Malnutrition in older adults can be hard to spot. Here's what to look for.
Good nutrition is critical to senior health, but many older adults don't eat right. Older people are more likely to have inadequate nutrition than younger adults are — and are more susceptible to numerous health problems related to an inadequate diet.
Many older adults in long term care facilities have poor nutrition. While seniors cared for at home or living independently generally fare better, patterns leading to inadequate nutrition — also called malnutrition — often begin at home. Knowing the causes and danger signs of nutrition problems, as well as taking steps to ensure a diet rich in protein and other necessary nutrients, is critical in maintaining senior health and strength.
Malnutrition in seniors: A web of factors
At first glance, the causes of malnutrition seem straightforward: too little food, a diet lacking in nutrients or absorption, eating or digestion problems related to getting older. But the causes of malnutrition are often more complex.
For instance, older single adults, even those who are energetic and self-sufficient, often don't cook for themselves. Their typical dinner may be nothing more than a handful of popcorn or a cup of tea. Carried on for a long time, a nutrient-poor diet accelerates the loss of muscle mass and strength that normally comes with aging. Shopping and preparing food become more difficult, which reinforces the tendency to subsist on easy but empty fare — such as toast, cold cereal or saltine crackers. Eventually, the chronic lack of nourishment leads to increased frailty, dependence and illness, which in turn can trigger depression — itself a major drain on appetite.
What you can do
Malnutrition is a complex problem, but even small changes make a big difference in an older person's health and well-being:
- Enrich diets. To boost nutrition, encourage seniors to spread peanut or other nut butters on toast and crackers, on fresh fruits such as apples and bananas, and on raw vegetables. Other suggestions include sprinkling nuts or wheat germ on yogurt, fruit and cereal; adding extra egg whites to scrambled eggs and omelets; and melting cheese on sandwiches, vegetables, soups, rice and noodles.
- Restore life to bland food. Try to make special diets more appealing by using lemon juice, herbs and spices and by varying the texture, color and temperature of foods. If loss of taste and smell is a problem, experiment with strong seasonings and flavors. Careful chewing can sometimes increase enjoyment because more flavor molecules come into contact with taste receptors. A dietitian can also suggest ways to perk up dull meals.
- Plan between-meal snacks. This can be particularly helpful for people who get full quickly. A piece of fruit or cheese, a spoonful of peanut butter, even a milkshake for people who aren't lactose intolerant can add nutrients and calories.
- Use nutritional supplements. Undernourished seniors are especially likely to be deficient in protein, vitamins B-6 and B-12, folate, niacin, vitamin D, calcium and zinc. Supplements are important because they can help supply missing nutrients, but they can't provide protein or needed calories and shouldn't become a substitute for meals. Older adults should talk with a doctor before taking a supplement.
- Consider outside help. If an older adult is very frail, consider hiring a home health aide to help prepare meals or look into Meals On Wheels and other community services, including home visits from registered dietitians. Local churches and civic groups often have volunteers willing to shop and cook for seniors who live alone. Your department of health or community hospital can usually provide information on programs in your area.
- Engage doctors. Talk to doctors about changing medications that affect appetite and nutritional status and about screening for nutrition problems during routine office visits. Be sure to inform doctors if you notice that an older loved one is losing weight. If you suspect depression, be sure to tell doctors about your concerns. Consult a dentist about oral pain or chewing problems
- Make meals social events. This may be the most important step in curbing malnutrition; older people clearly do better when they have company. Drop by during mealtime or invite seniors to your house. Or try eating out on a regular basis, which can boost spirits along with appetite. Take advantage of discount meals at earlier hours, and ask for small portions of food. If you can't share meals with the older adults in your life, encourage them to join programs where they can eat with others or arrange for them to have meals with friends.
- Encourage regular exercise. Many seniors, even those with serious health problems, can benefit from daily exercise — it stimulates appetite, helps depression, and strengthens bones and muscles. Resistance exercise — such as weightlifting — can be especially beneficial in increasing lean muscle mass and appetite. Exercising with others also provides motivation and social interaction.
Last Updated: 09/28/2007
