What to Know About Malnutrition in Older Adults

Malnutrition occurs when someone does not have the proper amount of nutrients to function. It often involves experiencing an imbalance of protein, calories, and other essential vitamins that your body needs every day.

While malnutrition is harmful at any age, it impacts older adults especially hard. When an older adult is malnourished, it leaves them vulnerable to increased risk of falling, slower recovery times, possible hospitalizations, re-hospitalizations, and possibly death.

Malnutrition in older adults can be caused by a variety of factors, including loss of appetite, lack of ability to chew and swallow, and increased use of prescription medications. Other risk factors include depression, dementia, chronic diseases, and lack of access to optimally nutritious food, whether due to food insecurity or lack of ability to prepare and/or shop for food.

What Does This Mean?

Malnutrition does not solely happen to seniors who suffer from hunger, or who do not have access to healthy food. Older adults are more likely to have chronic conditions that put them at risk for malnutrition.

For instance, if an older adult experiences diabetes, cancer, or Alzheimer’s disease, their appetite can be impacted, making eating difficult. When you’re managing diseases like these, it changes your metabolism, and sometimes requires dietary restrictions, putting older adults at risk of malnutrition.

Older adults are also hospitalized more frequently and are more likely to be in long-term care facilities, both of which put them at heightened risk of malnutrition. It’s estimated that 65 percent of hospitalized older adults could face malnutrition.

Signs of Malnutrition

Common signs of malnutrition include:

  • Unplanned weight loss
  • Feeling weak or tired
  • Loss of appetite
  • Swelling or fluid accumulation
  • Eating only a small amount at a time

Problems Caused by Malnutrition

Older adults may have various health concerns because of malnutrition, including:

  • An increased risk of death
  • An increased risk of hospitalization
  • A weakened immune system, which can increase the risk of infections
  • Decreased bone mass and muscle weakness, which can lead to falls and fractures
  • Wounds not healing well

Factors Contributing to Malnutrition

Malnutrition is generally caused by getting too little food or having a diet lacking in nutrients. However, malnutrition is often more complex and caused by a combination of physical, social, and psychological issues such as:

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Changes With Age. As you age, it’s normal to see a decline in your ability to smell, taste, and maintain a healthy appetite. This can make it difficult to enjoy food and have a regular eating habit.

Illness. If you experience disease-related complications and inflammation, they can contribute to changes in how the body processes nutrients and a lowered appetite.

Inability to eat. Poor dental health, a limited ability to handle tableware, or difficulty chewing or swallowing can contribute to malnutrition.

‌Dementia. Memory or behavioral problems from dementia or Alzheimer's disease can result in forgetting to eat, not buying groceries, or other irregular food habits.

Medications. Certain medications can affect your ability to absorb nutrients or your appetite.

Restricted diets. When you manage medical conditions through dietary restrictions, it can often lead to not eating enough.

Limited income. Older adults can have financial challenges that make it hard to buy healthy foods, especially if they're taking expensive maintenance medications.

Reduced social contact. Older adults who typically eat alone might not enjoy having meals as much and they may lose interest in cooking and eating.

Limited access to food. Older adults with limited mobility may not have easy access to the right types of food.

Depression. Grief, failing health, lack of mobility, loneliness, and other factors can contribute to depression — which may cause a loss of appetite.

Alcoholism. Misuse of alcohol may result in poor eating habits and poor decisions about nutrition. Too much alcohol in your body can interfere with the digestion and absorption of nutrients. 

Improving Nutrition

Mealtime strategies can help older adults maintain a healthy diet. Good eating habits should include the following:

  • Nutrient-rich foods. Pre-plan delicious meals with a variety of foods that include fish, fresh fruits and vegetables, lean meats, and whole grains.
  • Herbs and spices. Create excitement about eating and add flavor to meals by using herbs and spices.
  • Healthy snacks. Have nutrient-rich snacks on hand between meals like low-fat dairy products, fruits, or vegetables.
  • Nutritional supplements. To increase calories in your daily diet, you can have supplemental nutrition drinks. Add whey powder or egg whites to meals to increase proteins without adding saturated fats.

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When to Talk to a Doctor

Talk to a doctor about any concerns you may have regarding changes in appetite, weight changes, or other concerns about your nutrition and health — or that of an older adult you may know. The doctor can help you by:

  • Regularly monitoring your weight and screening your body for malnutrition
  • Assessing for medical conditions that may cause health problems or weight loss
  • Treating underlying conditions in your body that cause malnutrition
  • Changing a restricted diet for medical conditions such as diabetes
  • Recommending a daily calorie intake that’s appropriate for you
  • Recommending needed vitamin and mineral supplements
  • Changing your prescription medications

Good nutrition throughout your lifespan is key for preventing illness. Early detection through routine screening provides the best possible outcomes.

WebMD Medical Reference Reviewed by Dan Brennan, MD on March 18, 2021

Sources

SOURCES: 

Alliance for Aging Research: "Malnutrition."
Mayo Clinic: “Senior health: How to prevent and detect malnutrition.”
Public Health Post: "Malnutrition in Older Adults."

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