The signs of malnutrition in older adults and how to help

The UK as a nation has rising obesity levels, with numbers going up and up in the last 30 years – and not looking to slow in the coming ones. According to the UN Food and Agriculture Organisation 2013 report, one in four UK adults is obese. Obesity is a serious problem, but with such talk around it, it’s also easy to forget that the UK has problems with diet on the other end of the spectrum: undernutrition.

Malnutrition affects millions of people in the UK, and can be divided into two general categories – undernutrition, which means not getting enough nutrients, and overnutrition, which means getting too much. Nutrients come in many forms, including calories, carbohydrates, vitamins, proteins, and minerals.

Who is at risk from malnutrition?

While anyone can be affected by undernutrition, it is much more common in people who have swallowing problems, long-term health conditions affecting weight and appetite, conditions affecting how nutrients are absorbed, depression and isolation, and people who have low social mobility/low income.

The elderly are particularly vulnerable to malnourishment, and it is a serious issue which can affect older adults as a result of various causes. It is important to know the signs of inadequate nutrition, so you can ensure those around you and those you love are getting the nutrients that they need.

Signs of malnutrition in older adults

• A lack of interest in eating and drinking. Malnutrition can lead to a lack of appetite, or total disinterest in eating. Those who are sick might lack the drive to eat, and if someone lives alone, it might be difficult for them to find motivation to cook for themselves
• Weight loss. Sometimes it can be difficult to tell, but watch for changes in how clothing fits. Losing 5-10% of body weight in around 3-6 months is a common sign of malnutrition
• Bruising easily, or having wounds which take a long time to heal
• Constant tiredness, and feeling weak/frail
• Inability to keep warm
• A sore mouth, tongue, or bleeding/swollen gums
• Dry skin
• Frequent infections
• Diarrhoea, or constipation
• Being prone to falls, and often feeling dizzy

Some of these symptoms can be present with other conditions, but it is important to be aware of the signs, and if you suspect a loved one may be malnourished, you can help them to improve their access to food.

Ways in which you can help older, malnourished adults

• Share meals with them, or make mealtimes a social event, by inviting them to you or dropping by for a meal
• Encourage them to eat foods which are high in nutrients, such as nuts added to yoghurt or cereal, nut butter (peanut butter, almond butter) on fruit, extra egg whites in omelettes, and whole milk instead of skimmed
• Encourage physical activity. Do something together, such as going for a walk or exercising, which can stimulate appetite and also strengthen the muscles
• If the problem is a restricted diet, which can sometimes happen with certain medications and in the treatment of certain conditions, try to make the diet more appealing by using herbs and spices
• If you become very concerned, encourage them to visit the GP or a health specialist to get the help they might need, which can include assessing medical problems, or referral to a dietician or nutritionist

Even if they are in good health and have no medical complaints, it’s quite common for older people to lose appetite or not really feel like eating. Making little changes, like snacking, or frequently eating smaller meals can make it easier to manage, and boosting calorie intake through high-energy foods are ways for anyone to help improve their energy and nutrient intake if they feel they are not getting the nourishment they need.