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Senior health: How to detect and prevent malnutrition

How to spot malnutrition

The signs of malnutrition in older adults may be hard to spot, especially in people who don't seem at risk. To uncover problems before they become more serious:

  • Observe your loved one's eating habits. Spend time with an older loved one during meals at home, not just on special occasions. If your loved one lives alone, find out who buys his or her food. If your loved one is in a hospital or long term care facility, visit during mealtimes.
  • Look for physical problems. Red flags for malnutrition might include poor wound healing, easy bruising, dental difficulties and weight loss. Watch for signs of weight loss, such as changes in how clothing fits.
  • Know your loved one's medications. Many drugs affect appetite, digestion and nutrient absorption.

What you can do about malnutrition

Even small dietary changes can make a big difference in an older person's health and well-being. For example:

  • Encourage your loved one to eat foods packed with nutrients. Spread peanut or other nut butters on toast and crackers, fresh fruits and raw vegetables. Sprinkle finely chopped nuts or wheat germ on yogurt, fruit and cereal. Add extra egg whites to scrambled eggs and omelets. Add cheese to sandwiches, vegetables, soups, rice and noodles.
  • Restore life to bland food. Make a restricted diet more appealing by using lemon juice, herbs and spices. If loss of taste and smell is a problem, experiment with seasonings and recipes. A dietitian also can help.
  • Plan between-meal snacks. This can be helpful for older adults who get full quickly. A piece of fruit or cheese, a spoonful of peanut butter and even a milkshake can provide nutrients and calories.
  • Make meals social events. Drop by during mealtime or invite your loved one to your home for occasional meals. Encourage your loved one to join programs where he or she can eat with others.
  • Encourage regular physical activity. Daily exercise — even if it's light — can stimulate appetite and strengthen bones and muscles.
  • Provide food savings tips. If your loved one shops for groceries, encourage him or her to take a shopping list to the grocery store, check store fliers for sales and choose less expensive generic brands. Suggest splitting the cost of bulk goods or meals with a friend or neighbor, or frequenting restaurants that offer senior discounts.
  • Engage doctors. Talk to your loved one's doctors about changing medications that affect appetite or the need for a restricted diet. Request screenings for nutrition problems during routine office visits. Ask about nutritional supplements, including drinks and pudding. Inform doctors if you notice weight loss or suspect depression. Consult a dentist about oral pain or chewing problems.
  • Consider outside help. If necessary, hire a home health aide to shop for groceries or prepare meals. Also consider Meals On Wheels and other community services, including home visits from registered dietitians.

Remember, identifying and treating nutrition problems early can promote good health, independence and increased longevity. Take steps now to ensure your loved one's nutrition.

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References
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  2. Holmes S. Barriers to effective nutritional care for older adults. Nursing Standard. 2006;21:50.
  3. Bales CW, et al. Sarcopenia, weight loss, and nutritional frailty in the elderly. Annual Review of Nutrition. 2002;22:309.
  4. Zizza CA, et al. Benefits of snacking in older Americans. Journal of the American Dietetic Association. 2007;107:800.
  5. Chapman IM. Nutritional disorders in the elderly. The Medical Clinics of North America. 2006;90:887.
  6. Lee JS, et al. Nutritional and health consequences are associated with food insecurity among U.S. elderly persons. The Journal of Nutrition. 2001;131:1503.
  7. Johansson Y, et al. Malnutrition in a home-living older population: Prevalence, incidence and risk factors. A prospective study. Journal of Clinical Nursing. 2009;18:1354.
  8. Neno R, et al. Promoting a healthy diet for older people in the community. Nursing Standard. 2006;20:59.
  9. Eating well as you get older. National Institute on Aging. http://nihseniorhealth.gov/eatingwellasyougetolder/printerFriendly.html?selectedTopics=selectTopic&howtoeatwell=How+to+Eat+Well&howtoshopwisely=How+to+Shop+Wisely&faqs=Frequently+Asked+Questions&print=Confirm+print+selection. Accessed June 5, 2009.
  10. Effects of aging. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00191. Accessed June 5, 2009.
  11. Cabrera MA, et al. Malnutrition and depression among community-dwelling elderly people. Journal of the American Medical Directors Association. 2007;8:582.
  12. Bellini LM. Assessment of nutrition in the critically ill. http://www.uptodate.com/home/index.html. Accessed June 8, 2009.
  13. Lieber CS. Relationships between nutrition, alcohol use, and liver disease. Alcohol Research & Health. 2003;27:220.
  14. Ritchie C. Geriatric nutrition: Nutritional issues in older adults. http://www.uptodate.com/home/index.html. Accessed June 8, 2009.
  15. Zeratsky KA (expert opinion). Mayo Clinic, Rochester, Minn. June 17, 2009.
  16. Takahashi PY (expert opinion). Mayo Clinic, Rochester, Minn. June 17, 2009.

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Sept. 23, 2009

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