Do Not Overlook Malnutrition in Older Adults

Good nutrition is critical to overall health and well-being. Malnutrition is common among the elderly. In developed countries, around 15% of the elderly are malnourished. Malnutrition contributes not only to progressive decline in health, reduced physical and cognitive functional status but also increased utilization of health care services and increased mortality.

How to spot malnutrition

To detect malnutrition following indications are usually observed

• Unintentional weight loss more than 5% in the past 6 months
• Albumin less than 3.5 g/dL
• Body mass index (BMI) less than 18.5 kg/m²

Risk factors

1. Eating behavior – always eating the same kind of food, maintaining poor oral health, eating alone, consumption of improperly cooked food and so on.
2. Not getting enough nutrients – chronic illness (depression, dementia), use of certain medications, difficulty swallowing or absorbing nutrients, reduced sense of taste or smell etc.

Prevention and treatment

1. History taking, physical examination, laboratory investigations to find causes of malnutrition and correct them. Possible treatment can be lifestyle changes, adjusting certain medications that reduce appetite or even prescribing medications for depression if needed.
2. Nutrition supplements – Liquid nutrition supplements providing calories, protein, vitamins and minerals in a drink. Their purpose is to supplement the usual diet. Liquid nutrition supplements come in different types, including ones designed specifically for people with diabetes or kidney disease. Your doctor or dietitian can help you determine which supplement fits you best. Research shows that nutrition supplement can help increase hand-grip strength and increase appetite. Moreover, it can reduces complications and mortality rate in hospitalized patients with hip fracture.

Undernutrition in the elderly is common and can be associated with adverse medical consequences, contributing to frailty, morbidity, hospitalization and mortality. Early identification and management of people at risk of undernutrition is important.