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Overview1
The U.S. population of older adults2 is predicted to grow rapidly as
baby boomers (those born between 1946 and 1964) begin to reach 65 years
of age. Simultaneously, advancements in medical care and improved aware-
ness of healthy lifestyles have led to longer life expectancies. The Census
Bureau projects that the population of Americans 65 years of age and older
will rise from approximately 40 million in 2010 to 55 million in 2020, a
36 percent increase (AoA, 2010). Furthermore, older adults are choosing
to live independently in the community setting rather than residing in an
institutional environment. This increase in the older population will result
in a surge in the demand for delivery of services and create new challenges
for older people, their caregivers, and nutrition and social services profes-
sionals who seek to ensure the availability of services to this population.
The types of services needed by this population are shifting due to
changes in their health issues. Older adults have historically been viewed
as underweight and frail; however, over the past decade there has been an
increase in the number of obese older persons. Obesity in older adults is
not only associated with medical comorbidities such as diabetes; it is also
1 The planning committee’s role was limited to planning the workshop, and the workshop
summary has been prepared by the workshop rapporteurs as a factual summary of what
occurred at the workshop. Statements, recommendations, and opinions expressed are those
of individual presenters and participants, and are not necessarily endorsed or verified by the
Institute of Medicine, and they should not be construed as reflecting any group consensus.
2 According to the World Health Organization, “most developed world countries have
accepted the chronological age of 65 years as a definition of . . . older person.” http://www.
who.int/healthinfo/survey/ageingdefnolder/en/index.html.
1
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2 NUTRITION AND HEALTHY AGING
a major risk factor for functional decline and homebound status (Jensen et
al., 2006). The baby boomers have a greater prevalence of obesity than any
of their historic counterparts, and projections forecast an aging population
with even greater chronic disease burden and disability.
Nutrition is a key component to promoting healthy and functional liv-
ing among older adults. The 2000 Institute of Medicine (IOM) report The
Role of Nutrition in Maintaining Health in the Nation’s Elderly: Evaluating
Coverage of Nutrition Services for the Medicare Population highlighted
priorities for enhanced coverage and coordination of nutrition services
in the community setting. Little progress has been made toward meeting
those priorities during the decade since the report was published. Nutrition
services are fragmented and poorly integrated with other services. In addi-
tion, coverage and reimbursement continue to have serious limitations, thus
increasing the possibility that older adults requiring nutrition services will
fall through gaps in this tenuous service net.
In light of the increasing numbers of older adults choosing to live
independently rather than in nursing homes, and the important role nutri-
tion can play in healthy aging, the IOM convened a public workshop to
illuminate issues related to community-based delivery of nutrition services
for older adults and to identify nutrition interventions and model programs
which promote (1) successful transitions from acute, subacute, and chronic
care to home and (2) health and independent living in the community, as
well as to highlight needed research priorities. It is envisioned that the
workshop will improve awareness and understanding of technical and
policy issues related to nutrition needs of older adults in community set-
tings by fostering increased dialogue among health, nutrition, and social
services policy makers and researchers. This foundation will facilitate better
informed and more effective plans and decisions by government and non-
government policy makers, implementing agencies, and others informed by
the workshop and this summary.
The workshop, sponsored by the Department of Health and Human
Services Administration on Aging, the National Institutes of Health Division
of Nutrition Research Coordination and Office of Dietary Supplements, the
Meals On Wheels Association of America, the Meals On Wheels Research
Foundation, and Abbott Nutrition, was held on October 5–6, 2011, in
Washington, DC. The workshop agenda appears in Appendix A. The IOM-
appointed workshop planning committee was chaired by Dr. Gordon L.
Jensen of The Pennsylvania State University, who also served as the overall
moderator for the workshop. Each member of the planning committee, listed
in the front matter of this report, contributed to the substance of the agenda
and moderated the presentations and discussions for the five sessions.
This report is a summary of the presentations and discussions prepared
from the workshop transcript and slides. The report is organized accord-
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3
OVERVIEW
ing to the chronological order of the proceedings. Chapter 1 provides an
introduction; a summary of the keynote address on the demographics of the
aging population and resources available to them; and a case study of an
older adult who, with the assistance of nutrition and other services, transi-
tioned from acute care to his home. Chapter 2 examines nutrition-related
issues of concern experienced by older adults in the community including
nutrition screening, food insecurity, sarcopenic obesity, dietary patterns
for older adults, and economic issues. Chapter 3 explores transitional care
as individuals move from acute, subacute, or chronic care settings to the
community, and Chapter 4 provides models of transitional care in the com-
munity. Chapter 5 provides examples of successful intervention models in
the community setting, and Chapter 6 covers the discussion of research gaps
in knowledge about nutrition interventions and services for older adults
in the community. This workshop summary highlights issues and presents
recommendations made by individual speakers, but it does not represent
consensus recommendations of the workshop.
Appendixes at the end of the report provide additional information. As
mentioned above, the workshop agenda is reproduced in Appendix A. The
workshop planning committee and speakers’ biographical sketches appear
in Appendix B, the names and affiliations of workshop attendees are com-
piled in Appendix C, and a guide to the acronyms and abbreviations used
throughout the report is provided in Appendix D.
REFERENCES
AoA (Administration on Aging, Department of Health and Human Services). 2010. A Profile
of Older Americans: 2010. http://www.aoa.gov/AoARoot/Aging_StatisticsProfile/2010/
docs/2010profile.pdf (accessed October 18, 2011).
Jensen, G. L., H. J. Silver, M.-A. Roy, E. Callahan, C. Still, and W. Dupont. 2006. Obesity is
a risk factor for reporting homebound status among community-dwelling older persons.
Obesity 14(3):509–517.
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