MALNUTRITION

IN THE ELDERLY
Community & Hospital Settings
Joselynn Alaniz
Julia Darian
Krizianne Diego
Dianne Montano
Nayeli Ortiz Ramos
 MALNUTRITION DEFINED WHAT ARE THE CAUSES OF MALNUTRITION?

WHAT IS MALNUTRITION? Clinical

Malnutrition means poor nutrition whether... ● Disease-associated malnutrition

Functional/mental health

● Limited ability to shop, prepare, eat food

Socioenomic

● Social issues
● Finances

Mangels, A.R. (2018, March). Malnutrition In Older Adults. The American

Journal Of Nursing, 118(3), 34-41.
https://doi.org/10.1097/01.NAJ.0000530915.26091.be
Malnutrition: An Older Adult Crisis. (2019). Retrieved from
https://www.defeatmalnutrition.today/sites/default/files/images/DMT_Malnutrition_Info_Graphic_OnePage_Update_2.pdf
ECONOMIC & SOCIAL ISSUES OF COMMUNITY-RESIDING SENIORS

LIMITED INCOME TRANSPORTATION SOCIAL ISOLATION

OPTIONS

● Food ● Public transportation ● Reduced social

● Housing ● Family, friends contact
● Medications ● Loss of loved one
● Health care bills
● Diminished savings Mangels, A.R. (2018, March). Malnutrition In Older Adults. The American
Journal Of Nursing, 118(3), 34-41.
https://doi.org/10.1097/01.NAJ.0000530915.26091.be
COMMUNITY FOOD & NUTRITION PROGRAMS FOR SENIORS
OLDER AMERICANS ACT
NUTRITION PROGRAM
Primary federal food and nutrition
program serving older adults by providing
nutrition and social services in their own
home or community
EMERGENCY FOOD ASSISTANCE
PROGRAM
Supplements diets by providing
low-income residents emergency food,
generally through food banks, food
pantries, and soup kitchens
SUPPLEMENTAL NUTRITION
ASSISTANCE PROGRAM (SNAP)
● Largest federal food assistance
program
● Provides low-income individuals with
funds to purchase food that is
nutritionally adequate
SENIOR FARMERS’ MARKET
NUTRITION PROGRAM
Provides low-income seniors with access
to fresh fruits, vegetables, honey, herbs,
etc.
Mangels, A.R. (2018, March). Malnutrition In Older Adults. The American
https://doi.org/10.1097/01.NAJ.0000530915.26091.be
Journal Of Nursing, 118(3), 34-41.
COMMODITY SUPPLEMENTAL
FOOD PROGRAM
Supplements diets by providing
nutritious foods on a monthly basis,
along with nutrition education to those
60+ years of age
CHILD & ADULT CARE FOOD PROGRAM
Provides funding to adult day-care
centers for nutritious foods served to
eligible older adults and individuals with
disabilities
 ● ⅓ of senior households has no money left
over each month or is in debt after meeting
essential expenses

ECONOMIC SECURITY ● In 2018, 2.9 million households with a senior

aged 65+ experienced food insecurity
(Coleman-Jensen et al., 2019)
● NCOA’s Senior Hunger Initiative finds and
enrolls eligible older adults into the
Supplemental Nutrition Assistance Program
(SNAP) to help them pay for healthy food
● NCOA’s Benefits Check Up free online service
screens older adults with limited income for
Coleman-Jensen, A., Rabbitt, M.P., Gregory, C.A., & Singh, A. (2019). Household Food benefits like SNAP
Security In The United States In 2018. U.S. Department Of Agrigculture: Economic
Research Service. https://www.ers.usda.gov/webdocs/publications/94849/err-270.pdf
National Council On Aging. (2016). Economic Security For Seniors [fact sheet].
https://www.ncoa.org/wp-content/uploads/NCOA-Economic-Security.pdf
Haines, J., LeVan, D., & Roth-Kauffman, M. (2020, February 7). Malnutrition In The Elderly: Underrecognized And Increasing In Prevalence. Clinical Advisor.
https://www.clinicaladvisor.com/home/topics/geriatrics-information-center/malnutrition-in-the-elderly-underrecognized-and-increasing-in-prevalence/
VARIOUS HEALTH ISSUES RELATED TO MALNUTRITION

