Abstract
The scientific literature clearly establishes the relationship between good nutrition and healthy aging. Unfortunately though, a large number of older Americans are at risk for poor nutrition not only because of the aging process but because of poverty, rurality, and/or lack of access to good quality food. Poor nutrition can easily translate into malnutrition, a leading cause of morbidity and mortality among older Americans. Malnutrition is not an inevitable side effect of aging, it can be prevented or at least managed. Medical conditions and lifestyle, social and psychological factors all play a role in increasing one’s risk for malnutrition. Prevention of or treatment for malnutrition must be improved to reverse its deleterious effects among older Americans. Despite the availability of evidence that demonstrates the benefits of good nutrition for healing and recovery, there is no consensus for implementing optimal nutrition care with gaps associated with nutrition screening, assessment, intervention, monitoring, and overall care for malnourished and at-risk hospitalized older adults. Moreover, the US government spends $51.3 billion each year to prevent malnutrition in community-dwelling older adults. In 1965, the US Congress passed the Older Americans Act (OAA), which aims to provide support (including nutrition) services for older Americans. Title III of the OAA (of the seven titles) specifically addresses the delivery of nutrition services, including nutrition education, to older adults. To date, few evidence-based nutrition education programs target this population making it clear that thoroughly tested curricula are needed, especially programs tailored to the culture and context of the older adult and their environment.
Keywords
- Older adults
- Malnutrition
- Nutrition screening
- Nutrition education
- Lifestyle factors
- Social factors
- Medical conditions
- Nutrition education
- Poverty
- Rurality
This is a preview of subscription content, access via your institution.
Abbreviations
- AAA:
-
Area Agency on Aging
- AARP:
-
American Association of Retired Persons
- AoA:
-
Administration on Aging
- eCOMS:
-
Electronic clinical quality measures
- ENP:
-
Elderly Nutrition Program
- MNA:
-
Mini nutritional assessment
- MNA-SF:
-
Mini nutritional assessment, short form
- OAA:
-
Older Americans Act
- SNAP:
-
Supplemental Nutrition Assistance Program
- SPM:
-
Supplemental poverty measure
- US:
-
United States
References
Academy of Nutrition and Dietetics (2016) Malnutrition measures specification manual. http://www.eatrightpro.org/~/media/eatrightpro%20files/practice/quality%20management/quality%20improvement/malnutritionmeasuresspecificationmanual.ashx. Accessed 5 April 2017
Administration on Aging (2014) Nutrition program evaluations report. https://aoa.acl.gov/Program_Results/Nutrition_Report/er_ch1vol1_introduction.aspx. Last updated 24 July 2014. Accessed 7 April 2017
Agency for Healthcare Research and Quality (2017) About the National Quality Strategy. Last reviewed March 2017. https://www.ahrq.gov/workingforquality/about/index.html#aims. Accessed 10 April 2017
Aselage MB, Amella EJ (2010) An evolutionary analysis of mealtime difficulties in older adults with dementia. J Clin Nurs 19(1-2):33–41
Baernholdt M, Yan G, Hinton I et al (2012) Quality of life in rural and urban adults 65 years and older: findings from the National Health and Nutrition Examination survey. J Rural Health 28(4):339–347
Bandayrel K, Wong S (2011) Systematic literature review of randomized control trials assessing the effectiveness of nutrition interventions in community-dwelling older adults. J Nutr Educ Behav 43(4):251–262
Barefoot JC, Schroll M (1996) Symptoms of depression, acute myocardial infarction, and total mortality in a community sample. Circulation 93:1976–1980
Barker LA, Gout BS, Crowe TC (2011) Hospital malnutrition: prevalence, identification and impact on patient and healthcare system. Int Environ Res Public Health 8(2):514–527
