weight loss

Malnutrition in the elderly

Recent research has shown an increase in malnutrition in the elderly. Poor nutritional status and malnutrition in the elderly population are important areas of concern. Malnutrition and unintentional weight loss contribute to progressive decline in health, reduced physical and cognitive functional status, increased utilisation of health care services, premature institutionalisation, and increased mortality.

One in ten adults over the age of 65 are malnourished or at risk of being malnourished , with over 90% of these individuals living independently. Malnutrition is often due to one or more of the following factors: inadequate food intake; food choices that lead to dietary deficiencies; and illness that causes increased nutrient requirements, increased nutrient loss, poor nutrient absorption, or a combination of these factors.

When financial concerns are present, meals are often skipped and food that is purchased may not provide a nutritionally adequate diet. Declines in functional status both physical and cognitive, affect a person’s ability to shop for food and to prepare meals.

Nutritional problems are further compromised by inadequate social support networks and by the resultant social isolation, which commonly leads to apathy about food and therefore decreased intake. Late life can be a time of multiple losses. The older person has experienced change and loss through retirement, disability and death of friends and family as well as change in financial, social, and physical health status. These changes may lead to depression, a well-known cause of anorexia and weight loss. Even transient depressed mood (as with bereavement) can cause clinically significant weight loss.

Dehydration is common among older people and especially older people with dementia. People may not recognise they are thirsty, may forget to drink, may be unable to communicate that they are thirsty, or may refuse to drink because they are worried about incontinence.

Dehydration can cause headaches, confusion, irritability, falls, loss of appetite and constipation which can contribute to urinary tract infections – and these infections in turn can lead to incontinence. Older people who are incontinent need to drink more, not less, in order to encourage the bladder to empty regularly to prevent infection and to exercise the bladder muscles.

How can you help an elderly relative or neighbour?

If you have significant concerns with any sudden weight loss or other symptoms try and see if the individual would see their GP for a health check up.  An online screening tool is available which looks at the individuals weight now and three months ago to determine risk.

  • Having small, nutritious meals more often across the day can help if people have a poor appetite
  • Make sure drinks given between meals offer nutrients as well – for example, milky drinks, fresh fruit juices and smoothies
  • Make available nutritious snacks that the person can eat while moving around, for example some individuals with dementia pace around constantly and have high energy needs. Finger foods can be left out on the route that the older person may take when they wander.
  • It is important to remember that older people need to eat good food whatever their weight, and that overweight people can be under-nourished too, if they don’t get enough nutrients.
  • Ensure they stay hydrated, this can be from drinks such as tea, coffee, water, milk, fruit juice and smoothies and via the food they eat, soups, stews, fruit and vegetables, ice cream and yoghurt.
  • Older people with dementia may choose sweet foods over savoury ones and it has been shown that a craving for sweet foods is part of the clinical syndrome for dementia at some stages. If people eat only sweet foods – for example, if they just eat desserts – they will not get all the nutrients they need. However, it can be useful to add some sweet ingredients to dishes, to encourage people to eat a range of foods – for example, adding sweet apricots to a meat dish, adding fruit to salads and snacks, adding honey to porridge or milky puddings, or adding jam to peanut butter sandwiches, might encourage the person to eat the food and also make a useful contribution to nutrient intake.

If you want a personalised assessment of yours or a relative current diet and a weeks meal plan please contact Susan.









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