The Elderly and Malnutrition
At any age, nutrition is vital to maintaining health and enhancing quality of life. However, achieving good nutrition can be especially difficult for the elderly, the fastest growing portion of America's population. Many factors, including physiological changes, changes in nutritional needs, illness and physical limitations, food-medication interactions, depression and loneliness, and food insecurity are common causes of malnutrition in the elderly. This paper will explore factors affecting elderly nutrition, provide suggestions for obtaining and maintaining good nutrition after age 65, and describe the services available to help the elderly meet their nutritional needs.
A number of factors influence the nutritional status of the elderly. First, several physiological changes impact elderly nutritional requirements. Changes in taste and smell may decrease an individual's appetite or desire for food. Gastro-intestinal motility decreases with age and may lead to constipation, decreased nutrient absorption, and a decrease in fat and protein absorption. Metabolism also slows with age; this results in a decrease of lean body mass and an increase in body fat (8). Lastly, bone mass decreases, leaving the elderly vulnerable to bone fractures from falls and osteoporosis.
Ultimately, these physiological changes result in different nutritional needs for the elderly. The Food and Nutrition Board of the National Academy of Sciences issues the Recommended Daily Allowances for healthy people over the age of 51. However, these RDAs are limited in that they have been derived from studies of younger, healthy populations and do not account for extenuating factors, such as morbidity and drug interactions, which are common problems for the elderly diet.
The RDA for protein for seniors is 12-14% of the diet. Protein is needed to build and maintain body tissues, and these needs increase for individuals during illness and after surgery (8). Although fat digestion decreases with age, a small amount of fat is still necessary since it is a concentrated energy source and transports vitamins. No more than 30% of total calories should be from fat. Carbohydrates should make up 50% of daily calories, and 25-35 grams of fiber should be eaten to prevent GI stress. Overall, caloric needs decrease with age, generally a 10% reduction between the ages of 51-75 and up to a 15% reduction after age 75 (8). These needs are not exact; they are dependent on both activity level and body composition.
Although calorie needs decrease, the elderly have an increased need for certain vitamins and minerals. Therefore, it is especially important for the elderly to eat foods that are nutrient dense (6). They should eat an array of fruits, vegetables, whole grains, lean meat, fish, poultry, low-fat milk, and dairy products while ...