As the aging population in the United States increases, the issue of malnutrition is becoming more prevalent. Adequate nutrition is crucial for older adults and becomes even more vital for those who are ill or suffering from a chronic condition or dementia.
By understanding malnutrition in the aging body better and addressing it, we can help ensure that our loved ones or we enjoy optimal health and well-being in our golden years.
Malnutrition In Older Adults
Malnourishment is a significant and challenging health problem among older adults, often undetected. It can refer to a deficit, excess, or imbalance of protein, energy, or other nutrients that adversely affect a person’s body composition, function, and clinical outcomes.
Malnutrition can occur due to both under-nutrition and overnutrition, with varying definitions ranging from simple measures such as unintentional weight loss to more complex assessments that include anthropometric and biochemical measurements.
Overnutrition occurs when you consume an excess amount of a nutrient or nutrients on a daily basis, surpassing your body’s needs. Although malnutrition is commonly associated with nutrient deficiency, overconsumption is also considered a form of malnutrition as it can have detrimental effects on your health.
Undernutrition refers to a condition where the intake of nutrients or calories is insufficient. Similar to overnutrition, undernutrition can be classified into two types: energy (calorie) undernutrition and micronutrient undernutrition. It can arise from inadequate food consumption, insufficient intake of nutritious foods, or medical conditions that hinder nutrient absorption.
According to the Administration for Community Living, malnutrition among older adults in the country is an epidemic hiding in plain sight, with a fifty percent estimate of older Americans being malnourished.
The National Council on Aging also discovered the following numbers related to malnutrition in older adults:
- There are 715 000 U.S. adults aged 65 and above who are underweight.
- 1 in 3 U.S. adults aged 65 and above is overweight.
- There are 9 million older adults who can’t afford nutritious food.
- 1 in 4 adults aged 65 and above cut their meal portions or skip meals.
- Sixteen percent of independent older people have an increased risk of malnutrition.
- Around 60% of older adults in healthcare settings have malnutrition.
These numbers demonstrate the prevalence and need for measures to prevent malnutrition among older adults, and a great starting point would be understanding the factors that could contribute to malnutrition.
What Causes Malnutrition In Older Adults?
Many interrelated factors can contribute to malnutrition. Some older adults may live in a food desert and cannot buy nutrient-dense food. Some may not have the stamina to cook a meal or may not want to cook because they feel down. Others may not eat because they do not feel well enough to eat.
Several things may affect the amount and type of food older adults eat. These include:
- Chronic diseases
- Trouble chewing and swallowing
- Poor appetite/reduced nutrient intake
- Gastrointestinal symptoms, including constipation
- Living alone, social isolation, and limited social support
- Limited finances
- Being hospitalized
- Illness with inflammation, infection, or other catabolic conditions
- Overly restrictive diets
- Sensory impairment
- NPO (“nothing by mouth”) status for tests or while hospitalized
- Poor functional status (such as inability to prepare food)
- Altered mental status/dementia
- Lack of transportation to access food
- Food insecurity
Apart from these causes, certain risk factors may increase your chances of being malnourished.
Older adults may be considered at risk for becoming malnourished if they have any of the following:
- Involuntary loss of 10% or more of usual body weight within 6 months, or involuntary loss of greater than or 5% or more of usual body weight within 1 month
- Involuntary loss or gain of 10 pounds within 6 months
- Body mass index less than 18.5 kg/m2 or greater than 25 kg/m2
- Chronic disease
- Increased metabolic requirements
- Altered diets or diet schedules
- Inadequate nutrition intake, including not receiving food or nutrition products for greater than 7 days
Tell-tale Signs Your Older Loved Ones Have Malnutrition
Malnutrition can be difficult to detect just by looking at someone since it develops gradually. This is why malnutrition can go unnoticed.
Fortunately, certain changes can be observed and serve as indicators, such as:
- Unintentional weight loss of 5 percent of body weight or more per month, even if overweight
- Clothes that are usually worn appear loose or baggy
- Reduced appetite during meals
- Reduced physical strength, unsteady gait, or weakened grip strength
- Changes in the fit of dentures or dentures that seem to move around in the mouth
- Frequent illness
- Reduced ability to focus and concentrate
- Intolerance to cold
- Poor wound healing, rashes, and dry skin
- Mood disruptions
- Hair thinning
Indications of excessive intake of vitamins and minerals can vary depending on the specific nutrient, but certain signs to be aware of include:
- Cloudy urine
- Increased frequency and amount of urination
- Heartbeat irregularities
- Eye irritation or sensitivity to light
- Cracked, dry lips
Malnutrition can greatly impact one’s ability to maintain good health, particularly when faced with a serious health condition. Around 30 percent of older individuals admitted to hospitals are malnourished, and being malnourished during hospitalization usually leads to longer hospital stays.
However, many older adults still remain undiagnosed and unaware that they may be malnourished which can result in more adverse effects if left unchecked.
The Effect Of Malnutrition In Older Adults
While malnutrition is harmful at any age, it impacts older adults especially hard. Malnutrition in elderly individuals can lead to a range of health issues that older adults may experience, such as:
- Greater likelihood of mortality
- Higher likelihood of needing hospitalization
- Elevated risk of experiencing falls
- Prolonged recovery times
- Potential need for hospital readmissions
- Compromised immune system, heightening susceptibility to infections
- Reduced bone density and muscle strength, contributing to falls and fractures
- Poor wound healing capacity
Good nutrition throughout your lifespan is key for preventing illness. Early detection through routine screening provides the best possible outcomes.
