Malnutrition in the Elderly: What it is and How to Prevent it

Malnutrition in the Elderly: What it is and How to Prevent it


In this short article we will talk about malnutrition in the elderly ; more precisely what it consists of, how to classify it and above all how to prevent it.

This is a rather vast topic, very important both in socio-economic and health terms – given that the population of the so-called “elderly” seems to be constantly increasing (with the exception of the covid -19 pandemic period ).We have therefore selected the information which, in our opinion, is most important in the diet of the subject in old age.

However, it is advisable to keep in mind that geriatric nutritional complications are extremely “delicate” to treat, because they are sometimes potentially risky. It is therefore always good practice, when in doubt, to consult your doctor.

Malnutrition in the Third Age

What is meant by malnutrition and why it affects the elderly more

By  malnutrition  we mean a state of  functional , structural  and developmental  modification of the organism, consequent to the alteration of the balance between the needs and the income (or use) of dietary nutrients, which favors morbidity  and increases the risk of mortality .

Malnutrition occurs more easily in the elderly than in other age groups.

This is also because, due to aging , the organism reduces many of its physiological capacities causing a change in body composition  such as:

  • Lean mass ratio   (FFM)/ fat mass  (FM) in favor of fat ;
  • Reduction of overall hydration ;
  • Reduction of  bone mineralization .

All this is then aggravated by a reduced perception of bodily stimuli ( hunger and thirst ) and by the predisposition to psychiatric comorbidities ( depressive  and/or  anxious disorders ) or neuro-degenerative diseases ( Alzheimer’s disease ,  Parkinson ‘s  , etc.).

How is malnutrition classified in the elderly?

Malnutrition in the elderly can be classified into primary and secondary .

  • Primary malnutrition is linked to inappropriate eating behaviors influenced by physiological, pathological, socio-economic and environmental factors ;
  • Secondary malnutrition mainly depends on impaired digestive capacity , reduced intestinal absorption potential, ineffective blood transport and poor metabolization of nutrients .


Body weight and nutritional deficiencies

Can the elderly “should” or “should” lose weight?

The malnutrition trend in the elderly affects all nutrients, including  dietary fiber  and water .

They are mostly related to an insufficient overall dietary intake which, if sometimes it is the result of inappropriate food choices – or forced by precarious socio-economic conditions – in other cases concerns a nutritional strategy aimed at combating overweight .

This is because, in old age , the overall energy expenditure decreases due to the lowering of the basal metabolic rate  (MB) and the level of  physical activity (LAF), favoring excess weight. Sometimes, in order to prevent or remedy this condition, we intervene by reducing the caloric intake.

On the other hand, doing so risks compromising the recommended servings of essential nutrients . Moreover, in these subjects, a modest increase in adipose mass plays a protective role against  bone fractures  caused by contusion . Restrictive diets should therefore be limited as much as possible.

Sometimes unfortunately – as in the presence of severe obesity or important metabolic pathologies or cardio -respiratory complications – the application of a slimming diet is inevitable , as it constitutes the “lesser evil”. It must be the specialist’s care to prevent nutritional deficiencies by minutely balancing the diet or supplementing if necessary.

Diseases and Disorders

What conditions can make the situation worse?

Malnutrition in the elderly is often aggravated by pathological conditions of significant entity which can compromise both eating habits and levels of nutrient absorption . It is the case of:

  • Esophageal disease  ( dyspepsia ,  reflux and diverticulosis )
  • Gastric  ( gastritis ,  ulcers , dyspepsia)
  • swallowing ( dysphagia ) _
  • Intestinal  ( constipation , diverticulosis,  Crohn’s disease , etc.)

It should also be emphasized that other pathologies of a different nature can determine an increase in certain needs; are indicative examples:

  • Sarcopenia : requires a greater intake of essential amino acids ;
  • Osteoporosis : requires a greater intake of vitamin D.


Prevent Malnutrition

How to prevent malnutrition in the elderly?

Preventing malnutrition in the elderly is essential to ensure a better quality of life and life expectancy .

The most important precautions are:

  • Guarantee the intake of  proteins  of good  biological value  containing  essential amino acids useful for the preservation of muscle mass ;
  • Monitor that the intake of  carbohydrates is not excessive with the risk of compromising the energy -nutritional balance;

Note : since most of the elderly tend to consume little meat, fish , eggs and low-fat cheeses , by replacing some cereal-  based  foods  with those containing  legumes  , it is possible to increase the protein quota at the expense of that of carbohydrates;

  • Encourage the consumption of   fresh  vegetables  and  fruit containing an abundant ration of vitamins; water solubles ,  trace elements ,  antioxidants , water and dietary fiber;
  • Make sure that the intake levels of  essential fatty acids  fall within the  minimum requirement , as omega 3s participate in the health of the central nervous system in the elderly ;
  • Limit the consumption of  alcoholic beverages;
  • Promote water consumption.


In order to guarantee natural aging and limit health interventions on geriatric patients, it is very important to reduce the incidence of malnutrition in the elderly and to promote, when possible, the maintenance of  general fitness  through an  accurate cardiovascular training and muscle strengthening plan .



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