● Weak immune system

● Increased risk of
infections
● Muscle weakness
● Poor wound healing

Amarya, S., Singh, K., & Sabharwal, M. (2015, September). Changes During Aging And Their
Association With Malnutrition. Journal Of Clinical Gerontology And Geriatrics, 6(3): 78-84.
https://www.sciencedirect.com/science/article/pii/S2210833515000672
 DEFICIENCIES CAUSED BY MALNUTRITION
Up to 16% of community- dwelling As high as 35% of aging adults
elderly are deficient in protein and (over 65 years of age) have a
calories deficiency of vitamins, proteins,
minerals, and calories

Amarya, S., Singh, K., & Sabharwal, M. (2015, September). Changes During Aging And Their
Association With Malnutrition. Journal Of Clinical Gerontology And Geriatrics, 6(3): 78-84.
https://www.sciencedirect.com/science/article/pii/S2210833515000672
 STUDIES ON MALNUTRITION
20% to 65% of hospitalized older
patients suffer from malnutrition

30% to 60% of older patients in long

term care facilities suffer from
malnutrition

Nutritional assessment and nutrition
education are necessary for a
successful diagnosis of malnutrition in
aging people
Amarya, S., Singh, K., & Sabharwal, M. (2015, September). Changes
During Aging And Their Association With Malnutrition. Journal Of
Clinical Gerontology And Geriatrics, 6(3): 78-84.
https://www.sciencedirect.com/science/article/pii/S2210833515
000672
 AGING HEIGHTENS RISK FOR MALNUTRITION

Difficulty chewing, chronic illness, and

decreased appetite are all risk factors that
can lead the aging population to malnutrition

This can result in higher vulnerability to

disease, weakened immune systems,
which can lead to higher hospital
admission rates and longer hospital
stays

Bishop, M. (2017, June 20). Elder Malnutrition. Retrieved from

https://www.publichealthpost.org/databyte/elder-malnutrition/
Bishop, M. (2017, June 20). Elder Malnutrition. Retrieved from https://www.publichealthpost.org/databyte/elder-malnutrition/
 STUDY CONDUCTED IN AUSTRALIA HOSPITAL PATIENTS
● The rate of malnutrition among
hospitalized elderly patients in
Australia is 42.3%
○ 205 general medical patients
aged ≥ 60 years

Aim:

Assess nutrition screening adequacy and

investigate factors associated with missed
opportunity to diagnose malnutrition
Sharma, Y., Miller, M., Shahi, R., Hakendorf, P., Horwood, C., & Thompson, C.
(2016). Malnutrition Screening In Acutely Unwell Elderly Inpatients.
British Journal Of Nursing, 25(18), 1006-1014.
 IMPORTANCE OF NUTRITIONAL SCREENING
Malnutrition is known to lead to significant adverse
outcomes for the patients and increase hospital costs
through increased use of resources

❖ Ensuring consistent nutrition screening with

appropriate therapeutic interventions:
➢ Improved patient health
➢ Hospital reimbursement

Sharma, Y., Miller, M., Shahi, R., Hakendorf, P., Horwood, C., & Thompson, C.
(2016). Malnutrition Screening In Acutely Unwell Elderly Inpatients.
British Journal Of Nursing, 25(18), 1006-1014.
 COMMON FACTORS LEADING TO MISSED MALNUTRITION
IMPACT IN HOSPITAL SETTINGS
Common associations that explain low
inpatient screening rates for malnutrition:

● Inadequate nutritional status

● Lower staff to patient ratios
● Outlier ward locations

Rau, J. (2019, February 6). 'Like A Ghost Town': Erratic Nursing Home Staffing Revealed Through New
Records.https://khn.org/news/like-a-ghost-town-erratic-nursing-home-staffing-revealed-thro
ugh-new-records/
Sharma, Y., Miller, M., Shahi, R., Hakendorf, P., Horwood, C., & Thompson, C.
(2016). Malnutrition Screening In Acutely Unwell Elderly Inpatients.
British Journal Of Nursing, 25(18), 1006-1014.
 High prevalence of
malnutrition in both genders

