Older adults

Healthy ageing: supporting health behaviors in older adults

Supporting older adults to enjoy a healthy lifestyle

Older adults (>65) may not benefit from weight management, but are likely to benefit from increasing healthy behaviours such as nutrition and physical activity/movement.    

Whilst increasing healthy behaviours may cause weight loss, this is unlikely to increase sarcopenia, which can occur if a true ‘weight loss’ approach is encouraged.[1]

Ask and Assess

  • Measure and assess weight, height and BMI.  Review previous assessments to enable appropriate assessment of healthy weight and weight trend. 
  • Do not take previous given heights, as they are likely to have changed.   
  • Ask about current lifestyle behaviours (fruit and vegetables, sugary drink intake, take away/eating out, tv and screen time, physical activity/movement, sleep routines). 

Advise and Assist

  • Discuss healthy behaviours and chronic disease risk, and medications (if relevant). 
  • Use a non-judgmental, sensitive manner. 
  • Empower and encourage older adults to make healthy lifestyle changes. Provide healthy eating and physical activity advice and resources (increase fruit and vegetables intake, staying active). 
  • Encourage social interactions that build healthy behaviours. 

Arrange and Ask Again

Resource Library

There are no existing evidence-based practice guidelines to assist clinicians in classifying BMI for elderly populations. However, there is strong emerging evidence that WHO cut-offs may not be appropriate in increasing age.[2] Weight loss in older adults is commonly associated with poor health outcomes including muscle mass loss. Clinical judgement should be used in deciding whether weight loss is required.

Assessment of diet and physical activity can identify areas for health behaviour improvement and can support older adults continue their independence and good health for longer, without focusing on weight loss.

Queensland Stay on Your Feet provides self-assessment of Nutrition and Physical Activity in older adults to stay healthy and active and reduce the risk of falls.[3]

Resource
Author
ASK
Ask: starting the conversation about weight
WA Shape
ASSESS
Taking patient centered measurements
WA Shape
Using BMI in older adults
NEMO
BMI and waist
DoH
Measuring waist circumference
British Heart Foundation
Healthy Eating Quiz for Adults
University of Newcastle
BMI calculator heart foundation
Heart Foundation
ESSA screening tool: Adult pre-exercise screening system
ESSA
Physical Activity Stage of Change
Exercise is medicine
Falls assessment: Strong bones, muscles and healthy eating
Qld Health
Falls assessment: Stay active and stay independent
Qld Health

Advise, assist, and empower your patients.

Discuss with each individual the importance of positive health behaviours for healthy aging and chronic disease prevention and/or management. Where changes are required, you can work with individuals to create SMART goals which are achievable and sustainable, and which are more likely to become habits.

Healthy eating:

The Healthy Eating when you’re older webpage outlines guidelines for older adults nutrition and includes tips.

Physical Activity

The Australian Choose Health: Be Active resource for adults 65 years and older includes guidelines, planners and tips for older adults to incorporate more physical activity.

Further resources below can be used to educate and advise individuals to adopt healthy behaviour changes that will help them work towards achieving their health goals:

Resource
Author
NUTRITION
Healthy eating when you're older
DoH
PHYSICAL ACTIVITY
Choose health, be active
DoH
Physical Activity: Tips and ideas for older Australian
DoH
Aging with vitality workbook
Queensland Health
Aging with vitality
Queensland Health
HEALTHY AGEING
Appetite for life: resource library
Tasmanian Government

When supporting individuals to adopt healthy behaviours, it is important to arrange follow-up appointments to continue to monitor progress and reflect on support required.

Up-to-date information about the assessment and management of a range of conditions can be found on HealthPathways. HealthPathways is delivered across Queensland thanks to the support of Clinical Excellence Queensland, and you can find your local HealthPathways website here.

Programs listed below may help facilitate health behaviour change for individuals, or provide additional support or management where appropriate:

Resource
Author
HEALTHY HABITS
My health for life
Diabetes Australia
Logan Healthy Living
UQ Healthcare
Work it out - IUIH
IUIH
SMoCC Service (Self Management of Chronic Conditions)
Queensland Health
RACGP Healthy Habits App
RACGP
NUTRITION
Dietitian (Dietitians Australia)
Dietitians Australia
MENTAL HEALTH
GP Eating Disorder Plan (EDP)
InsideOut
Helplines and Online Counselling Services
AIFS
PHYSICAL ACTIVITY
10,000 Steps
CQUniversity
Heart foundation walking
Heart Foundation
Exercise Professional (ESSA)
ESSA
ASSESSMENT AND MANAGEMENT
Health pathways
Queensland Government

Health professionals are recommended to upskill in best-practice prevention, treatment, and management of chronic health conditions in older adults.

Resources to support clinicians to continue to deliver care with empathy, confidence and success are linked below:

Resource
Format
Author
OLDER ADULTS
Nutrition for older people online training
elearning
Tasmanian Government
RACGP: Managing undernutrition in the elderly
Webpage
RACGP
Using Body Mass Index in over 65
PDF
NEMO
Resistance Training for Older Adults: Position Statement From the National Strength and Conditioning Association
Journal Article
National Strength and Conditioning Association: America
Position Statement – Obesity and the older person
PDF
Australian and New Zealand Society for Geriatric Medicine (ANZGSM)
GENERAL SKILLS
5As: Ask, assess, advise, assist and arrange
PDF
RACGP
5As of Obesity Management
Video
Obesity Canada
SCOPE E-learning for obesity
eLearning
WorldObesity
Brief interventions for a healthy lifestyle
eLearning
Insight - Qhealth
Brief Interventions: Nutrition and Physical Activity
eLearning
Insight - Qhealth
Motivational Interviewing RACGP
Journal Article
RACGP
Motivational Interviewing
Webpage and videos
Healthify He Puna Waira
Weight stigma and obesity
Video
Yale University
Shift: A guide for media and communications professionals
PDF
Government of Western Australia
EQUITY
Working with people with a disability
PDF
Metro South

Healthy eating:

The Australian Dietary Guidelines resource summarises the key recommendations and the underlying evidence supporting food, diet and health relationships.

Physical Activity

The Australian Physical Activity and exercise guidelines for older Australians includes recommendations for amount and type of activity.

Further clinical guidelines which may assist clinicians supporting the prevention, early intervention and management of overweight and older adults in adulthood are included below:

Resource
Author
NUTRITION
Australian Dietary Guidelines
NHMRC
PHYSICAL ACTIVITY
Physical Activity and exercise guidelines for older Australians
DoH
Physical activity recommendations for people with disability or chronic conditions
DoH
FALLS PREVENTION
Stay on your feet: community good practice guidelines
Qld Health
PREVENTION
Guidelines for preventive activities in general practice
RACGP
WEIGHT MANAGEMENT
Clinical Practice Guidelines for the management of overweight and obesity
NHMRC
WEIGHT INCLUSIVITY
Quick Guide: Safe, inclusive and accessible environments for people with obesity
The Obesity Collective

References

1. Australia and New Zealand Society for Geriatric Medicine (ANZSGM). Position Statement 19: Obesity and the Older Person. 2011 

2. Queensland Health: Nutrition Education Materials Online “NEMO”. Using Body Mass Index 

3. Queensland Health. Queensland Stay on Your Feet. https://www.health.qld.gov.au/stayonyourfeet. 2021 

Clinicians Hub is brought to you by Health and Wellbeing Queensland in partnership with Allied Health Profession’s Office of Queensland, Clinical Excellence Queensland.

Last updated 18 December 2023