March 21, 2018

When we think of malnutrition, we often think of people who simply don’t get enough to eat. But according to the National Council on Aging, malnutrition can refer to any nutritional problem, from a diet that’s excessive to one that is inadequate or simply poorly balanced.

And while malnutrition is a problem for anyone experiencing it, older adults are especially vulnerable. Malnutrition is a leading cause of morbidity and mortality, especially in this population. Experts says that 20 percent – and perhaps as much as 50 percent -- of all patients admitted to hospital are malnourished or at risk of being malnourished, yet only 7 percent are appropriately diagnosed. This means that millions of cases are undiagnosed and potentially untreated.

Malnutrition increases length of hospital stays on average by 4 to 6 days. Further related to malnutrition is sarcopenia (loss of muscle mass) which is now linked to a higher risk of falls in older adults.

“It’s an issue is we’ve ignored for a long time, but it makes a big difference in the health of older people,” said Debbie King, director of Waco’s Meals on Wheels’ Nutrition Services.

According to the Mayo Clinic, the causes of malnutrition seem simple enough — too little food or a diet lacking in nutrients. However, malnutrition in older people can be caused by a unique combination of physical, social and psychological issues. For example:

  • Poor general health. Health problems more common in older adults can lead to decreased appetite or trouble eating. Chronic illness, certain medications, difficulty swallowing or absorbing nutrients, a recent hospitalization, a diminished sense of taste or smell, or abdominal issues, such as pain or bloating can lead to malnutrition.
  • Restricted diets. Limiting salt, fat, protein or sugar can help manage certain medical conditions but can also contribute to inadequate eating.
  • Limited income. Older adults might have trouble affording groceries, especially if they're taking expensive medications.
  • Reduced social contact. Older adults who eat alone might not enjoy eating, which can make them lose interest in cooking and eating.
  • Limited access to food. Many older adults don’t drive, which can restrict access to the right sorts of food.
  • Aging-associated factors such as grief, loneliness, failing health, lack of mobility and other factors might contribute to depression, which in turn can lead to loss of appetite.
  • Too much alcohol can interfere with the digestion and absorption of nutrients, especially if alcohol is substituted for meals.

“Texas has resources to help seniors address malnutrition,” said Chelsea Couch, Texas Health and Human Services Aging Service Coordination unit. “SNAP-Ed, the educational component of Supplemental Nutrition Assistance Program, helps people lead healthier lives, teaches people about good nutrition and how to make their food dollars stretch further.”

Area agencies on aging (AAA) also provide nutrition services, as do meal-delivery services such as Meals on Wheels. “When older adults go to a community center and have a meal that can provide them with social support and companionship. Sometimes simply eating with others can promote better eating, and it also provides social connection. Seniors can call 855-252-9240, and their call will be routed to the nearest AAA,” Couch said.

“They can also call Aging and Disability Resource Center at 855-937-2372. Counselors there can help them determine what resources they need and what services they may qualify for” Couch said.

The Texas Department of Agriculture’s Square Meals program (, a supplemental food program, can help seniors get fresh, nutritious food while also making the food dollar go further. In addition, Texas A&M’s AgriLife Extension Service offers ideas for healthy low-cost meals at