It may come as a surprise to many that, in a developed and high-income economy like Singapore, 28% of Singaporean adults aged 55 years and above are at risk of undernutrition (Wei et al. 2017).
Undernutrition is not just about being underweight. It refers to an inadequate intake of calories, protein, vitamins and minerals to meet an individual’s needs to maintain good health. Undernutrition in older adults can lead to poor wound healing, decline in physical function and poor quality of life. It is also linked with increased risk of infection, prolonged stay in hospital and increased risk of death.
Which groups of older adults are more likely to develop undernutrition?
- Those who stay and eat alone.
They may lack motivation and interest to prepare meals for themselves. Loneliness will also further reduce their desire to eat.
- Those who have swallowing difficulty/dysphagia.
They may have limited access to nutritious texture-modified meals. Lack of food variety can also lead to poor appetite.
- Those who have limited or no income.
Financially-challenged elderly individuals, especially those who have multiple medical conditions that require numerous medications, can be forced to choose between paying for medication and food.
- Those with physical mobility constraints
This may limit their ability to buy food or groceries, as well as participate in social activities. Reduced participation in social activities is linked to increased risk of death among older adults.
- Those who are on multiple dietary restrictions or medications
Over-restrictive diets may cause older adults to develop poor appetite. Medications such as erythromycin (antibiotic) and metformin (medication for diabetes) can also lead to poor appetite.
What are some early signs of undernutrition?
- Unintentional Weight loss
- Eating less than usual
- Body weakness and frequent falls
- Longer healing times for wounds
Identifying early signs of undernutrition can help to prevent complications such as infections and hospitalisation.
- If your loved one is experiencing any of the above symptoms, please consult a doctor. Some of these symptoms may be due to underlying medical conditions such as cancer, dementia and kidney failure.
- If you have concerns about managing poor appetite as a side effect of a particular medication, please seek professional advice from a pharmacist and/or doctor.
Some tips on improving older adults’ food intake:
- Encourage them to have 5 to 6 small meals a day.
- Arrange meal delivery for those who are unable to purchase meals on their own.
- Provide budget-friendly, healthy balanced meal ideas e.g. instant oatmeal with banana for breakfast, rice with barley, stir fried vegetables, steamed egg for lunch, wholemeal bee hoon soup with vegetables and tofu or chicken fillet for dinner. Some snack ideas include fruit, yogurt, red bean soup and soy beancurd dessert.
- Encourage them to dine with family and friends.
- Mann, J., & Truswell, S. (Eds.). (2017). Essentials of Human Nutrition(5th edition). Oxford: Oxford University Press.
- Robnett, R. H., & Chop, W. C. (2013). Gerontology for the Health Care Professional(3rdedition). Jones & Bartlett Learning.
- Wei, K., Nyunt, M. S. Z., Gao, Q., Wee, S. L., & Ng, T.-P. (2017). Frailty and Malnutrition: Related and Distinct Syndrome Prevalence and Association among Community-Dwelling Older Adults: Singapore Longitudinal Ageing Studies. Journal of the American Medical Directors Association, 18(12), 1019–1028. https://doi.org/10.1016/j.jamda.2017.06.017
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