If you have concerns about your nutritional status or that of a loved one, you can download and utilize any nutrition screening tools available, such as the DETERMINE Checklist, the Mini Nutritional Screening tool, or even the Malnutrition Screening Tool online.
Afterward, it is advisable to discuss the results with your medical professional.
The Consequences Of Malnutrition In Older Adult’s Health
The presence of malnutrition puts individuals at risk of developing problems or exacerbating existing health issues in older adults. Learning about malnutrition’s consequences on one’s health can promote awareness and efforts to prevent malnutrition.
The following are ways in which malnutrition can impact various aspects of your health:
- Mobility: Weak muscles and bones can make it difficult to perform everyday activities such as walking, dressing, and bathing. Eating a diet high in protein, calcium, and vitamin D and engaging in regular physical activity is crucial for maintaining and rebuilding muscle and bone.
- Posture: Muscles and bones play a key role in keeping you upright. You may experience pain in your neck, back, and shoulders if they are weak.
- Strength: Poor muscle strength can make engaging in your favorite activities harder.
- Falls: Bone and joint problems can increase your risk of falling, which is the leading cause of death and injury among older adults.
- Healing: Inadequate nutrition can lower your white blood cell count, making it harder for your body to heal and fight illnesses. Providing your body with the necessary energy, protein, vitamins, and minerals can aid recovery.
- Cancer: Malnutrition can make it more challenging to tolerate chemotherapy.
- Illness: A weak immune system can increase your likelihood of getting sick and developing infections.
- Eyes: A lack of essential vitamins and minerals can accelerate vision loss caused by glaucoma, cataracts, and macular degeneration.
- Brain: Nutrient deficiencies can accelerate the loss of neurons in the brain, which can impair speech, coordination, and memory.
- Kidneys: Inadequate fluid and electrolyte intake can cause your kidneys to overwork and impair their ability to function properly, potentially leading to dehydration, joint pain, and heart problems.
Ways to Address Malnutrition in Older Adults
It’s important to understand what malnutrition is and what it is not. Malnourished individuals come in all shapes and sizes, including those who are obese. Here are five essential facts to know about malnutrition in older adults:
- Make informed food choices. As you age, you must know how to eat healthily and create a balanced plate with foods high in nutrients like protein.
Strategies for mealtime can assist older adults in maintaining a nutritious diet. Essential components of healthy eating habits for older adults include:
- Opting for nutrient-rich foods: Plan and prepare delicious meals incorporating a diverse range of foods such as fish, fresh fruits and vegetables, lean meats, and whole grains.
- Incorporating herbs and spices: Enhance the appeal of meals by adding herbs and spices to add flavor and excitement to the dining experience.
- Including healthy snacks: Keep nutrient-rich snacks, such as low-fat dairy products, fruits, and vegetables, readily available between meals for convenient and healthy snacking options.
- Considering nutritional supplements: Increase calorie intake by incorporating supplemental nutrition drinks or adding whey powder or egg whites to meals to boost protein without adding saturated fats to the diet.
- Consider using oral nutritional supplements. These supplements contain essential nutrients, calories, and protein that can help maintain complete and balanced nutrition at any stage of life.
- Maintain good oral health. Poor oral health can lead to dental problems like gum disease that may limit your ability to eat well or consume certain foods vital for good nutrition.
- Consult your healthcare provider. Talk to your doctor if you’re experiencing unintentional weight loss, poor appetite, difficulty chewing or swallowing, or problems with ill-fitting dentures that affect eating.
The doctor can assist by:
- Regularly monitoring weight and screening for malnutrition.
- Assessing for medical conditions that may cause health problems or weight loss.
- Treating underlying conditions that cause malnutrition.
- Modifying restricted diets for medical conditions like diabetes.
- Recommending appropriate daily calorie intake.
- Suggesting necessary vitamin and mineral supplements.
- Adjusting prescription medications as needed.
- Good nutrition throughout your lifespan is key for preventing illness.
- Early detection through routine screening provides the best possible outcomes.
- Seek assistance if needed. If you’re having trouble driving, preparing, or purchasing food, contact a friend or family member for help. You can also contact Meals on Wheels to inquire about home-delivered meals. Additionally, applying for the Supplemental Nutrition Assistance Program (SNAP) may help cover the costs of groceries, as millions of older adults use this program to supplement their monthly food budget.
Older adults are particularly susceptible to malnutrition because they have different nutritional needs than younger adults, take more medications, and have higher rates of chronic medical conditions such as diabetes and heart disease. They also may be experiencing a change in their taste buds, a lack of appetite, or depression – or may have trouble getting used to new nutritional needs` after decades of employing certain eating habits.
This makes managing your health and nutrition as you age difficult. If you are helping your loved one, talk to their family doctor and ask for help when needed. The doctor can talk to you about their risk for malnutrition, health conditions, and medicines.
You may need help making sure your loved one is eating right. Home health aides can help shop for groceries and prepare meals. Check with your local Council on Aging and other older adult community resources and programs, such as Meals on Wheels. They may be able to help you care for your loved one.