Malnutrition is highly prevalent yet widely underdiagnosed in the elderly, according to the European Nutrition for Health Alliance (ENHA).* As a call to action for the detection, prevention, and treatment of malnutrition, ENHA recently sponsored its inaugural conference in London, “Malnutrition within an Ageing Population.”
Malnutrition is an imbalance of energy, protein, and other nutrients that causes measurably adverse effects on tissue, body form and function, and clinical outcomes. Ironically, malnutrition among the elderly is occurring at a time when many public health officials are promoting campaigns to reduce caloric intake in an effort to avert the obesity epidemic.
According to ENHA, 14% of community-dwelling adults in the United Kingdom over 65 years of age are malnourished, while 60-100% of nursing home residents suffer from malnutrition. Further, an estimated 10% of nursing home residents lose 10% of their body weight in the first six months following admission. In patients under a physician’s care—including hospitalized patients—malnutrition goes undiagnosed in up to 70% of cases.
Numerous factors contribute to malnutrition in the elderly. In some cases, acquiring and preparing food is prohibitively difficult. Additionally, older adults may experience loss of appetite due to diminished sense of taste, side effects of medication, or depressed mood. Difficulties with chewing or swallowing can also make it challenging for the elderly to maintain optimal nutritional intake. Furthermore, metabolic and physiological changes associated with aging render older people more susceptible to mineral and nutrient deficiencies.
The elderly are not only at higher risk of malnutrition than are younger adults, but also are less likely to recover from metabolic complications accompanying malnutrition. The malnourished are at greater risk for complications of surgery, are more vulnerable to infection, and have longer hospital stays.
Conference attendees recommended addressing malnutrition in the elderly as a public health issue through measures such as promoting screening programs and increasing efforts to educate health care and social care professionals.
—Linda M. Smith, RN