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A personal care worker giving a plate of food to a senior.

How to Spot and Manage Malnutrition Before it’s Too Late

Malnutrition in Seniors

Malnutrition in seniors is a widespread problem that can have serious consequences for their well-being and continued independence. People over the age of 65 are more likely to be malnourished than those in any other age group, and estimates are that between 27–50% of the elderly are malnourished to some extent.

This article discusses what malnutrition in seniors is, the possible signs and consequences, and the complex factors which could contribute to the problem. We will then look at how malnutrition in the elderly can be managed, and most importantly, prevented.

The Problem of Malnutrition in Seniors


In medical terms, malnutrition is defined as a BMI (an index using height and weight) of below 18.5, or unintentional weight loss of more that 10% of body weight in six months or less.

This means that one would suspect malnutrition if an elderly person is very thin or unintentionally loses a lot of weight in a short period of time. This could be obvious from loose-fitting clothing, jewelry, or even dentures. You might even notice a general loss of interest in food. While weight loss is an obvious sign of malnutrition, a person might be malnourished even if they haven’t lost weight.

As we grow older our metabolic rate slows down. We become less active and generally need fewer calories for energy requirements. However, for continued physical and mental health, we still need all the nutrients that are essential to maintain all the functions of our body. In fact, because of changes in absorption we might even need more of certain nutrients.

Rather than just not eating enough, a lack of nutrients (such as protein, vitamins and minerals) is often the underlying reason for malnutrition in seniors.

More subtle signs of malnutrition include:

  • Reduced energy levels, being tired and sleepy all the time.
  • Increasing muscle weakness and loss of muscle mass.
  • Feeling cold all the time.
  • Dry, cracked skin and hair loss.
  • A weakened immune system with frequent infections and poor wound healing.
  • Changes in mood, including depression and deteriorating concentration and memory.

Many of the above signs can also occur at the same time and are concerning consequences of malnutrition. For example decreased muscle mass can contribute to falls and factures; a weakened immune system increases the risk of serious infections and hospitalization; mood and memory changes could reduce independence.

Malnutrition in the elderly speeds up what we view as the aging process, both physically and mentally.

Reasons for Malnutrition in Seniors

Poor nutrition in older people is usually caused by a combination of physical, psychological, and social factors. Some of these factors are:

  • The reduced taste and smell which accompanies aging could contribute to loss of interest in eating.
  • Dental issues which cause difficulty in chewing could lead to poor food choices.
  • Eating in a social setting is known to improve appetite. People living alone may find it too much effort to prepare healthy meals just for themselves and to eat on their own.
  • Reduced mobility might make it difficult to go out and buy food and prepare meals. It might even cause problems with opening packaging or getting food to their mouth.
  • Lack of knowledge about healthy food choices and the age-related changes in nutritional needs.
  • Aging and chronic conditions causing shifts in the absorption and processing of nutrients.
  • Increased nutritional and energy needs from acute disease or injury might trigger malnutrition.
  • Special diets prescribed for chronic conditions might limit certain nutrients and/or make food unappetizing.
  • Medications might affect appetite, cause nausea, or reduce absorption of certain nutrients.
  • Changes in mental status such as depression, memory loss, or dementia can contribute to loss of appetite, poor and irregular eating habits, or even neglecting to buy food.
  • The type of food purchased might be limited by financial constraints.

Managing Malnutrition in the Elderly

Once you identify that you or a loved one might be malnourished it’s crucial to take to take action to turn the situation around. This will most likely improve quality of life and well-being within a relatively short period of time.

First of all, because there are so many factors that could contribute to malnutrition, one needs to establish the likely causes and then find solutions to address them.

The problem might be simple to solve if the main cause is linked to access to healthy food and/or the provision of meals which are appetizing, nutritious, and easy to eat. You could assist with food purchases if getting to the shops is the problem.

If meal preparation and eating are falling by the wayside for whatever reason you could advise on proper nutrition, establish what foods the person enjoys, encourage them to eat a variety of foods, and even pre-prepare meals and healthy snacks.

Consider herbs and spices to enhance flavor. If the person has difficulty with chewing and swallowing, prepare foods that are cut finely, minced or shredded, or soups and smoothies. You can also consider supplements and nutrition drinks which add protein, without the bulk. Furthermore, remember that adequate fluid intake is essential to prevent dehydration.

Another option is a local meal delivery service for the elderly. You can consider joining them for a meal a few times a week to provide a pleasant, social environment while also making sure that they are eating.

Professional Intervention for Malnutrition

Consult a medical practitioner for a full examination in case of rapid weight loss or other significant signs of malnutrition. A health care provider can determine the extent of the problem, assess whether a medical condition or medications are contributing factors, and prescribe treatment accordingly.

A visit to a dentist is called for if oral health is affecting eating habits. You can also consider consulting a dietician for an individualized approach, including nutritional counseling and education. They will do a full assessment of the person’s circumstances, knowledge, underlying medical conditions, and food preferences, and design a dietary plan accordingly.

Serious cases of malnutrition might require hospitalization where emergency nourishment will be provided either via a tube through the nose or intravenously.

Preventing Malnutrition in Seniors

It’s important to understand what you need to include in your diet to provide your body with all the nutrients that are essential for good health. The sooner you adopt healthy eating habits the better, and the more likely it will be that you will stick to these habits throughout your lifespan.

Consider the causes of malnutrition in seniors and take steps to prevent them. Arrange for help with shopping or food preparation if it becomes necessary. People are usually more than willing to help if you just ask. Visit your dentist to address dental issues. Make adjustments to food types and textures if necessary.

Don’t ignore anything that changes your eating patterns. This might be loss of appetite; nausea, or other gastric issues which might affect absorption of nutrients or rapid, unintentional weight loss. Consult your health care provider for a check-up, advice, and treatment before malnutrition sets in.

Conclusion

Obesity in seniors is a growing global epidemic and the underlying cause of many chronic conditions. On the other side of the coin, however, malnutrition in seniors appears to be just as widespread and increasing.

The cause of malnutrition in seniors is not simply a matter of not eating enough; rather, it is most often a variety of factors contributing to the problem. This means that, in order to manage or prevent malnutrition in the elderly, one needs to address everyone’s individual circumstances.