By Nell Lake
After her stroke, a 95-year-old woman in New York State found that she could no longer taste her food. She was also unable to feel hunger, so she didn’t know when she was supposed to eat. As a result, the woman began losing weight, grew weak and wasn’t getting the nutrients she needed.
Enter Meals on Wheels, a national home-delivered meals program established by the 1965 Older Americans Act. The woman (who asked that her name not be used) began receiving meals at her home five days a week. This, she says, helped her remember to eat regularly. Her weight improved, and so did her general health.
Malnutrition like hers is surprisingly common. Six percent of the elderly who live at home in the United States and in other developed countries are malnourished, according to a 2010 study in the Journal of the American Geriatric Society. The rate of elder malnutrition doubles among those in nursing homes, where it is 14 percent, according to the same study.
And rates skyrocket among elderly populations in rehabilitation facilities and hospitals: Various measures show an astonishing one third to one half of seniors are malnourished upon being admitted to the hospital.
“Malnutrition is a serious and under-recognized problem among older adults,” says Nancy Wellman, a nutritionist and instructor at Tuft University’s Friedman School of Nutrition Science and Policy.
It’s not a new problem. But growth in the elderly population, and concerns about healthcare costs, have helped renew efforts by nutritionists and other advocates to establish screenings for malnutrition in medical settings, and to improve interventions that can prevent or reverse the issue.
Most basically, malnutrition means not getting enough nutrients for optimal health. In older adults, the causes are complex, experts say. Illness, disability, social isolation, poverty — often a combination of these — can all contribute to malnutrition. An older person may become malnourished because she has trouble chewing or swallowing. The medications she takes may suppress appetite. She may be unable to get to a grocery store. She may live alone, be depressed, or simply be uninterested in eating.
It’s important to know, says Connie Bales, a dietician and faculty member at Duke University Medical Center, that obese and overweight seniors can be malnourished, too. Eating too many calories doesn’t necessarily mean you’re getting the right nutrients for maintaining muscle and bone. “One can be quite malnourished, yet not be skinny,” Bales says.
Whatever the cause, malnutrition leads to further trouble. It increases older adults’ risk of illness, frailty and infection. Malnourished people visit the doctor and are admitted to the hospital more often, have longer hospital stays and recover from surgery more slowly.
The association between malnutrition and hospitalization goes both ways, say Wellman and other experts: The sick are more likely to become malnourished, and the malnourished are more likely to get sick. Continue reading