Recognizing Malnutrition in Older Adults

Malnutrition, which happens when the body does not get the nutrients it needs, is a major concern for seniors. Life-threatening malnutrition disproportionately affects those 85 and older. Recognizing malnutrition can help family members and caregivers know when to seek out medical care and assistance for their aging loved one.

Undernourished older adults can experience wasting, in which they have a low weight for their height. They may have micronutrient, macronutrient, or caloric deficiencies.

Some people with malnutrition can also have excess weight or obesity. These individuals have exceeded their caloric needs but lack essential nutrients to keep themselves healthy.

Effects of Malnutrition

When malnutrition progresses, it can lead to adverse health consequences, resulting in hospitalizations and death. In addition to increasing these risks, malnutrition can lead to the following:

• Weakened immune system
• Decreased bone mass
• Muscle weakness
• Poor wound healing
• Problems with oral health, which can cause chewing difficulties
• Diminished cognitive functioning

Hunger Among Seniors

Older adults living in the community may have inadequate diets that fail to meet their nutritional needs. They may lack access to healthful food, such as fruit, vegetables, whole grains, and lean protein.

Feeding America reports that one in 14 adults aged 60 and older experienced food insecurity in 2021. Food insecure older adults had deficiencies in micronutrients such as iron as well as macronutrients such as protein. Those with disabilities had food insecurity rates twice as high. Seniors living in multigenerational households also experienced more food insecurity as families struggling to make ends prioritize the nutritional needs of their children.

Residents in long-term care facilities can encounter hunger as well. Malnutrition in a resident can indicate neglect. When staff do not provide adequate food and water or do not address the needs of residents, inadequate nutrition can result.

Elders living in the community and in nursing homes may experience hunger and malnutrition because of chronic health conditions that affect their eating habits or nutrient absorption.

Chronic Conditions and Malnutrition

Chronic conditions and acute illness can cause malnutrition in older adults. The National Council on Aging reports that approximately 95 percent of adults 60 and older have at least one chronic condition, and 80 percent have two or more chronic conditions.

For instance, diabetes, cancer, and dementia can reduce appetite, making it challenging to consume enough nutritious food. These diseases can affect the metabolism as well.

When chronic conditions progress and result in hospitalization, older adults can face a heightened risk of nutritional problems. Sixty-five percent of hospitalized older adults are at risk of malnutrition, according to WebMD.

Signs of Malnutrition

When malnutrition is the result of disease, the symptoms of malnutrition may be similar to the disease symptoms, per the American Society for Parenteral and Enteral Nutrition.

The following signs and symptoms could suggest malnutrition in older adults:

• Sudden weight loss or weight gain
• Weakness
• Fatigue, complaints of tiredness, and lethargy
• Difficulty concentrating
• Loss of appetite and trouble eating
• Swelling and fluid accumulation
• Ill-fitting clothes from weight loss or weight gain
• Mood changes, including becoming depressed, angry, or irritable
• Hair loss
• Complaints of being cold
• Thin, cold skin
• Slow recovery from illness

Additional Resources

If you notice indications of malnutrition in yourself or a loved one, these resources could help.

• Consult with a health care professional. A physician can help your loved one address their medical needs.
• Elders experiencing hunger could explore programs such as Meals on Wheels, which delivers meals to homebound older adults for low or no cost.
• Seniors who have limited income may also qualify for food stamps through the Supplemental Nutrition Assistance Program (SNAP). Learn more about SNAP benefits and whether your loved one may be eligible.
• This holiday, you may also want to check out these five tips on healthy nutrition for seniors.
• Speak to a local, qualified elder law attorney if the poor nutrition could be a result of neglect. An attorney can take action against the nursing home or caregivers responsible for any elder abuse or neglect.