The Senior (70+) life stage is characterised by a winding down and slower pace of life for many individuals. It can be a time of great fulfilment, spending time with loved ones and having more time to pursue life long passions. However, this can also be a life stage where there is an increased risk of chronic illness and related disability, and memory loss, as demonstrated in dementia, as well as loneliness. Read on for more information on key risk factors, as well as nutrition and life style interventions which may be supportive during this stage.
Risk Factors
Genetic Factors
Some individuals may be more at risk of developing memory loss and cognitive impairment. The APOE4 gene variation has been one of the most studied genetic risk factors with relation to Alzheimer’s disease. Telomeres are the protective ends of chromosomes, which protect the integrity of genes (think of the caps at the end of a shoe lace, and how these hold the lace together). Notably, telomeres have been observed to be shorter in individuals with the APOE4 gene variant. Telomeres shorten across the life span, to an extent as part of the natural ageing process, although length is a marker generally of biological age rather than chronological age. Shortening of telomere length is accelerated as a result of oxidative stress. Oxidative stress is a state that occurs as a result of an imbalance between free radicals in the body and antioxidant defences, due to chronic stress, alcohol over consumption, drug abuse and poor diet. Once telomere length has shortened to a certain point – known as the Hayflick limit– cells begin to deteriorate and age, including brain cells. This may be a key consideration for Alzheimer’s disease, although further research is required as research to date has shown mixed results in terms of the role of telomere length in Alzheimer’s disease.
Gut Health
The gut is essential for good health, due to its role in absorbing and transporting nutrients, as well as its communications with other organs, such as the brain (known as the gut brain axis). Balance of gut bacteria may be affected, as beneficial bacteria in the gut can decrease as a result of poor diet and antibiotics usage, alcohol over consumption, sensitivity to gluten. This results in reduced synthesis on brain chemicals – called neurotransmitters – which are synthesised by beneficial bacteria strains and involved in mood, sleep and cognition. When the balance of gut bacteria is imbalanced, inflammation is increased in the gut and also in the brain, via the gut-brain axis.
Obesity and Type II Diabetes
In the UK, 78% of men and 71% of women between 70-74 years of age are overweight or obese. Individuals who are overweight or obese have an increased risk of insulin resistance, a key factor in Type II diabetes, and also leptin resistance. Leptin is a hormone which regulates food intake and also levels of the excitatory neurotransmitter, glutamate, in the brain. Leptin resistance and increased levels of neurotransmitter glutamate have been observed as playing a significant role in cognitive decline and Alzheimer’s disease development. Moreover, insulin resistance and blood sugar instability, as in Type II diabetes, has also been observed as being a risk factor and driver of Alzheimer’s disease, due to alterations in areas of the brain, which are involved in memory and cognition.
Cholesterol
Cholesterol levels have been suggested to be an important consideration for Alzheimer’s disease. High cholesterol has been indicated to increase accumulation of beta amyloid plaques in the brain, a key fature and driver of Alzheimer’s disease.
Homocysteine
Homocysteine levels have been indicated to be a key risk factor for cognitive decline and neurological disorders such as Alzheimer’s disease and Parkinson’s disease. Homocysteine levels may be higher in seniors generally due to micronutrient deficiency of B vitamins, which are required for its metabolism. Furthermore, in postmenopausal women are at high risk of having high homocysteine levels, due to reductions in oestrogen following menopause.
Micronutrient Deficiency
Older adults are at increased risk of micronutrient deficiencies, most notably vitamin D, B1, B2, Calcium, Magnesium and Selenium, which may occur for a variety of reasons., including:
poor or limited diet, due to dependence on ready meals, financial constraints or food culture of care facility or hospital
Vitamin B12 deficiency is more common in seniors due to increased malabsorbtion of B12 and higher risk of pernicious anaemia.
Other Lifestyle Risk Factors
Sleep Deprivation
Sleep disruption has been identified as a risk factor for, and characteristic of, cognitive decline. Beta amyloid, a marker associated with Alzheimer’s disease, is cleared by a specific system in the brain, called the glymphatic system, which operates during sleep. Individuals with disrupted sleep have been suggested to be at a higher risk of cognitive decline and Alzheimer’s disease. Moreover, individuals who have been diagnosed with dementia have been observed to commonly present with sleep disturbances.
Loneliness
Loneliness is associated with impaired cognition and poor psychological and physical health. Research has additionally demonstrated that the effects of loneliness with relation to negative health outcomes and premature death are comparable to those associated with obesity and smoking. In a Dutch study, individuals who reported not experiencing belonging were more likely to be socially isolated and internalise their feelings and problems. Elderly individuals are at increased risk of experiencing loneliness if they are living alone or living in care homes, or carers to a significant other.
Nutritional Strategies
Paleo Diet
Research has indicated that a diet that is higher in fats and protein, known as a paleo diet, including a wide array of colourful vegetables and fruits and lower levels of refined carbohydrates and processed foods may be beneficial for supporting brain health. Omega 3 fats, as found in oily fish, walnuts and flaxseeds, may increase the presence of beneficial bacteria, and may help to support a healthy gut and reduce inflammation. Some research has also suggested that omega 3 may also be protective against cognitive decline. Extra virgin olive oil consumption has been associated with improved memory and cognitive scores and reduced incidence of mild cognitive decline. Consuming more protein may help to prevent loss of muscle mass, whilst supporting energy levels and weight management. Furthermore, increasing protein intake may also help to support memory and learning in senior adults. Moreover, recent research has indicated that consuming 10 x 80g (800g) portions of vegetables and fruits daily has been associated with a reduced risk of all cause mortality and chronic disease development.
Below some nutritional strategies are presented to provide a practical means of putting the above into practice:
Increase healthy fats: consume more oily fish, olive oil, avocados, nuts and seeds.
Increase quality sources of protein: consume more lean meats, fish, beans, legumes, pulses, nuts, and seeds.
Increase vegetables and fruit intake to 10 x 80g (800g) per day: Consume a wide array of colourful vegetables and fruits, adding them to smoothies, salads, curries, stews, pasta sauces and as accompaniments to oily fish, turkey, chicken and nut roasts.
Lifestyle Considerations
Increase Sleep Duration of 7-8 Hours
7-8 hours has been suggested as the optimal sleep duration for older adults. However, it should be noted that there research has suggested there is some genetic variations which may impact on an individual’s optimal sleep duration time.
Increase Social Interaction
Social interaction appears to become incrementally more important for health and well being with age. Elderly people have been demonstrated to report improved self esteem and health and wellbeing outcomes when experiencing belonging in friendships, compared to those who reported loneliness and isolation. Findings ways during this life stage to increase social interaction, via meeting up with friends for coffee, to do activities or take up a new hobby, are all ways to increase social interaction.
