A single copy of this article may be reprinted for personal, noncommercial use only.
Senior health: How to prevent and detect malnutritionBy Mayo Clinic staff
Original Article: http://www.mayoclinic.com/health/senior-health/HA00066
Aging parents (9)
- Caregiving: Tips for long-distance caregivers
- Caregiver depression: Prevention counts
- Caring for the elderly: Dealing with resistance
- see all in Aging parents
Alzheimer's caregiver (23)
- Alzheimer's care: Simple tips for daily tasks
- Alzheimer's: Consider options for long-term care
- Alzheimer's: Tips to make holidays more enjoyable
- see all in Alzheimer's caregiver
Senior health: How to prevent and detect malnutrition
Malnutrition is a serious senior health issue. Know the warning signs and how to help an older loved one avoid poor nutrition.By Mayo Clinic staff
Good nutrition is critical to overall health and well-being — yet many older adults are at risk of inadequate nutrition. Know the causes and signs of nutrition problems in older adults, as well as steps you can take to ensure a nutrient-rich diet for an older loved one.
Problems caused by malnutrition
Malnutrition in older adults can lead to various health concerns, including:
- A weak immune system, which increases the risk of infections
- Poor wound healing
- Muscle weakness, which can lead to falls and fractures
In addition, malnutrition can lead to further disinterest in eating or lack of appetite — which only makes the problem worse.
Older adults who are seriously ill and those who have dementia or have lost weight are especially vulnerable to the effects of poor nutrition.
How malnutrition begins
The causes of malnutrition might seem straightforward: too little food or a diet lacking in nutrients. In reality, though, malnutrition is often caused by a combination of physical, social and psychological issues. For example:
- Health concerns. Older adults often have health issues that can lead to decreased appetite or trouble eating, such as chronic illness, use of certain medications, difficulty swallowing or absorbing nutrients, or trouble chewing due to dental issues. A recent hospitalization might be accompanied by loss of appetite or other nutrition problems. In other cases, a diminished sense of taste or smell decreases appetite. Dementia also can contribute to malnutrition.
- Restricted diets. Dietary restrictions — such as limits on salt, fat, protein or sugar — can help manage certain medical conditions, but might also contribute to inadequate eating.
- Limited income. Some older adults might have trouble affording groceries, especially if they're taking expensive medications.
- Reduced social contact. Older adults who eat alone might not enjoy meals, causing them to lose interest in cooking and eating.
- Depression. Grief, loneliness, failing health, lack of mobility and other factors might contribute to depression — causing loss of appetite.
- Alcoholism. Too much alcohol can interfere with the digestion and absorption of various nutrients. In addition, nutrients are lacking if alcohol is substituted for meals.
How to spot malnutrition
The signs of malnutrition in older adults can be tough to spot, especially in people who don't seem at risk — but uncovering problems at the earliest stage can help prevent complications later. To detect malnutrition:
- Observe your loved one's eating habits. Spend time with your loved one during meals at home, not just on special occasions. If your loved one lives alone, find out who buys his or her food. If your loved one is in a hospital or long term care facility, visit during mealtimes.
- Watch for weight loss. Help your loved one monitor his or her weight at home. You might also watch for other signs of weight loss, such as changes in how clothing fits.
- Be alert to other red flags. In addition to weight loss, malnutrition can cause poor wound healing, easy bruising and dental difficulties.
- Know your loved one's medications. Many drugs affect appetite, digestion and nutrient absorption.
What you can do about malnutrition
Even small dietary changes can make a big difference in an older adult's health and well-being. For example:
- Engage doctors. If your loved one is losing weight, work with his or her doctors to identify — and address — any contributing factors. This might include changing medications that affect appetite, suspending any diet restrictions until your loved one is eating more effectively, and working with a dentist to treat oral pain or chewing problems. Request screenings for nutrition problems during routine office visits, and ask about nutritional supplements. You might also ask for a referral to a registered dietitian.
- Encourage your loved one to eat foods packed with nutrients. Spread peanut or other nut butters on toast and crackers, fresh fruits, and raw vegetables. Sprinkle finely chopped nuts or wheat germ on yogurt, fruit and cereal. Add extra egg whites to scrambled eggs and omelets. Add cheese to sandwiches, vegetables, soups, rice and noodles.
- Restore life to bland food. Make a restricted diet more appealing by using lemon juice, herbs and spices. If loss of taste and smell is a problem, experiment with seasonings and recipes.
- Plan between-meal snacks. A piece of fruit or cheese, a spoonful of peanut butter, or a fruit smoothie can provide nutrients and calories.
- Make meals social events. Drop by during mealtime or invite your loved one to your home for occasional meals. Encourage your loved one to join programs where he or she can eat with others.
- Encourage regular physical activity. Daily exercise — even if it's light — can stimulate appetite and strengthen bones and muscles.
- Provide food-savings tips. If your loved one shops for groceries, encourage him or her to take a shopping list to the grocery store, check store fliers for sales and choose less expensive generic brands. Suggest splitting the cost of bulk goods or meals with a friend or neighbor, or frequenting restaurants that offer discounts for older adults.
- Consider outside help. If necessary, hire a home health aide to shop for groceries or prepare meals. Also consider Meals On Wheels and other community services, including home visits from nurses and registered dietitians.
Remember, identifying and treating nutrition issues early can promote good health, independence and increased longevity. Take steps now to ensure your loved one's nutrition.
- Ritchie C. Geriatric nutrition: Nutritional issues in older adults. http://www.uptodate.com/index.html. Accessed June 24, 2011.
- Johansson Y, et al. Malnutrition in a home-living older population: Prevalence, incidence and risk factors. A prospective study. Journal of Clinical Nursing. 2009;18:1354.
- Eating well as you get older. National Institute on Aging. http://nihseniorhealth.gov/eatingwellasyougetolder/printerFriendly.html?allTopics=entireTopic&print=Confirm+print+selection. Accessed June 24, 2011.
- Sullivan DH, et al. Nutrition and aging. In: Halter JB, et al. Hazzard's Geriatric Medicine and Gerontology. 6th ed. New York, N.Y.: The McGraw-Hill Companies; 2009. http://www.accessmedicine.com/content.aspx?aID=5114939. Accessed June 24, 2011.
- Wallace JI. Malnutrition. In: Halter JB, et al. Hazzard's Geriatric Medicine and Gerontology. 6th ed. New York, N.Y.: The McGraw-Hill Companies; 2009. http://www.accessmedicine.com/content.aspx?aid=5115287. Accessed June 24, 2011.
- Lieber CS. Relationships between nutrition, alcohol use, and liver disease. Alcohol Research & Health. 2003;27:220.
- Shepherd A. Nutrition through the life span. Part 3: Adults aged 65 years and over. British Journal of Nursing. 2009;18:301.