1. Aparatul senzorial

Gustul, mirosul, văzul, auzul, pipăitul, toate se diminuează odată cu trecerea anilor. Afectarea funcției gustative și olfactive debutează în jurul vârstei de 60 de ani și se agravează la persoanele trecute de 70 de ani. Pe lângă neplăcerile iminente – scăderea apetitului, nerecunoașterea mâncărurilor, diminuarea gustului, mirosului – apar și modificări ale proceselor de digestie și metabolism, legate în mod direct de scăderea secrețiilor salivare, gastrice și pancreatice.

2. Gura și dinții

Peste 70% din seniori se plâng de senzația de „gură uscată“ cauzată de reducerea secreției de salivă (hiposalivație), fenomen care poate afecta major capacitatea acestora de a se alimenta. Cariile netratate și paradontoza duc la pierderea definitivă a dinților și la imposibilitatea de a fi consumate alimente greu de mestecat (carne, fructe, legume); acest lucru face posibilă apariția unor carențe de minerale (fier) și vitamine (B și C).

seniori _ foto _ 23. Ochii

Lentilele ochilor sunt foarte sensibile la procesele oxidative ce definesc îmbătrânirea, fapt

care pune cataracta în topul bolilor cu incidență crescută la vârstnici; 50% din persoanele peste 65 de ani suferă de această afecțiune. Zonele opace din cristalin apar prin coagularea progresivă a fibrelor proteice, care sunt transparente în mod normal. Acestea formează o peliculă alb-lăptoasă pe ochi și, netratate, duc la orbire.

Glaucomul este o altă afecțiune întâlnită frecvent la seniori (mai ales dacă au diabetul ca

boală asociată) și constă în creșterea anormală a tensiunii intraoculare cu comprimarea nervului optic și diminuarea vederii.

4. Sistemul osos și muscular

Îmbătrânirea produce schimbări dramatice ale compoziției corporale, cu creșterea cantității de grăsime din organism și reducerea masei musculare.

Mușchii își pierd atât din forță, cât și din volum, 2-3% din masa musculară totală dispărând la fiecare decadă de viață.

Modificarea compoziției corporale cu vârsta

Bărbați: procentul de grăsime crește de la 15% la tineri, la 25% pentru domnii de 60 de ani. Femei: depozitele adipoase cresc de la 18-20% la tinere, la 32% pentru doamnele de 60 de ani.

Aceste schimbări apar ca urmare a diminuării activității fizice și a scăderii producției de testosteron și hormoni de creștere, substanțe cu rol esențial în procesele de metabolism și în dezvoltarea masei musculare. Nivelul total al proteinelor din organism este cu 30-40% mai mic la seniori față de tineri și se traduce prin scăderea cantității de țesut muscular și a capacității de efort. Articulațiile umflate, deformate și dureroase, atât de frecvente la vârstnici, pot fi cauzate de două afecțiuni: osteoartrita și artrita reumatoidă. Cea mai frecventă este osteoartrita, care apare datorită diminuării sacului de lichid cu rol lubrifiant

dintre două terminații osoase; cartilagiile osoase se erodează prin frecare directă, articulația se deformează și doare.

Un alt fenomen care culminează în a treia decadă de viață este osteoporoza. Pe măsură ce

îmbătrânim, densitatea osoasă scade și fragilitatea oaselor crește, sporind implicit riscul de fracturi. Scăderea nivelului hormonilor estrogeni după menopauză, dar și metabolismul defectuos al calciului și vitaminei D la bătrâni, fac din osteoporoză o afecțiune handicapantă, care poate pune viața în pericol.

20% dintre fracturile de șold survenite după vârsta de 70 de ani se soldează cu deces.

5. Funcția digestivă

Aportul, digestia și absorbția principiilor nutritive sunt influențate direct de înaintarea în

vârstă.

  •  Scade producția de enzime și mai ales de lactază, responsabila pentru digestia și absorbția lactozei din lapte și produsele lactate, fapt care determină evitarea acestor alimente din meniul zilnic și, în consecință, crește riscul de osteoporoză.
  •  Metabolismul calciului și al vitaminei D sunt afectate major de: scăderea absorbției calciului din intestinul subțire, dieta săracă în calciu și vitamina D, producția redusă de provitamină D în piele din cauza lipsei expunerii la soare.
  •  Scade sau dispare secreția de acid gastric (hipoclorhidria). Fenomenul apare la aproape 30% din seniori și determină malabsorbție, proliferarea exagerată a florei bacteriene din intestinul subțire, diminuarea absorbției unor nutrienți (în special vitamina B12) și anemie pernicioasă.
  •  Constipația este o altă problemă nelipsită din peisajul senectuții, fiind datorată unui aport insuficient de lichide și fibre alimentare, dar și sedentarismului. Bătrânețea duce la scăderea poftei de mâncare, ceea ce înseamnă mese puține și sărace în nutrienți și diminuarea aportului hidric  – factori determinanți în apariția constipației.

