Around the world the elderly population is increasing. Along with it comes the increase in malnutrition. Despite the significant advances in medicine, even in developed countries, under-nutrition remains a significant public health problem. The overall prevalence of malnutrition is 22.6 percent. In hospital settings, nearly 40 percent of the elderly and 50 percent of those in rehabilitation facilities are malnourished. In nursing homes, 67 percent of the residents are malnourished or are considered at risk for developing malnutrition. Those living alone in the community are not immune — 38 percent are malnourished or at risk of malnutrition.

Why is malnutrition of concern? One of the major reasons is that it increases morbidity (diseased state) and mortality (death) . Malnutrition can delay the time it takes to recover from a hospitalization, can increase the susceptibility to infection, interfere with the quality of life and increase the risk of death. Malnutrition costs society financially. Malnourished people tend to make more visits to physicians and emergency rooms, usually need more assistance from health and social services, spend more time in the hospital and are a strain on caregivers. Older malnourished patients are readmitted to the hospital more frequently than those that are better nourished.

Good nutrition is vital to keeping older people healthy and functioning to the best of their capacity. Older Americans who have lost their teeth have a difficult time chewing. Those that no longer drive and don’t live along a bus route may find it hard getting to the grocery store. Many are on a fixed income that doesn’t afford them the opportunity to buy nutritious foods as they would like. Often older Americans report having to make the decision about buying oil to heat their home, food for their table or medicine for their health.

Why do older people eat too little? The reasons include little money, too many medications, and inability to shop for groceries or the stamina to cook for themselves. Those that live alone usually are motivated to cook for themselves. Older Americans take more medicines than any other age group. Medications can interact with each other leading to poor absorption of nutrients, loss of appetite, nausea and vomiting and reduced sense of taste and smell.

Of those 65 and older, the estimate is that more than 80 percent suffer from chronic diseases and conditions associated with malnutrition. Income plays a role in malnutrition. Nearly half of the nation’s low-income elderly have lost all of their natural teeth. Problems with chewing and swallowing can lead to malnutrition. Decreased physical activity and progressive depletion of lean body mass is associated with aging. This can lead a loss of muscle mass, known as sarcopenia. Older persons who are obese are at risk for sarcopenia because fat often replaces muscle mass which results in decreased functioning ability.

If you have a friend, relative or neighbor that you believe may be at nutritional risk how can you help? There is a very easy Mini Nutritional Assessment, the Self-MNA ® available that you can complete and based on how the person scores you may want to take it to a healthcare professional for consultation. The assessment looks at food intake, weight loss, mobility, stress and dementia and/or prolonged sadness. Body weight and height or calf circumference is also considered. This is a

screening tool that is quick and easy to use. For a copy, visit

During the month of September take the time to complete this Self-MNA® for an elderly neighbor, friend, relative, spouse or maybe yourself. Based on your score you may want to bring the assessment to your primary health care professional at your next visit. There are many things that can be done to intervene when someone is at nutritional risk. Malnutrition doesn’t have to happen.

Georgia Clark-Albert is a registered dietitian nutritionist and certified diabetes educator at Penobscot Community Health Care in Bangor. She provides nutrition consultant services through Mainely Nutrition in Athens. Read her columns and post questions at or email her at