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 adult 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. As the adult child or caregiver of an older adult, you can learn the signs and risks of malnutrition and how to promote a nutrient-rich diet.
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 and decreased bone mass, which can lead to falls and fractures
- A higher risk of hospitalization
- An increased risk of death
Factors contributing to malnutrition
The causes of malnutrition might seem straightforward — too little food or a diet lacking in nutrients. In reality, malnutrition is often caused by a combination of physical, social and psychological issues. For example:
- Normal age-related changes. Changes in taste, smell and appetite generally decline with age, making it more difficult to enjoy eating and keep regular eating habits.
- Illness. Disease-related inflammation and illnesses can contribute to declines in appetite and changes in how the body processes nutrients.
- Impairment in ability to eat. Difficulty chewing or swallowing, poor dental health, or limited ability in handling tableware can contribute to malnutrition.
- Dementia. Behavioral or memory problems from Alzheimer's disease or a related dementia can result in forgetting to eat, not buying groceries or other irregular food habits.
- Medications. Some medications can affect appetite or the ability to absorb nutrients.
- Restricted diets. Dietary restrictions for managing medical conditions — such as limits on salt, fat or sugar — might also contribute to inadequate eating.
- Limited income. Older adults may have trouble affording groceries, especially if they're taking expensive medications.
- Reduced social contact. Older adults who eat alone might not enjoy meals as before and lose interest in cooking and eating.
- Limited access to food. Adults with limited mobility may not have access to food or the right types of food.
- 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 nutrients. Misuse of alcohol may result in poor eating habits and poor decisions about nutrition.
Monitoring nutrition and preventing malnutrition
As a caregiver or adult child of an older adult, you can take steps to monitor nutritional health, watch for weight loss and address risk factors of malnutrition. Consider the following:
- Monitor weight. Help the older adult check his or her weight at home. Keep a weekly record. Changes in how clothes fit can also indicate weight loss.
- Observe habits. Spend mealtimes together at home — or during mealtime in a hospital or care facility — to observe eating habits. Note what kinds of food are eaten and how much.
- Keep track of medications. Keep a record of all medications, the reason for each medication, dosages, treatment schedules and possible side effects.
- Help with meal plans. Help plan healthy meals or prepare meals ahead of time. Help prepare a shopping list or shop together. Help with money-saving shopping choices.
- Use local services. Contact local service agencies that provide at-home meal deliveries, in-home visits from nurses or dietitians, access to a food pantry, or other nutrition services. The local Area Agency on Aging or a county social worker can provide information about services.
- Make meals social events. Drop by during mealtime or invite the older adult to your home for occasional meals. Go out to eat at a restaurant with senior discounts. Encourage participation in social programs where members of the community can eat together.
- Encourage regular physical activity. Daily exercise — even if it's light — can stimulate appetite and strengthen bones and muscles.
Mealtime strategies to help an older adult maintain a healthy diet and good eating habits include the following:
- Nutrient-rich foods. Plan meals with nutrient-rich foods that include a variety of fresh fruits and vegetables, whole grains, fish, and lean meats.
- Herbs and spices. Use herbs and spices to add flavor to meals and improve interest in eating. Experiment to find favorites.
- Healthy snacks. Plan nutrient-rich snacks between meals with fruits, vegetables or low-fat dairy products.
- Nutritional supplements. Use supplemental nutrition drinks to help with calorie intake. Add egg whites or whey powder to meals to increase proteins without adding saturated fats.
Talking to your doctor
Talk to your family member's doctor about any concerns you have regarding the older adult's weight, changes in appetite, or other concerns about health and nutrition. The doctor's role may include:
Sept. 17, 2019
- Regularly monitoring weight and screening for malnutrition
- Assessing for medical conditions that may be affecting weight loss or nutritional health
- Treating underlying conditions causing malnutrition
- Changing a restricted diet for diabetes or other medical conditions
- Recommending an appropriate daily calorie intake
- Recommending vitamin and mineral supplements
- Changing prescription medications
See more In-depth
- Ritchie C, et al. Geriatric nutrition: Nutritional issues in older adults. https://www.uptodate.com/contents/search. Accessed Aug. 16, 2019.
- Halter JB, et al., eds. Malnutrition and enteral/parenteral alimentation. In: Hazzard's Geriatric Medicine and Gerontology. 7th ed. McGraw-Hill Education; 2017. https://accessmedicine.mhmedical.com. Accessed Aug. 16, 2019.
- Fávaro-Moreira NC, et al. Risk factors for malnutrition in older adults: A systematic review of the literature based on longitudinal data. Advanced Nutrition. 2016; doi: 10.3945/an.115.011254.
- Cederholm T, et al. GLIM criteria for the diagnosis of malnutrition: A consensus report from the global clinical nutrition community. Clinical Nutrition. 2019; doi:10.1016/j.clnu.2018.08.002.
- Smart food choices for healthy aging. National Instititute on Aging. https://www.nia.nih.gov/health/smart-food-choices-healthy-aging. Accessed Aug. 16, 2019.
- Choosing healthy meals as you get older. National Institute on Aging. https://www.nia.nih.gov/health/choosing-healthy-meals-you-get-older. Accessed Aug. 16, 2019.
- Takahashi PY (expert opinion). Mayo Clinic. Aug. 28, 2019.