Percentage of malnourished:
● 26% of females
● 16.3% of males

Percentage at risk:
● 40.9% of females
● 35% of males

Donini, L.M., Scardella, P., Piombo, L., Neri, B., Asprino, R., Proietti, A. R., …
Morrone, A. (2013, January). Malnutrition In Elderly: Social And Economic
Determinants. Retrieved from How To Prevent Senior Malnutrition. (n.d.). Retrieved from
https://www.ncbi.nlm.nih.gov/pubmed/23299371 http://nursing-homes.aplaceformom.com/nutrition
 IMPACT IN A COMMUNITY SETTING

A relationship was shown between

malnutrition and:

● Inability to shop
● Prepare and cook meals due to low
income
● Distance from markets/supermarkets
● Impossibility to drive a car or use
public transportation

Beseler, L. (2017, May 31). Hospital Impact: Adoption Of Malnutrition Measures Is Critical
To Ensuring Health Of Seniors. Retrieved from
Donini, L.M., Scardella, P., Piombo, L., Neri, B., Asprino, R., Proietti, A. R., …
https://www.fiercehealthcare.com/hospitals/hospital-impact-adopting-malnutri
Morrone, A. (2013, January). Malnutrition In Elderly: Social And Economic
tion-measures-critical-ensuring-quality-senior
Determinants. Retrieved from
https://www.ncbi.nlm.nih.gov/pubmed/23299371
STUDY CONDUCTED IN EMERGENCY ROOMS

● Objective: Identify risk factors related

to malnutrition, as they are often
missed by healthcare workers
● Measured using the Mini Nutritional
Assessment Short Form (example to
the right)
● Results: Identified multiple factors
associated with malnutrition in older
adults

MNA Forms. (n.d.). Retrieved from

https://www.mna-elderly.com/mna_forms.html
FACTORS RELATED TO CHANGES & THEIR ASSOCIATION WITH MALNUTRITION
 MALNUTRITION ON A PHYSIOLOGICAL LEVEL
Physiological effects: Malnutrition can cause a multitude of physiological
changes. Our muscles and bones rely on nutrients to
Muscles and bones maintain strength, posture, and mobility. Our immune
system relies on nutrients to promote healing and decrease
● Mobility, posture, strength, susceptible to falls
the risk of infections and the recovery time. Adequate
nutrition is important for our organs as well. Nutritional
Immune system and healing
deficiencies can cause vision loss, memory loss, as well as
● Healing, cancer, susceptible to illness impaired coordination. Without proper fluids and
electrolytes, our kidneys can become overworked, which
Organs can cause dehydration, joint, and heart issues.

● Eyes, brain, kidneys

10 Ways Malnutrition Can Impact Your Health And 6 Steps to Prevent It. (n.d.). Retrieved
from National Council On Aging:
https://www.ncoa.org/healthy-aging/chronic-disease/nutrition-chronic-conditions/w
hy-malnutrition-matters/10-ways-malnutrition-impact-your-health-6-steps-prevention
 MALNUTRITION ON A SOCIOLOGICAL LEVEL

There are many sociological factors that influence

malnutrition in the elderly population. Economic
status, housing/living situation, and marital status
to name a few. Having low income can make it hard
to shop and prepare meals. Also, not having a life
partner can make it difficult to prepare food for
elderly that live alone. However, this is not the only
cause; elderly people who are institutionalized are
also susceptible to malnutrition. This can be due to
improper evaluation of nutritional status.

What Are Social Determinants Of Health. (n.d.). Retrieved from

http://www.sunshineclinic.org/blog/social-determinants-of-health/
 MALNUTRITION ON A PSYCHOLOGICAL LEVEL

Psychological effects of malnutrition

include (but are not limited to) depression,
irritability, and associability. Nutrients
influence the way our brain signals
interact, which can alter our emotional
behavior. They also aid in the balance of
neurotransmitters, which is crucial in
preventing mental issues associated with
malnourishment.

Cederholm, T. (2003). Psychological Effects Of Generalized Nutritional

Deprivation In The Elderly. Scandinavian Journal Of Nutrition, 47(3), 143-146.
https://doi.org/10.1080/11026480310014928
WAYS TO COMBAT MALNUTRITION IN THE ELDERLY
 ACKNOWLEDGMENTS
Joselynn Alaniz: Slides 18, 19, 23, 24