Beekman ATF, Penninx BWJH, Deeg DJH et al (2002) The impact of depression on the well-being, disability and use of services in older adults: a longitudinal perspective. Acta Psychiatr Scand 105:20–27
Berdanier C, Dwyer J, Heber D. (2013) Handbook of nutrition and food, CRC Press, vol 3. p 507
Blazer DG, Hybels CF, Pieper CF (2001) The association of depression and mortality in elderly persons: a case for multiple independent pathways. J Gerontol A Biol Sci Med Sci 56(8):M505–M509
Boyce J, Shone G (2006) Effects of ageing on smell and taste. Postgrad Med J 82(966):239–241
Braunschweig C, Gomez S, Sheean PM (2000) Impact of declines in nutritional status on outcomes in adult patients hospitalized for more than 7 days. J Am Diet Assoc 100:1316–1322
Bruce M, Seeman T, Merril S et al (1994) The impact of depressive symptomatology on physical disability: MacArthur studies of successful aging. Am J Public Health 84(11):1796–1799
Brugler L, DiPrinzio MJ, Bernstein L (1999) The five-year evolution of a malnutrition treatment program in a community hospital. Jt Comm J Qual Improv 25(4):191–206
Buzby JC (2002) Older adults at risk of complications from microbial foodborne illness. Food review-Washington DC 25:30–35
Centers for Disease Control and Prevention (2006) Oral health for older Americans. https://www.cdc.gov/oralhealth/publications/factsheets/adult_oral_health/adult_older.htm. Last updated 10 July 2013. Accessed 5 April 2017
Centers for Disease Control and Prevention (2009) Leading causes of death, 1900–1998. Updated 12 Nov .2009. https://www.cdc.gov/nchs/data/dvs/lead1900_98.pdf. Accessed 29 March 2017
Centers for Disease Control and Prevention (2011) Healthy People 2020. Updated 14 Oct .2011. https://www.cdc.gov/nchs/healthy_people/hp2020.htm. Accessed 10 April 2017
Centers for Disease Control and Prevention website (2012) National hospital discharge survey. http://www.cdc.gov/nchs/nhds/nhds_tables.htm#number. Accessed 15 May 2015
Centers for Medicare and Medicaid Services (2015) On its 50th anniversary, more than 55 million Americans covered by Medicare. https://www.cms.gov/newsroom/mediareleasedatabase/press-releases/2015-press-releases-items/2015-07-28.html. Accessed 4 April 2017
Clark JB (2013) The benefits of aging in place. In: Kiplinger’s personal finance. http://www.kiplinger.com/article/retirement/T006-C022-S002-the-benefits-of-aging-in-place.html. Accessed 10 April 2017
Comjis HC, Jonker C, Beekman AT et al (2001) The association between depressive symptoms and cognitive decline in community-dwelling elderly person. Int J Geriatr Psychiatry 16:361–367
Corkins MR, Guenter P, DiMaria-Ghalili RA et al (2014) Malnutrition diagnoses in hospitalized patients: United States, 2010. JPEN J Parenter Enteral Nutr 38(2):186–195
Correia MITD, Waitzberg DL (2003) The impact of malnutrition on morbidity, mortality, length of hospital stay and costs evaluated through a multivariate model analysis. Clin Nutr 22(3):235–239
DiMaria-Ghalili RA (2014) Integrating nutrition in the comprehensive geriatric assessment. Nutr Clin Pract 29(4):420–427
DiMaria-Ghalili RA, Michael YL, Rosso AL (2013) Malnutrition in a sample of community-dwelling older Pennsylvanians. J Aging Res Clin Pract 2:39–45
Duerr L (2006) Prevalence of food insecurity and comprehensiveness of its measurement for older adult congregate meals program participants. J Nutr Elder 25(3-4):121–146
Farber N, Shinkle N, Lynott J, et al (2011) Aging in place: a state survey of livability policies and practices. National conference of state legislators and AARP Public Policy Institute. http://assets.aarp.org/rgcenter/ppi/liv-com/aging-in-place-2011-full.pdf. Accessed 10 April 2017
Federal Interagency Forum on Aging-Related Statistics (2016) Older Americans key indicators of well-being. https://agingstats.gov/docs/LatestReport/Older-Americans-2016-Key-Indicators-of-WellBeing.pdf. Accessed 5 April 2017
Fjellstrom C (2004) Mealtime and meal patterns from a cultural perspective. Sand J Food Nutr 48(4):161–164
