How to identify malnutrition in older adults

April 24, 2018
/ Aged Care, Malnutrition, Muscle, Nutrition, Sarcopenia

Thinking of malnutrition tends to generate images of starving people in third world countries. But malnutrition is silently affecting aging people at home. It afflicts a third of older adults admitted to hospital and over half of aged care residents – and it is often overlooked.

Malnutrition in aging can have serious consequences for physical and mental health, recovery from illness and quality of life. Prevention is best, so it is important to detect malnutrition early.

How can you tell if your loved one – whether it be partner, parent, grandparent or someone you care for – is malnourished or at risk for malnutrition? Here are some clues to be aware of.

Signs of malnutrition

Weight loss
The primary, most obvious symptom is weight loss. Technically malnutrition is defined as unintentionally losing 5-10% body weight over 3-6 months. Other indicators include baggy clothes and belts. Even loose jewellery (e.g. rings) and dentures are tell-tale signs.

Feeling tired, weak or dizzy

Food provides calories and essential nutrients needed to produce energy. Not meeting nutritional needs through diet can result in tiredness, weakness and dizziness. A clue here could be reduced levels of mobility. Look out for diminished muscle mass – a risk factor for sarcopenia.

Depression, low mood

It’s commonly recognised that depression can affect people’s appetite. But nutrients from food – carbohydrates, protein, healthy fats, vitamins and minerals – are also vital for healthy brain function. Not getting enough can impact mood and even lead to major depression.

Poor appetite

Aging and some medications can alter taste and appetite. Eating less can, in turn, reduce appetite. Strategies to provide tasty, nutrient-rich food, small meals and regular snacks can help mitigate this.

Teeth and gums

You can’t fool your dentist. Teeth and gums are a key indicator of nutrition and health status. Swollen or bleeding gums are early oral symptoms of malnutrition. If malnutrition progresses, it can cause irreversible tooth decay.

Hair & nails

Check brushes and clothes for excess hair. Hair loss and lack lustre hair can reflect poor nutrition status, particularly insufficient protein and iron. Nails also become dry, brittle and discoloured if essential nutrients are lacking. When iron levels drop too low, nails can start curling upwards, signalling possible iron-deficiency anaemia.

Infections and wound healing

Our immune system needs nutrients to prevent and ward off disease. Frequent illness and infections can reveal poor nutrition status. Also be on the watch for easy bruising and wounds that don’t heal easily.

Bowel habits

Chronic constipation can signal insufficient food intake to mobilise the digestive tract; it can also reflect inadequate fibre and/or dehydration – common in older adults. Conversely, watch out for persistent diarrhoea because this can decrease nutrient absorption and exacerbate malnutrition.

Addressing malnutrition

Several strategies can prevent and alleviate malnutrition. Most important are regular meals and snacks containing protein and energy, a variety of food from the key food groups, and regular drinks to avoid dehydration.

Barriers and catalysts of eating need to be identified and addressed, and every effort made to help older people enjoy food and the enhanced wellbeing that it delivers.