Approximately 8% of older Australians living in the community are malnourished, and it is estimated that of those living in residential aged care facilities (RACFs), between 22% and 50% are malnourished.
Malnutrition in aged care is associated with poorer health outcomes and an increased risk of hospitalisation. Those with malnutrition are at a higher risk of falls and fractures, and the severity of those fractures is worse. It is also associated with weakened immunity, poorer wound healing, development of pressure wounds and decreased strength and mobility.
Reversing malnutrition in aged care is difficult as older people don’t generally regain their appetite like younger people. Therefore, prevention and early intervention is needed.
Appetite loss is a leading cause of malnutrition and is attributed to some of the factors discussed below:
Physiological Causes
The physiological changes that occur with ageing that can increase the risk of malnutrition include changes to the digestive system, hormonal changes, illness, pain, changes to the sense of smell, taste and vision and a decreased need for energy.
Reduce Saliva
An estimated 33% of older people have reduced saliva production, which can impair appetite and make it harder to eat; this is usually associated with medication side effects. In relation to this, older people are also more likely to have poor dentition and wear partial or full dentures, which can have an impact on chewing ability and, therefore enjoyment of food. Overall, poorer oral health impacts taste, which may impact appetite and food enjoyment.
Gastric Emptying
Gastric emptying is slower; therefore, food remains in the stomach longer therefore reducing appetite and increasing time between meals. In relation to this, between 30-50% of older people struggle with chronic constipation, which also impacts appetite
Chronic Disease
Chronic diseases can also worsen appetite and lead to an increase in nutrition needs, therefore increasing the risk of malnutrition. These include cardiac failure, chronic obstructive pulmonary disease, renal disease, liver disease, Parkinson’s disease, Dementia and cancer, all of which are more prevalent in older people.
Reduced dexterity and, therefore, the ability to prepare a meal and feed oneself; food takes longer to consume and goes cold. Chronic pain is associated with a decrease in appetite; it is estimated about 50% of older people have a form of chronic pain.
Other Causes
Other causes may include:
- Feeding or swallowing issues
- Poorer oral health, which can impact the taste
- Constipation
- Changes in the levels and responsiveness to some of the hormones involved in appetite control
- Side effects of medications, such as nausea
- Impairment of the sense decreasing the enjoyment of food
- Decrease in muscle mass and physical activity
- Depression and loneliness
How can we help?
Our dietitians are dedicated to reducing the risk of malnutrition in our clients and improving their quality of life.
Here are some outcomes that you could expect with dietetic management:
- Increase in physical function and energy levels
- Improved hydration, digestion and better bowel health
- Healthy weight range
- Education on food choices
- Increased independence and improved mobility
- Improvement in food preparation skills
- Increased mealtime independence
- Commencement of a meal delivery service
- Commencement of appropriate oral nutritional supplements
For more information on understanding malnutrition, speak with a qualified dietician via our friendly team at Recovery station on 1300 588 851.
Until next time,
