aging. To a large extent, good nutrition status can prevent or at least slow down changes considered to be part of the natural progression of aging.
Inadequate consumption of certain nutrients can affect both mental and physical function. This functional decline can result from poor maintenance of muscle and nerves (including the brain), and things as basic as adequate blood volume — all of which increase the risk of falls.
Question: What key nutrients are needed to maintain good mental function?
Answer: In reality, an adequate intake of all essential nutrients is the key. However, there are some nutrient deficiencies that are more likely to cause problems than others. For example something as basic as not meeting protein needs can compromise multiple body functions. One effect can be a drop in blood volume, which can decrease blood flow to the brain, making basic mental function challenging and make falling more likely.
Add to this a low intake of folate and vitamins B12, B6 and C, along with a low iron and copper status, and mental decline is virtually assured. Other things that help to maintain a healthy blood volume include adequate water consumption along with adequate sodium and potassium. Yes, even sodium intake can get too low. It is an essential nutrient. Blood pressure also can get too low (or too high) at times in response to some of these deficiencies. When blood pressure drops too low, brain function can be compromised by limited blood flow and nutrient delivery to the brain.
Long-term vitamin B12 deficiency that develops gradually but insidiously in many older people can damage nerve function throughout the body, including the brain. Changes in brain function from B12 deficiency can mimic early Alzheimer’s disease and can get misdiagnosed as Alzheimer’s in some cases. Fortunately, B12 supplementation has little or no risk of toxicity, unlike some other nutrients.
Q: What nutrients are important for maintaining muscle strength and function?
A: As with other parts of the body, all nutrients are important, but the most central nutrient is protein. There is growing evidence that protein requirements increase after age 50 or 60 in most people. Consequently, getting an adequate amount of high-quality protein becomes more important with aging. Of course, muscle is a "use it or lose it" part of the body. Consequently, physical activity works hand in hand with adequate protein intake to maintain muscle. Another nutrient commonly low in older people and associated with compromised muscle function and increased falling risk is vitamin D. Fortunately, testing vitamin D status has become more routine.
Remember, greater dietary variety generally translates into greater essential nutrients and better health.
Alan Titchenal, Ph.D., C.N.S., and Joannie Dobbs, Ph.D., C.N.S., are nutritionists in the Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawaii-Manoa. Dobbs also works with University Health Services.