Foley DJ, Heimovitz HK, Guralnik JM et al (2002) Driving life expectancy of persons aged 70 years and older in the United States. Am J Infect Control 92(8):1284–1289
Getty MD, Mueller M, Amella EJ et al (2016) Differences in medical and life-style risk factors for malnutrion in limited-resource older adults in a rural U.S. state: a descriptive study. J Nutr Health Aging 20(2):121–127
Goates S, Du K, Braunschweig CA et al (2016) Economic burden of disease-associated malnutrition at the state level. PLoS One 11(9):e0161833
Goldney RD, Fisher LJ, Wilson DH et al (2000) Major depression and its associated morbidity and quality of life in a random, representative Australian community sample. Aust N Z J Psychiatry 34(6):1022–1029
Health Care Cost Institute (2015) 2014 Health care cost and utilization report. http://www.healthcostinstitute.org/files/2014%20HCCUR%2010.29.15.pdf. Accessed 5 April 2017
Higgs S, Thomas J (2016) Social influence on eating. Curr Opin Behav Sci 9:1–6
Inagami S, Cohen DA, Kinch BK et al (2006) You are where you shop: grocery store locations, weight, and neighborhoods. Am J Prev Med 31:10–17
Institute of Medicine (2013) U.S. Health in International Perspective: shorter lives, poorer health. http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2013/US-Health-International-Perspective/USHealth_Intl_PerspectiveRB.pdf. Accessed 5 April 2017
Kochanek K, Murphy S, Xu J, et al. (2016) National vital statistics reports. Centers for disease control and prevention website. https://www.cdc.gov/nchs/data/nvsr/nvsr65/nvsr65_04.pdf. Accessed 29 March 2017
Krumholz HM (2013) Post-hospital syndrome – a condition of generalized risk. N Engl J Med 368(2):100–102
Kupka-Schutt L, Mitchell ME (1992) Positive effect of a nutrition instruction model on the dietary behavior of a selected group of elderly. J Nutr Elder 12(2):29–53
Mayeda C, Anderson J (1993) Evaluating the effectiveness of the self-care for a healthy heart program with older adults. J Nutr Elder 13:11–22
Meals on Wheels America (2015) The problem and our solution. http://www.mealsonwheelsamerica.org/theissue/problemandsolution. Accessed 5 April 2017
Mitchell RE, Ash SL, McClelland JW (2006) Nutrition education among low-income older adults: a randomized intervention trial in congregate nutrition sites. Health Educ Behav 33:374–392
Mogensen KM, DiMaria-Ghalili RA (2015) Malnutrition in older adults. Today’s Dietitian 17(9):56
Moynihan PJ (1995) The relationship between diet, nutrition and dental health: an overview and update for the 90s. Nutr Res Rev 8:193–224
National Alliance on Mental Illness (2009) Depression in older persons fact sheet. https://www.ncoa.org/wp-content/uploads/Depression_Older_Persons_FactSheet_2009.pdf. Accessed 5 April 2017
National Committee to Preserve Social Security and Medicare (2016) Older Americans Act. http://www.ncpssm.org/PublicPolicy/OlderAmericans/Documents/ArticleID/1171/Older-Americans-Act. Accessed 10 April 2017
National Conference of State Legislatures (2016) Federal and state recognized tribes. http://www.ncsl.org/research/state-tribal-institute/list-of-federal-and-state-recognized-tribes.aspx. Updated Oct 2016. Accessed 3 April 2017
National Council on Aging (2015a) Facts about healthy aging. https://www.ncoa.org/news/resources-for-reporters/get-the-facts/healthy-aging-facts/. Accessed 3 April 2017
National Council on Aging (2015b) Senior SNAP participation visualization. https://www.ncoa.org/economic-security/benefits/visualizations/senior-snap-participation/. Accessed 5 April 2017
National Institute on Aging (2015) Encouraging eating: advice for at-home dementia caregivers. Nutrition Institute on Aging. https://www.nia.nih.gov/alzheimers/features/encouraging-eating-advice-home-dementia-caregivers. Accessed 5 April 2017
Nestle Nutrition Institution (2009) MNA Mini nutrition assessment overview. Revised 2009. http://www.mna-elderly.com/. Accessed 3 April 2017
Patel V, Romano M, Corkins MR et al (2014) Nutrition screening and assessment in hospitalized patients: a survey of current practice in the United States. Nutr Clin Pract 29(4):483–490
