Malnutrition in the Elderly: Why It Happens and How to Address It

Eating less as you get older is both natural and a potential cause for concern. Older adults are at higher risk of malnutrition, a condition in which you don't get enough protein, calories, vitamins, and minerals. Not eating enough can lead to exactly this outcome, which can, in turn, introduce a whole other slew of health problems. The good news is that malnutrition in elderly people is easy to spot and treat - here's everything you should know.

Why are older adults at greater risk of malnutrition?

Often, malnutrition is the direct result of a loss in appetite. In fact, many common causes of reduced appetite are also known to lead to malnutrition. These shared causes include:

• Chronic conditions such as cancer, Alzheimer's, diabetes, and dementia, as well as accompanying dietary restrictions
• Medication side effects
• Changes in sense of taste or smell
• Difficulty chewing and swallowing, including due to dental conditions
• Loss of dexterity (such as the loss of ability to use silverware)
• Clinical depression
• Lack of access to healthy food, such as no ability to reach grocery stores, afford food alongside expensive medications, or cook for oneself

Additionally, more frequent hospitalizations and long-term care stays are associated with malnutrition. In fact, a 2022 Nutrients study found that 20 to 50 percent of hospitalized adults were malnourished before admission. On top of that, 49 percent of patients became more malnourished after a week in the hospital. Furthermore, among patients who were hospitalized with good nutrition, one-third became malnourished during their hospital stay.

What are the signs of malnutrition in older adults?

The most commonly cited signs of malnutrition in older adults are:

• Unexpected or inexplicable weight fluctuations, particularly weight loss
• Poor appetite
• Only eating small amounts during meals
• Eating mostly or entirely processed foods
• Regularly feeling fatigued or weak
• Fewer bowel movements than usual
• Swelling or edema

What are the consequences of malnutrition in older adults?

Malnutrition in older adults can increase the risk of the below conditions. These too can be signs of malnutrition, though the signs listed above are likely to appear first.

• Decreased cognitive and physical function. Physical decline is the consequence most associated with malnutrition. This decline, as well as the cognitive decline often associated with malnutrition, can make day-to-day activities significantly more difficult. A decrease in quality of life is typically the result.

• Greater likelihood of hospitalization and death. Increased use of healthcare services is common among malnourished older adults. In extreme cases, death can result from malnutrition as well.

• Lower muscle and bone mass. These consequences of malnutrition are common among hospitalized older adults, and they occur outside hospitalized populations as well. In fact, they can make you more likely to fall or experience fractures, thus requiring a hospital visit in the first place.

• Lower immune system function. There are six main nutrients associated with proper immune system functioning. These are vitamins A, C, D, and E as well as zinc and selenium. Malnutrition deprives your body of these nutrients, reducing your immune system functioning and potentially leading to more infections.

• Wounds not healing properly. Although inflammation feels unpleasant, it's also a key wound-healing process. Vitamins A, B, C, and D, and zinc and iron, are key to your body's inflammation process. When you're malnourished, your body will thus struggle to heal wounds.

How to treat (and prevent) malnutrition in older adults

If malnutrition concerns you, rest assured - it's easy to treat. Here's how.

• Routine nutrition screening. A medical professional conducts this screening. This professional will review your ongoing and previous dietary intake, physical and cognitive functioning, and medications and medical history. They will also take blood samples for lab testing, conduct a physical exam, and ask about your quality of life. Based on their findings, they'll determine whether you need to make lifestyle changes that improve your nutrition.

• Nutritional supplements. Take these between, but not in place of, meals to work toward proper nutrition or maintain your already-great nutrition. Your doctor can advise you on whether a daily multivitamin or supplements containing one or just a few nutrients is better for you.

• Eating enough macronutrients. Incorporating the right amount of macronutrients into your diet is the fastest way to improve nutrition in older adults. You may find this easier if, instead of the usual three meals, you eat several small meals per day, including liquid or soft foods. Adding high-calorie foods such as oil, butter, avocado, or nuts to your meals can help too. Plus, with meal delivery services, eating well is convenient, affordable, and hassle-free.

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