Julia Darian: Slides 7, 20-22

Krizianne Diego: Slides 2-6

Dianne Montano: Slides 13-17

Nayeli Ortiz Ramos: Slides 8-12

 WORKS CITED

10 Ways Malnutrition Can Impact Your Health And 6 Steps to Prevent It. (n.d.). Retrieved from National Council On Aging:
https://www.ncoa.org/healthy-aging/chronic-disease/nutrition-chronic-conditions/why-malnutrition-matters/10-ways-malnutrition-impact-your-health-6-steps-pr
evention/

Amarya, S., Singh, K., & Sabharwal, M. (2015, September). Changes During Aging And Their Association With Malnutrition. Journal Of Clinical Gerontology And Geriatrics, 6(3):
78-84. https://www.sciencedirect.com/science/article/pii/S2210833515000672

Bishop, M. (2017, June 20). Elder Malnutrition. Retrieved from https://www.publichealthpost.org/databyte/elder-malnutrition/

Burks, C.E., Jones, C.W., Braz, V.A., Swor, R.A., Richmond, N.L., Hwang, K.S., Hollowell, A.G., Weaver, M.A. & Platts‐Mills, T.F. (2017). Risk Factors For Malnutrition Among Older
Adults In The Emergency Department: A Multicenter Study. Journal Of The American Geriatrics Society, 65: 1741-1747. https://doi/10.1111/jgs.14862

Coleman-Jensen, A., Rabbitt, M.P., Gregory, C.A., & Singh, A. (2019). Household Food Security In The United States In 2018. U.S. Department Of Agriculture: Economic
Research Service. https://www.ers.usda.gov/webdocs/publications/94849/err-270.pdf

Donini, L.M., Scardella, P., Piombo, L., Neri, B., Asprino, R., Proietti, A. R., … Morrone, A. (2013, January). Malnutrition In Elderly: Social And Economic Determinants. Retrieved
from https://www.ncbi.nlm.nih.gov/pubmed/23299371

Malnutrition: An Older Adult Crisis. (2019). Retrieved from

https://www.defeatmalnutrition.today/sites/default/files/images/DMT_Malnutrition_Info_Graphic_OnePage_Update_2.pdf

Malnutrition In The Elderly: Healthy Aging. (2016). Retrieved from https://www.aegisliving.com/resource-center/malnutrition-among-the-elderly/

Mangels, A.R. (2018, March). Malnutrition In Older Adults. The American Journal Of Nursing, 118(3), 34-41. https://doi.org/10.1097/01.NAJ.0000530915.26091.be
 WORKS CITED

National Council On Aging. (2016). Economic Security For Seniors [fact sheet]. https://www.ncoa.org/wp-content/uploads/NCOA-Economic-Security.pdf

Sharma, Y., Miller, M., Shahi, R., Hakendorf, P., Horwood, C., & Thompson, C. (2016). Malnutrition Screening In Acutely Unwell Elderly Inpatients. British Journal Of Nursing,
25(18), 1006-1014.
 WORKS CITED (IMAGES/FIGURES)

Bishop, M. (2017, June 20). Elder Malnutrition. Retrieved from https://www.publichealthpost.org/databyte/elder-malnutrition/

Beseler, L. (2017, May 31). Hospital Impact: Adoption Of Malnutrition Measures Is Critical To Ensuring Health Of Seniors. Retrieved from
https://www.fiercehealthcare.com/hospitals/hospital-impact-adopting-malnutrition-measures-critical-ensuring-quality-senior

Elder Malnutrition. (2017). Retrieved from https://www.publichealthpost.org/databyte/elder-malnutrition/

Haines, J., LeVan, D., & Roth-Kauffman, M. (2020, February 7). Malnutrition In The Elderly: Underrecognized And Increasing In Prevalence. Clinical Advisor.
https://www.clinicaladvisor.com/home/topics/geriatrics-information-center/malnutrition-in-the-elderly-underrecognized-and-increasing-in-prevalence/

How To Prevent Senior Malnutrition. (n.d.). Retrieved from http://nursing-homes.aplaceformom.com/nutrition

Malnutrition Awareness Week™. (n.d.). Retrieved April 12, 2020, from http://www.nutritioncare.org/maw/

MNA Forms. (n.d.). Retrieved from https://www.mna-elderly.com/mna_forms.html

Rau, J. (2019, February 6). 'Like A Ghost Town': Erratic Nursing Home Staffing Revealed Through New Records. Retrieved from
https://khn.org/news/like-a-ghost-town-erratic-nursing-home-staffing-revealed-through-new-records/