Advancing age can bring with it experience, wisdom and unfortunately, a higher risk of malnutrition. Almost a million Canadians aged 65 and older are at nutritional risk, with women being at a higher risk than men. This means that almost one million Canadians have one or more of the risk factors that contribute to poor dietary intake, some of which are preventable.
Impaired mobility and dexterity, declining health and lack of transportation can all be barriers to purchasing and preparing meals. The loss of a spouse can also lead to a decline in dietary intake, especially if that spouse was responsible for preparing all meals.
Chronic conditions and the medications many seniors take to treat them can inhibit appetite, the absorption of nutrients and the taste and enjoyment of food. Poorly-fitting dentures, poor dentition or difficulty swallowing may also lead to decreased intake due to the avoidance of certain foods for a fear of choking. It can be difficult for many seniors to meet their dietary requirements when multiple barriers present themselves.
Without intervention, seniors at risk of malnutrition may become frail and more likely to develop functional limitations, skin breakdown, poorer quality of life, longer hospital stays and readmissions, and earlier death. It's important to be able to identify the risk factors for malnutrition later in life to help prevent or prolong the onset of these issues.
In hospital, I visit with many elderly patients whose level of malnutrition is affecting their mobility, overall health and length of admission. Unfortunately, many of these patients have deteriorated because multiple risk factors have either gone unnoticed or were disregarded as being a "normal part of aging." It's up to loved ones and care providers to recognize the signs of malnutrition, especially when a senior does not have as much insight into their own health and behaviours, such as in those individuals with dementia.
Signs of malnutrition in the elderly can include being underweight, weight loss, loose fitting dentures or clothes, a lack of body fat, slow healing wounds, significant weakness and frequently getting sick.
Malnutrition can go unnoticed when an individual appears to be a normal body weight or overweight. It's not just a lack of calories or protein that can lead to malnutrition but a lack of vital micronutrients. A deficiency of calcium and Vitamin D can have a detrimental effect on bone health, and a zinc deficiency can lower immune function in older adults. A poor quality diet can contribute to cognitive impairment, functional limitations, anemia and a lower ability to recover from illness or surgery. Malnutrition of important micronutrients can lead to a ripple effect in the overall health of a senior.
Although caloric requirements decrease with advanced age, the importance of eating a nutritious diet does not diminish. Unfortunately, an inadequate diet can lead to chronic conditions, while existing conditions, and the associated treatments, can affect or impair the adequacy of the current diet.
If you're aged 65 or older, or have a senior in your life, and notice any of the risk factors or signs of malnutrition call HealthLink BC at 8-1-1 to speak with a dietitian or go to www2.gov.bc.ca/gov and search "Healthy Eating for Seniors Handbook" for more information.
Kelsey Leckovic is a Registered Dietitian with Northern Health working in chronic disease management.