Healthy Hearts through the Golden Years

Recognizing American Heart Month in February

Maria Pannucci, MA, RD, LDN
Clinical Nutrition Manager: Gracedale Nursing Home

Every February Americans recognize American Heart Month, which continues to emphasize the importance of taking care of cardiac health through eating right, keeping active, smoking cessation, and managing stress. Along with diet management and heart health, a recent emphasis on plant-based diets has forged its way to the forefront, further popularized by the surge of plant-based products and meat substitutes.

Technology has positively impacted children and young adults with the advent of virtual games, where children can participate in sports games, dance classes, or other activities in the safety of their home. Adults are encouraged to combat a sedentary lifestyle with virtual exercise classes, apps to track diet and exercise, and often use social media to gain support and encouragement on their path to fitness. But what are the unique challenges seniors face in efforts to maintain cardiac health, and can maintaining cardiac health positively impact cognitive function associated with aging?

Senior Health: Cardiovascular and Cognitive Concerns

Heart Disease remains the number one cause of death in the United States, and continues to be a major threat to seniors, both male and female. Hypertension, Congestive Heart Failure, Coronary Artery Disease, and Myocardial Infarction increase in prevalence as the cardiovascular system ages. Johns Hopkins cardiologist Seth Martin, M.D., M.H.S. (2021) notes, “There is increasing evidence connecting cardiovascular risk factors with brain health” (Johns Hopkins Medicine).

While common, memory decline cannot solely be attributed to aging. Factors such as genetics, lifestyle, utilization of decision-making skills, and socialization are also attributed to maintaining memory and cognition. One particular study conducted at the Heart Institute (InCor), Faculty of Medicine, University of São Paulo, SP, Brazil, found positive correlations between poor heart health (in particular, elevated lipids) with memory impairment (Tsuchihashi Takeda et al., 2017).

In particular, nutrition and lifestyle are continually flaunted as leading preventative measures in preservation of health. This further highlights the importance of maintaining a healthy diet and lifestyle in order to preserve both cardiac and cognitive function though the lifespan.

Nutrition and Dementia

Though all Americans are charged with maintaining their heart health, seniors have the added concern of cognitive decline – ranging from mild memory impairment to a diagnosis of Dementia. Too many food choices, difficulty using utensils or feeding self, and forgetting meals are among some of the challenges facing many seniors. Proper nutrition to address heart health and to support cognitive impairment relies on properly trained staff, thoughtfully crafted menus integrating therapeutic hospitality principles, and education for residents and their families.

Some helpful tips for mealtimes and eating:

• Heart-healthy menus can support dementia care with high-quality handheld items, modified for the residents’ level of acuity.
• Healthy snacks keep hunger at bay and support maintaining healthy habits during mealtime, especially when intake at meals is low.
• Limit distractions at meals and encourage intakes with visual and verbal cueing. Independence can be encouraged by demonstrating how to feed self and allowing them to mimic the action.
• Allow plenty of time to eat and be flexible to food preferences. Previously favorite foods may be rejected, and new preferences may be requested.
• Simplify the dining experience. Serve only one or two foods at a time, keep the table clear of clutter, and decrease visual and audio stimulation where possible.

 

Sodexo’s Solution

According to Lori Stevic-Rust, Ph.D., ABPP (2020), “A person with dementia needs an environment that is easy to navigate and makes sense to them” (p.9). In senior living, ideal care relies on person-centered interactions, with trained staff that connect with residents and leverage the dining environment as a therapeutic tool. For example, seniors with cognitive impairment respond well to visual cues, with contrasting plates and table-scapes that sympathetically support dignity.

Often therapeutic barriers prevent ideal care, so trained staff can address these barriers and incorporate dementia treatment knowledge into meal service. Dr. Stevic-Rust recommends dementia care training for staff to support nutrition and other areas of care. She believes in holistic approaches to dementia care, emphasizing the integration of the mind, body, and essence of the person. Dining service that supports cognition along with the various services within a community should integrate to serve those with dementia.

Fueling the Heart

As a reminder, general guidelines to follow a heart healthy diet include:

• Eating a balanced diet with whole grains, fruits and vegetables, and lean protein sources.
• Achieving and maintaining a healthy weight. Physical activity of 30-60 minutes a day, 3-5 days a week is recommended.
• Choosing heart-healthy unsaturated fats. Limit saturated fats, trans fats, and cholesterol intake.
• Eating more plant-based or vegetarian meals, using beans and soy foods for protein.
• Eating whole, unprocessed foods to limit the amount of sodium consumed.
• Limiting refined carbohydrates, especially sugar, sweets and sugar-sweetened beverages.
• Drinking alcohol in moderation: one serving per day (women) and two servings per day (men). One serving is equivalent to 12 ounces beer, 5 ounces wine, or 1.5 ounces distilled spirits

What we do today impacts our tomorrow. And, while it is never too late to start living a healthier lifestyle, it is beneficial to develop healthy habits early. Seniors that maintain a healthy lifestyle or modify less desirable habits are more likely to reap the benefits of a strong heart and sharp mind well into their golden years.

 

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References

• Alzheimer’s Association. (2021). Food and eating.
• Martin, S. (2021). Dementia and heart health: Are they related? Johns Hopkins Medicine.
• Sodexo (2020). Integrated dining and therapeutic hospitality. 2020 Mar 24.
• Tsuchihashi Takeda, et al. (2017). Cardiovascular risk factors and cognitive performance in aging. Dement Neuropsychol. 2017 Oct-Dec; 11(4): 442–448. doi: 10.1590/1980-57642016dn11-040015