Guide to Nutrition in Older Adults

Kenneth Knowles, MD
Medically reviewed by Kenneth Knowles, MDFebruary 16th, 2021
resiized kitchen table

Nutrition plays a major role in determining someone’s quality of life, impacting everything from physical health to mental well-being. As a person begins to age, however, certain physiological changes can increase the risk of malnutrition and other nutritional deficiencies—making diet critically important for geriatric health. What can poor nutrition mean for your aging patients and clients? And how can you help older adults maintain good dietary habits? DispatchHealth is helping healthcare leaders and community directors answer these questions with a guide on nutrition in older adults.

Why nutrition is important to consider in seniors

Adults over the age of 60 are at higher risk for malnutrition due to different physiological, psychological, social, and dietary factors. The Health and Nutrition Examination Survey (HANES), an annual U.S. research program that assesses health and nutrition, indicated that roughly 16% of community-dwelling Americans older than 65 consume fewer than 1000 calories per day, placing them at increased risk for undernutrition. Recent studies have also shown that the body’s ability to absorb and utilize certain nutrients becomes less efficient over time. This means that nutrient requirements in older adults (particularly in those age 70 and over) increases. As such, malnutrition and nutritional deficiencies in older adults have become a major concern. 

Due to the changing dietary needs of older adults, the importance of maintaining a nutrient-dense diet is critical. Research has shown that poor nutrition in seniors can impact:

  • Physical condition (poor wound healing)
  • Cognitive condition (weakness and fatigue)
  • Bone health (decreased bone mass)
  • Eye health
  • Vascular function
  • The immune system

The overall impact of malnutrition in an older adult can leave a person vulnerable to infection in addition to causing weight and muscle loss. This can lead to balance issues (falls), frailty (broken bones), disability, and loss of independence—heightening the risk of hospitalization and death. This is a scary reality, as experts have estimated that the occurrence of malnutrition ranges from 12% to 50% among hospitalized seniors and from 23% to 60% among institutionalized older adults.

Risk factors attributed to malnutrition in the aging population

Physiological, psychological, and social factors that can lead to malnutrition in older adults include:

  • Inactivity: Adults tend to be less active with age, resulting in a slowed metabolism and nutrient deficiencies.
  • Illness and medications: Some chronic conditions and medications can affect appetite and nutrition absorption (particularly B vitamins).
  • Mobility constraints: Some older adults experience mobility constraints and loss of dexterity, which can make it difficult to shop for and prepare food, open containers, use tableware, etc.
  • Oral health: In general, aging is often accompanied by a decline in oral health. This can impact the ability to chew and swallow.
  • Dementia. Memory problems and behavioral issues caused by 

Alzheimer’s disease or dementia can result in forgetting to eat, not buying groceries, and other irregular food habits.

  • Depression: Loneliness, poor or failing health, lack of mobility, and other factors might contribute to depression in older adults, which can cause a loss of appetite.
  • Limited income: Many adults find shopping for nutrient-rich foods to be pricey, especially if funds are going towards medications and other important expenses.
  • Isolation: Eating alone consistently can change the way older adults view mealtime, leading to a loss of interest in food and cooking.

  • Limited access to food: Older adults who live alone, can’t drive, suffer from a chronic health condition, or have mobility restraints may find it difficult to regularly shop for groceries.

How to assess nutritional status in older adults

Nutritional assessments are key to promoting health as well as preventing, and even spotting, diseases in older adults. Many different types of assessments can be performed to gauge nutritional status: anthropometric, biochemical, clinical, and dietary (ABCD). However, reviewing nutritional status in the elderly often starts with clinical observation.

Observable Signs of Poor Nutrition

The symptoms of malnutrition (disease-related or not) often mirror the signs of aging, which can make it difficult to spot in older adults. Some observable indicators of poor nutrition include:

Observing these physical and psychological changes in an older adult should prompt further clinical evaluation, as the malnutrition could be related to a chronic condition. 

Strategies for encouraging healthy habits in older adults

There are a number of tips that older adults may find useful in improving their nutritional status, including:

  • Plan healthy meals with trusted nutritional information from sources like ChooseMyPlate.gov or National Institute on Aging.
  • Read nutritional labels to ensure you are giving your body the right amount of what it needs.
  • Ask your doctor about vitamins or supplements to support your health.
  • Opt for softer food choices if dental problems are causing pain while eating

Addressing modifiable SDoH to address insufficient nutrients

There are many solutions to support proper nutrition for older adults. One prominent program is the Supplemental Nutrition Assistance Program (SNAP.)

SNAP:

  • Plays a critical role in reducing hunger, malnutrition, and poverty
  • Is 100% federally funded for eligible adults
  • Can be used at thousands of locations across the country where older adults would normally buy their food

DispatchHealth’s Advanced Care service can also be used to help mitigate harmful SDoH, by identifying potentially harmful financial, nutritional, functional, transportation, housing, personal safety, mental health, substance/alcohol use, and medication management risks. Our team of RN nurse navigators, clinical RNs, APPs and physicians work together to address gaps and concerns that affect our patients’ overall health and well-being. 

Preventing malnutrition

Preventing malnutrition in older adults starts with prioritizing nutrition. Many mealtime strategies can help improve overall nutrition, such as nutrient-rich meal plans and nutritional supplements. Additional tips that caregivers and healthcare professionals can utilize to better assess nutrition in older adults include:

  • Monitoring medications
  • Assessing for medical conditions that may affect nutritional health
  • Regularly monitoring weight and habits
  • Recommending appropriate daily calorie intake, vitamin, and mineral supplements

DispatchHealth treats a wide range of chronic conditions in the comfort of your patients’ homes, and we’re in-network with most insurances—keeping costs down without sacrificing access to top care. Reach out today to learn more about our partnerships with senior living community leaders and other healthcare directors.

To learn more about Nutrition in Older Adults, please watch our webinar recording

Sources

DispatchHealth relies only on authoritative sources, including medical associations, research institutions, and peer-reviewed medical studies. 

Sources referenced in this article: 

  1. https://www.azhealthzone.org/uploads/tools/Senior-Nutrition-Report.pdf
  2. https://www.sciencedirect.com/science/article/pii/B9780128053768000095
  3. https://www.lifecareservices-seniorliving.com/blog/health-risks-of-poor-nutrition-for-seniors/
  4. https://www.nutrition.gov/topics/nutrition-age/older-individuals
  5. https://www.ncbi.nlm.nih.gov/books/NBK51837/
  6. https://www.winchesterhospital.org/health-library/article?id=8749
  7. https://www.fantaproject.org/sites/default/files/resources/NACS-Users-Guide-Module2-May2016.pdf
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3396084
  9. SeniorsNutrition
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