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[5 min read] Managing malnutrition in older adults
Well before COVID-19 emerged to become a global public health crisis, the world was already witnessing a much quieter epidemic: malnutrition.
Malnutrition, often referred to as undernutrition, is common among elderly individuals, with an estimated 10-44 per cent of older Australians living in the community being at risk (1). It is a condition resulting from inadequate intake or absorption of dietary energy, protein, and other nutrients (2), and can be associated with adverse medical consequences and a general decline in functional status, contributing to high hospitalisation and readmission rates, morbidity, and mortality (3).
Validated screening tools such as the Malnutrition Screening Tool provide a simple and reliable way to identify if elderly patients are at risk of malnutrition (4). Other common signs include their jewellery and clothing becoming loose, a reduced appetite, tiredness, and altered mood. While there is no single marker for malnutrition, proper training and awareness of the issue will help promote early intervention for older patients at risk.
An important component in the prevention and management of malnutrition is nutritional therapy, which can be delivered alongside medical and functional interventions. The first step is to focus on increasing intake using a food-first approach (5), which aims to improve the person’s nutrition through tailored dietary strategies including:
- Small and frequent: Encouraging many small meals and snacks throughout the day
- Nourishing drinks: Drinking liquids such as milk, hot chocolate, smoothies and lassis as an easy way of increasing energy intake
- Food enrichment: Use pantry staples to enrich meals and snacks such as adding skim milk powder, butter, almond meal and grated cheese to boost the nutritional content of foods
Patients with complex needs or high malnutrition risk should be referred to an Accredited Practising Dietitian for full assessment and intervention.
General practice is an ideal setting for the early identification and management of patients at risk of malnutrition. Learn more about how medical nutrition therapy can be incorporated into your practice in the online Professional Diploma Program in Medical Nutrition.
– Lynette Law, Bond University
- Flanagan D, Fisher T, Murray M, Visvanathan R, Charlton K, Thesing C, et al. Managing undernutrition in the elderly Prevention is better than cure. Australian Family Physician. 2012;41:695-9.
- Cederholm T, Bosaeus I, Barazzoni R, Bauer J, Van Gossum A, Klek S, et al. Diagnostic criteria for malnutrition–an ESPEN consensus statement. Clinical nutrition. 2015;34(3):335-40.
- Fávaro-Moreira NC, Krausch-Hofmann S, Matthys C, Vereecken C, Vanhauwaert E, Declercq A, et al. Risk Factors for Malnutrition in Older Adults: A Systematic Review of the Literature Based on Longitudinal Data. Advances in Nutrition. 2016;7(3):507-22.
- Aged, Community and Mental Health Division, Victoria. Identifying and planning assistance for home-based adults who are nutritionally at risk: a resource manual. Melbourne: Home and Community Care Program, 2001 [Available from www.health.vic.gov.au/hacc/downloads/pdf/resourcemanual.pdf]
- British Association for Parenteral and Enteral Nutrition. Food First/Food Enrichment. 2016 [Available from: https://www.bapen.org.uk/nutrition-support/nutrition-by-mouth/food-first-food-enrichment.