Dieting is a way of life for many
people. The Boston Medical Center
says an estimated 45 million
Americans go on a diet each year, spending
$33 billion annually on weight loss
products. The fi gures are close to $7 billion
in Canada. However, for one segment
of the population — the elderly —
weight loss can be a sign of something
wrong.
The Mayo Clinic says that malnutrition
is a serious health concern
among seniors. Inadequate nutrition
can result in weight loss that has farreaching
health effects. These include
a compromised immune system, which
increases the risk of infections, poor
wound healing, and muscle weakness
that can result in falls and fractures.
Malnutrition also can lead to further
disinterest in eating, which only
compounds a weight loss problem.
Weight loss and loss of appetite are
common among seniors, particularly
those with dementia. Learning to recognize
COURIER L 32 IFE, SEPT. 20-26, 2019
weight loss signs in the elderly
can help others act promptly to correct
the problem.
According to senior care advocate
and placement center A Place for Mom,
the senior population is at risk of malnourishment
for several reasons, including:
• Lack of energy to cook
• Specifi c health conditions that
impact ability to prepare or acquire
meals
• Lack of appetite attributed to decreased
taste bud function or depression
• Inability to afford quality foods
• Side effects of certain medications
Unfortunately, malnutrition is a
very common, yet widely undiagnosed,
problem among seniors. If a friend or
loved one has visible bones under the
skin, loose dentures, loose rings on
fi ngers, has dropped clothing sizes, or
is leaving food on his plate, he may be
suffering from malnourishment. Concerned
loved ones can
take several steps to determine
if their friend or
family member is malnourished:
Observe loved ones’
eating habits. Routinely
check the refrigerator
and pantry to see which
foods your loved one is
eating. In a nursing home
setting, check with an administrator to
see how mealtimes are going.
Speak with doctors. This will help
you see if the weight loss is a side effect
of medications or another health concern.
Bring up any concerns you have
about malnutrition.
Provide fi nger food for the senior.
Easy-to-manage foods will help
seniors who have lost dexterity still be
able to feed themselves.
Encourage foods that are fortifi
ed with nutrients. Supplementation
with nutritional shakes can help fi ll the
void.
Make meals social events. Making
the concept of gathering around the
table for food fun can encourage your
loved one to eat.
Mild or moderate exercise can
stir up one’s appetite. Walking or
chair-based exercises can help make
people more interested in food.
Introduce new foods that can
whet the appetite.
Weight loss can benefi t some people.
But among the elderly, weight loss may
be a byproduct of malnutrition.
Wellness
When weight loss
may be worrisome
Seniors may need some help with meals to ensure they do
not suffer the effects of malnutrition.
n recent years, much attention
has been focused
on the BRCA1 and BRCA2
gene mutations and their potential
impact on women’s
health. These mutations,
which run in families, affect
the production of tumor-suppressor
proteins involved in
DNA repair that are believed
to help prevent cancer. Such
mutations significantly raise
a woman’s risk of breast and
ovarian cancers.
The chance of developing
breast cancer before
age 70 among BRCA1 and
BRCA2 carriers is 55-65
percent and 45 percent, respectively.
By comparison,
women in the general population,
have about an eight percent
chance. BRCA1 carriers
have up to a 55 percent risk
of developing ovarian cancer
before age 70, compared to
women in the general population
who have less than a two
percent chance of developing
ovarian cancer. Although
BRCA2 carriers are still at
elevated risk for ovarian cancer,
they face somewhat less
risk than BRCA1 carriers.
“Having a BRCA1 or
BRCA2 genetic mutation
does not mean that a woman
has or will necessarily develop
breast or ovarian cancer,”
says Karen David, M.D.,
chief of the division of genetics
at NewYork-Presbyterian
Brooklyn Methodist Hospital.
“But it does mean that
she is at greater risk for it.
Knowing the family history
and having genetic testing
done as recommended, enables
women to make more
informed decisions about
screening and prevention.”
Women who have a personal
or family history of
breast cancer—especially
cancers that developed before
age 50—should consider
being tested to determine
whether they carry one of
the BRCA genetic mutations.
Women who have a personal
or family history of ovarian
cancer at any age should also
consider testing. Men can
also carry the mutations, and
if so, are at increased risk for
developing male breast cancer
and prostate cancer.
People of Ashkenazi Jewish
heritage are more likely
to carry the BRCA1 or BRCA2
mutations and may benefit
from genetic testing. It is estimated
that one in 40 people
of Ashkenazi Jewish descent
carries a BRCA mutation, regardless
of personal or family
history of cancer. That is
at least 10 times the rate of
the general population, and
the likelihood of passing it
on to children is high. Every
child born to a parent with
the mutation has a 50 percent
chance of inheriting it.
The first step in the testing
process is to meet with a
medical geneticist or genetic
counselor, who will determine
whether the test could
be beneficial. If so, a sample
of blood or saliva will be
taken and sent to a laboratory
for evaluation. It may
then take several weeks to receive
results. For women who
fall into high-risk categories,
the testing is usually covered
by insurance.
If results come back positive,
a medical oncologist or
genetic clinician can develop
a course of screening and prevention.
Enhanced screening
for early detection of breast
cancer includes annual breast
MRIs starting at age 25, with
annual mammograms starting
at age 30 and physical examinations
every six to 12
months. Breast cancer risk
can also be reduced through
the use of chemoprevention
drugs, such as tamoxifen and
raloxifene. However, these
drugs do come with side effects
that should be discussed
with a physician. There are
also screening methods for
ovarian cancer, including annual
pelvic exams starting
at age 25, annual transvaginal
ultrasound examinations
starting at age 30 and CA-125
blood testing, which can detect
a protein in the blood that
may be suggestive of cancer.
However, unlike breast cancer,
ovarian cancer is notoriously
difficult to detect in its
early stage, and screening is
not considered to be comprehensive.
National guidelines recommend
that women who
carry the BRCA mutations
have their ovaries and fallopian
tubes removed, as it
significantly reduces the
risk of developing ovarian
and breast cancer. If women
choose to have the procedure,
they should have it
done by age 35-40 or once desired
childbearing is completed.
BRCA mutation carriers
may also choose to get the
breasts removed, as this procedure
substantially reduces
the risk of developing breast
cancer.
A negative BRCA test result
can be a relief, but it is
not a guarantee that a woman
will never develop breast or
ovarian cancer as these cancers
are not always related to
BRCA mutations. It is important
to consult a physician
to develop an appropriate
screening routine.
To schedule a consultation
with a medical geneticist at New-
York-Presbyterian Brooklyn
Methodist Hospital, please call
718.499.2273.