Pennix B, Guralnik L, Ferrucci D et al (1998) Depressive symptoms and physical decline in community-dwelling older persons. JAMA 276(20):1720–1726
Pheley AM, Holben DH, Graham AS et al (2002) Food security and perceptions of health status: a preliminary study in rural Appalachia. J Rural Health 18(3):477–454
Shils ME, Shike M (2006) Modern nutrition in health and disease. Lippincott Williams and Wilkins, Philadelphia
Short K. (2015) Current population report: the supplemental poverty measure 2014. United States Census Bureau. https://www.census.gov/content/dam/Census/library/publications/2015/demo/p60-254.pdf. Accessed 7 April 2017
Somanchi M, Tao X, Mullin GE (2011) The facilitated early enteral and dietary management effectiveness trail in hospitalized patients with malnutrition. JPEN J Parenter Enteral Nutr 35(2):209–216
Star KNP, McDonald SR, Bales CW (2015) Nutritional vulnerability in older adults: a continuum of concerns. Curr Nutr Report 4(2):176–184
Sullivan DH, Sun S, Walls RC (1995) Protein-Energy Undernutrition and the risk of mortality within one year of hospital discharge: a follow up study. Clin Geriatr Med 11(4):661–674
Sullivan DH, Sun S, Walls RC (1999) Protein-energy undernutrition among elderly hospitalized patients. JAMA 281:2013–2019
Tappenden KA, Quatrara B, Parkhurst ML et al (2013) Critical role of nutrition in improving quality of care: an interdisciplinary call to action to address adult hospital malnutrition. J Acad Nutr Diet 113(9):1219–1237
Turner M, Ship J (2007) Dry mouth and its effects on the oral health of elderly people. J Am Dent Assoc 138:S15–S20
U.S Department of Health and Human Services (2005) Dietary Guidelines for Americans 2005. https://health.gov/dietaryguidelines/dga2005/document/pdf/DGA2005.pdf?_ga=1.140347059.1624647505.1491237771. Accessed 10 April 2017
U.S. Census Bureau (2014) .An aging nation: the older population in The United States. https://www.census.gov/prod/2014pubs/p25-1140.pdf. Accessed 29 March 2017
U.S. Census Bureau (2016) Poverty: about this topic. Last updated 12 May .2016. https://www.census.gov/topics/income-poverty/poverty/about.html. Accessed 5 April 2017
U.S. Department of Health and Human Services (2007) Choices for Independence: the older Americans Act Amendments of 2006. Administration on Aging. https://www.scribd.com/document/2001662/Health-and-Human-Services-ChoicesforIndependenceSept07. Accessed 10 April 2017
United States Department of Agriculture Food and Nutrition Services (2015) Fact sheet: USDA support for older Americans. Last updated 13 July 2015. https://www.fns.usda.gov/pressrelease/2015/020215. Accessed 5 April 2017
Wacker RR, Roberto KA (2008) Community resources for older adults: program and services in an era of change, 3rd edn. SAGE publication, London, pp 24–27
White JV, Guenter P, Jensen G et al (2012) Consensus statement of the Academy of Nutrition and Dietetics and American Society for Parenteral and Enteral Nutrition: characteristics recommended for the identification and documentation of adult malnutrition (undernutrition). JPEN J Parenter Enteral Nutr 112(5):730–738
Wolfe WS, Frongillo EA, Valois P (2003) Understanding the experience of food insecurity by elders suggests ways to improve its measurement. J Nutr 133(9):2762–2769
Zeanandin G, Molato O, Le Duff F et al (2012) Impact of restrictive diets on the risk of undernutrition in a free-living elderly population. Clin Nutr 31(1):69–73
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG
About this entry
Cite this entry
Fraser, A.M. (2018). Malnutrition in Older Adults in the United States. In: Preedy, V., Patel, V. (eds) Handbook of Famine, Starvation, and Nutrient Deprivation. Springer, Cham. https://doi.org/10.1007/978-3-319-40007-5_87-1
Download citation
DOI: https://doi.org/10.1007/978-3-319-40007-5_87-1
Received:
Accepted:
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-40007-5
Online ISBN: 978-3-319-40007-5
eBook Packages: Springer Reference MedicineReference Module Medicine