Nutrition and Malnutrition in the Elderly

Author: Shannon Pearce, DNP

Key Points

Poor nutrition and malnutrition occur in 15 to 50 % of the elderly population, while hospitalized elders have a prevalence of 20 to 60%.

Malnourished elderly are approximately 10 times more likely to die versus those without nutritional deficits.

A diagnostic criterion for significant weight loss includes:

 

Overview

Older persons undergo changes in body composition and age related changes in physiology, metabolism and functional reserve. Consequently the well standardized nutritional requirements for younger and middle aged persons cannot be generalized to the elderly.

The following normal changes in the aging older adult

 

Etiology

The following DETERMINE acronym can be utilized to help discern the cause for malnutrition:

Etiology of Unintentional Weight Loss in the Elderly: Data from Selected Studies 
Incidence of diagnosis (%)

Diagnosis Outpatients
(N = 45)
Nursing home residents
  (N = 185)
Inpatients
(N = 154)
Outpatients and inpatients 
(N = 91)
No identified cause 24 3 23 26
Psychiatric disorder (including depression) 18 58 8 17
Cancer 16 7 36 19
Benign (nonmalignant) gastrointestinal disorder 11 3 17 14
Medication effect 9 14 NA 2
Neurologic disorder 7 15 5 2
Others (hyperthyroidism, poor intake, tuberculosis, cholesterol phobia, Others (hyperthyroidism, poor intake, tuberculosis, cholesterol phobia, 15 NA 11 20

• NA = not applicable.
• Adapted with permission from Gazewood JD, Mehr DR. Diagnosis and management of weight loss in the elderly. J Fam Pract 1998; 47:19–25.

 

Nutritional Risk Factors for Elders include:

 

Assessment

 

Prevention Strategies

MUCH EASIER THAN TREATMENT FOR MALNUTRITION

 

References

Alibhai, S.M.H. (2005). An approach to the management of unintentional weight loss in elderly people. Canadian Medical Association Journal; 172:773.

GRS 6th edition/Teaching Slides. American Geriatric Society Web site. http://www.frycomm.com/ags/teachingslides . Accessed February 12, 2010. 

Huffman, G.B. (2002). Evaluating and treating unintentional weight loss in the elderly. American Journal of Family Physicians; 65(4):640-650. 

Maher, D., & Eliade, C. (2013). Malnutrition in the elderly: An unrecognized health issue. RN Journal Online. http://rnjournal.com/journal-of-nursing/malnutrition-in-the-elderly-an-unrecognized-health-issue . Accessed October 30, 2013.

Nutrition Screening: Determine Your Nutritional Health: The Nutritional Screening Initiative Society of Hospital Medicine Web site. http://www.hospitalmedicine.org/geriresource/toolbox/pdfs/determine.pdf . Accessed February 12, 2010.

Verdy, R.B. (1997). Failure to thrive in old age: follow-up on a workshop. Journal of Gerontological A Biol Sci Medical Science; 52:M333-M6.