6. Funcția neurologică

Este normal ca odată cu înaintarea în vârstă să apară pierderi ușoare de memorie, însă dacă acestea sunt importante atunci e vorba de boala Alzheimer sau demența senilă. În timp ce la Alzheimer, în afară de factorii genetici nu s-au găsit alte mecanisme declanșatoare, demența senilă presupune pierderea neuronilor, scăderea producției de substanțe cerebrale și a fluxului sangvin spre țesuturile creierului, cu afectarea zonelor responsabile de memorie și recunoaștere.

Maladia Alzheimer se manifestă prin diminuarea capacității de gândire și memorare acompaniată de pierderea abilității de a comunica, de a efectua diferite activități obișnuite, dar și anxietate, depresie, iritabilitate, tulburări de somn, comportament inadecvat. Odată instalată, deteriorarea cerebrală este ireversibilă.

7. Funcția cardiovasculară

Bolile cardiovasculare se situează pe primul loc în rândul afecțiunilor cu risc vital după 50 de ani. Fenomenul de îmbătrânire duce la pierderea elasticității vaselor sangvine, creșterea rezistenței periferice cu suprasolicitarea inimii și apariția hipertensiunii arteriale.

Presiunea sângelui continuă să crească la femei și după 80 de ani, în timp ce la bărbați se ameliorează spectaculos după aceeași vârstă. În mod similar, nivelul colesterolului din sânge atinge un nivel maxim la bărbați la 60 de ani, în timp ce la femei continuă să crească până la 70 de ani. Atât hipertensiunea, cât și dislipidemiile cresc morbiditatea prin boli cardiovasculare și mortalitatea la persoanele în vârstă.

8. Funcția metabolică

Necesarul caloric scade odată cu înaintarea în vârstă prin micșorarea numărului de celule

active din fiecare organ, reducerea activității fizice și schimbarea compoziției corporale – crește cantitatea de grăsime și scade masa musculară.

După 60 de ani fiecare decadă de viață determină o scădere de 8-10% a ratei metabolismului bazal, deci aportul caloric trebuie diminuat corespunzător, dacă nu vreți să apară kilogramele în plus.

Creșterea depozitelor adipoase și în special a cantității de grăsime abdominală predispune la boli cronice precum diabet, hipertensiune arterială, hipercolesterolemie.

9. Funcția renală

Între 30 și 80 de ani funcția renală și rata filtrării glomerulare scade cu 60% din cauza reducerii numărului de nefroni, afectării fluxului sangvin și prezenței bolilor cronice asociate. Starea de hidratare, echilibrul acido- bazic și capacitatea de eliminare a produșilor toxici de metabolism sunt mai greu de controlat și de stabilizat la vârstnici, ceea ce impune un aport adecvat de lichide, proteine și alți nutrienți.

10. Sistemul imunitar

Răspunsul imun este și el afectat de vârstă, la seniori fiind diminuată capacitatea de luptă împotriva bolilor și infecțiilor. Așa se explică, probabil, incidența crescută a cancerului și a altor afecțiuni grave în rândul acestei populații.

11. Factorii psiho-sociali

Depresia este o afecțiune comună în rândul vârstnicilor și poate afecta apetitul, digestia, greutatea, tonusul fizic și psihic, starea de bine.

La senectute depresia este determinată frecvent de pierderea rudelor și a prietenilor, sentimentul de inutilitate, izolarea socială, grijile financiare, imposibilitatea de a-ți purta singur de grijă. Singurătatea duce de multe ori la neglijarea obiceiurilor legate de aprovizionarea, prepararea și consumul alimentelor, adică un fel de abandon culinar. Incapacitatea vârstnicilor de a se deplasa sau bolile care le afectează mobilitatea au drept

urmare limitarea opțiunilor legate de mâncare. Statusul financiar precar poate face imposibilă aloca-rea unui buget satisfăcător, atât în ceea ce privește aportul diversificat de alimente, cât și apelarea la serviciile suplimentare care pot îmbunătăți calitatea vieții.

Nu putem opri timpul în loc, însă durata și calitatea vieții pe care o avem pot fi influențate major de obiceiurile noastre zilnice. Cercetătorii au studiat elementele implicate în procesul de îmbătrânire și au identificat 6 factori de care depinde vârsta biologică.

3 sunt legați de nutriție

  • abstinența de la alcool
  • mesele regulate și echilibrate nutrițional
  • menținerea greutății în limite normale.

3 țin de igiena vieții:

  • somnul odihnitor (minim 7-8 ore/noapte)
  • evitarea fumatului (activ și pasiv)
  • activitatea fizică regulată.

Deși pare simplu de respectat, nu e deloc așa, de aceea în multe cazuri vârsta biologică este mult mai avansată decât vârsta arătată de buletin.

 

*Material extras din cartea “Sănătatea are gust”, Dr. Mihaela Bilic, pag. 30-32

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