Malnutrition is a ‘serious problem’ among older Australians, and screening is needed in aged care facilities, dietitians say

Hair loss. Weakness and disorientation. Wounds that won’t heal.

All of these symptoms may indicate malnutrition, but they are commonly confused with the “normal” aging process.

“People say, ‘I’m just getting old,’ when in reality they are malnourished and many people could avoid it altogether,” says Judi Porter, professor of dietetics at Deakin University.

Older adults have higher protein and energy needs than younger adults, but their daily intake is often much lower, so malnutrition can easily occur.

In fact, 68 per cent of people living in aged care homes are malnourished or at risk of malnutrition. And up to one in two older Australians in the community may have an inadequate diet.

“It’s a major problem in Australia,” says Karly Bartrim, a dietitian and co-ordinator of the aged care group at Dietitians Australia.

Vegetable soup and juice may fill someone up, but they do not provide enough protein.(Getty Images: Fabian Ponce)

Early intervention is crucial because waiting for help can prove fatal.

“Unfortunately, in Australia you can die from malnutrition… people can definitely disappear,” Professor Porter said.

Despite the scale of the problem, there are no specific nutritional guidelines for older people at risk of malnutrition in Australia.

There is no mandatory screening for malnutrition in senior care facilities.

“Malnutrition is so common in aged care, but dietitians only get involved when there is weight loss, which is often a side effect,” Ms Bartrim says.

“If we had been caught earlier, we could have prevented the weight loss.”

How is this possible?

Loss of appetite or reduced interest in food can have a variety of causes – some physical, others psychological.

Older people carry a heavy burden chronic diseases that can affect appetite, such as kidney and liver disease and congestive heart failure.

And people living with dementia They may forget to eat, shop, or simply forget about foods they used to enjoy.

“If someone in your family asks you what you had for lunch, you might just say a sandwich, because you’ve been eating sandwiches for the last 80 years, but maybe you haven’t actually eaten one,” says Professor Porter.

Bad fit dentures it can discourage someone from eating and also dysphagiai.e. when someone has difficulty swallowing.

Nutritionists say that older people should first eat foods rich in protein, and only then vegetables.(Getty Images: Johnce)

Poor emotional well-being can also discourage someone from eating.

Lonelinesswhich affects one in five older Australians, clinical depression AND sadness are common causes.

“It happens to thousands of Australians – they get a bad mood, so their appetite goes down,” Professor Porter says.

“This is about seeing your GP and treating depression, not low appetite.”

Unsafe food is another important reason. If someone can’t afford to buy nutritious food, they may skip meals or eat cheap, unhealthy options.

Besides, we often take more Medicines As we age, we may experience impaired absorption of nutrients, including vitamin B12, sodium and magnesium.

What can happen?

If someone loses 5 to 10 percent or more of their total body weight over a period of three to six months, it usually indicates malnutrition.

But there are other things worth paying attention to.

Energy levels may disappear and the person may not feel like himself, as this may affect his cognitive functions and behavior.

Their resistant system they can also be weaker and may have weaker wound healing : recovery.

“We can always tell when someone isn’t eating because the wound takes a long time to heal,” says PhD student Ms. Bartrim.

They will probably lose too muscle mass because their body is in starvation mode and burns muscle to function.

Being underweight may be more dangerous for older people than being overweight.(Getty photos)

This can lead to a musculoskeletal disorder called sarcopeniathat is, when the strength, quantity or quality of muscles, as well as physical fitness, decreases.

This can keep someone from getting up and doing what they love.

“That leads to people becoming more socially isolated, often becoming depressed, feeling lonely, and that creates a feedback loop where they don’t want to bother with food,” says Professor Porter.

People with sarcopenia have a higher risk it’s falling AND fractures and less ability to regenerate.

“If someone is malnourished and falls, their body simply doesn’t have the reserves to support them,” Ms Bartrim says.

A fracture may require hospitalization, and the patient’s health condition will deteriorate due to malnutrition acquired in the hospital, which may affect up to 65% of hospitalized patients.

This is because people are in unfamiliar surroundings, disoriented, and have few choices about what to eat. On average, this means a patient stays in hospital for an additional 21 days.

Changing your diet and meal times can help

Early diagnosis is key.

Don’t wait to seek help, because once you lose muscle mass, it can be very difficult to rebuild it.

“So if you start to notice changes in your mobility or changes in your weight or eating habits, I wouldn’t hesitate to seek a referral to a dietitian,” Ms. Bartrim says.

If someone has a chronic condition, they may be eligible for up to five subsidised sessions with a healthcare professional e.g. a dietitian or exercise physiologist who can help you rebuild muscle mass.

However, there are simple dietary changes you can make immediately.

For older people, the emphasis should be on eating foods that are lots of protein and energywhich means vegetables take a back seat.

Eggs are high in protein and good for people who wear dentures or have difficulty swallowing.(Getty photos)

“People say to me, ‘OK, I’ll just go home and eat more vegetable soups and salads,’ but they shouldn’t worry about that because it makes the problem worse because they don’t have the energy,” says Professor Porter.

AND don’t buy “diet” or “low fat” optionsCarrying a few extra pounds as an older person is protective; it could be the padding that keeps you from breaking in a fall, or the extra energy needed during chemotherapy.

“We’re telling people the opposite of what they were told as children,” Miss Bartrim says.

“Don’t skip dessert, eat the ice cream.”

But how can you eat more if you don’t feel like it?

A technique called “eating by the clock” can help establish a routine if you have lost your appetite and need mental incentive to eat.

It involves eating six small meals at the same time every day, even if you are not hungry.

Beverages that are dietary supplements between meals are better than just tea or coffee, but food should always be the first option.

“We know that people derive much more joy from eating than from drinking,” Ms Bartrim says.

And finally, family members should try not to cause stress during meals putting a lot of pressure on someone to eat. Approach it socially, choose comfort foods, and take your time.

The Bigger Picture

The current Australian Dietary Guidelines do not cover “frail older people at risk of malnutrition”, who are “typically” over 75 years of age.

The guidance says this is because of the “complex health needs” of this group and that specialists should be consulted for advice.

However, the National Health and Medical Research Council (NHMRC) is currently reviewing the guidelines and the updated version will cover people aged 65 and over and include advice in the prevention of malnutrition, frailty, falls and chronic diseases.

Updated guidelines are expected to be published in 2026.