SGD B 6

Learning Task Day 1: 1. Describe causes of poor food intake and failure to thrive in older adult! Answer: Poor intake dan failure to thrive in older adult caused by 14 impairments: 1. Immobility 2. Instability 3.Penurunan Intelectual 4. Isolation 5. Inkontinence 6. Impotence 7. Immunodeficiency 8. Infection 2. Describe comprehensive clinical assessment of nutritional status in elderly! Answer: Direct Antropometric measurement Measure height and weight BMI measurement 9. Inanitation 10. Impaction 11. Insomnia 12. Iatrogenesis 13. Impecunity 14. Impairment of vision

Biochemical Biophysic

Indirect: Survei konsumsi makanan Angka statistik: angka kematian, angka kesakitan akibat Ekologi : geografis, irigasi, iklim SCALES S : sadness (yesavage Geriatric Depression, skala 15 s/d 30 to determine whether the geriatric depression or not C : cholesterol (<160 mg/dL) A : albumin (<4 gr/dL)

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L : loss of weight (declining of body weight 2 lbs in 1 month or 5 lbs in 6 months) E : eat (problem eating alone cause of physic, ex. Tremor, or problem of cognitive S : stopping (enough money to buy food and ability to get and preparingShopping According to WHO: Disease Impairment Disability Handicap 3. Recommended dietary allowance and tolerable upper limits and selected vitamins and minerals! Answer: Kalori yang dibutuhkan perhari oleh lansia sebagai berikut: -Liquid -Protein - Lipid : 1-2 L/day : 0.8 - 1 g/kg bb

- Karbohidrat : 50-60% total kalori : 20-30% total kalori

4. Describe the pathophisiology of frailty! Answer: According to Dr. Robert Penhall (Australia): Frailty is a health condition that happen because interaction between medical and social problem, and affect the decrease of the respon of the patient to the stress so do the fungsional performance. 5. Describe dietary guidelines for the prevention of chronic disease of WHO! Answer: 1. Makanlah aneka makanan 2. Makanlah sumber karbohidrat kompleks (sereal, umbi) dalam jumlah sesuai dengan aturan 3. Batasi konsumsi lemak dan minyak secara berlebihan

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4. Makanlah sumber zat besi secara cukup, bergantian antara sumber hewan dan nabati, sumber hewani ada pada daging (red meal) dan sumber nabati ada pada semua sayur yang berwarna hijau pekat 5. Minumlah air yang bersih, aman, cukup jumlahnya dan telah dididihkan 6. Kurangi konsumsi makanan, jajanan dan minuman yang tinggi gula murni dan lemak 7. Perbanyak frekuensi konsumsi hewani laut dalam menu harian 8. Gunakanlah garam ber-iodium, namun batasilah penggunaan garam secara berlebihan,atau kurangi konsumsi makanan yang diawetkan atau yang diolah dengan menggunakan banyak garam, penyedap atau pengawet lainnya 9. Perbanyak konsumsi sayur dan buah-buahan berwarna hijau, kuning maupun oranye karena banyak mengandung serat, vitamin C, provitamin A dan vitamin E yang melindungi sel-sel tubuh dari kerusakan yang terjadi secara dini 10. Hindari makanan pedas + bumbu tajam 11. Hindari makanan yang berlemak 12. Bacalah label setiap bahan makanan 13. Latihan/exercise secara teratur

6. Describe effect of weight loss and protein-energy malnutrition on function in the elderly! Answer: Effect weight loss and protein-energy malnutrition on functioning in the elderly are delayed functional recovery, mortality, failure to thrive, sarcopenia, arthrophy, pressure ulcers, anemia, falls, cognitive deficits, osteoponia, altered drug metabolism, euthyroid sick syndrome, decreased maximal breathing capacity, immune deficiency decreased helper T cells increased infection, and dyspepsia. For chronic weight lossOrgan disfunction (joint contracture), can cause immobility For acute weigt loss Pasien get dehidration that cause hypotension and delirium

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7. Describe causes of the physiological anorexia of ageing! Answer: Anorexia of ageing: when glucose tryacylglycerol is infused directly into the duodenum of younger persons, it causes a decrease in hunger and food intake. This effect is probably due predominantly to the release of one or more or gastrointestinal signals because intravenous glucose fails to produce a similar degree of satiety. The cause of anorexia is increase in circulating concentrations of the satiating hormone, cholecystokinin, occurs with aging in humans. This is occurred because of the alteration neuropeptides controlling food intake (appetite and satienty).