Malnutrition and dehydration are common health concerns for older adults. Malnutrition is an imbalance in nutrient intake that negatively affects bodily function. Dehydration occurs when the body loses more fluid than it takes in, leading to insufficient water for proper bodily functions. While anyone can be affected, these conditions pose a heightened risk for individuals over 65, with about one in two older adults at risk. These issues are not an inevitable part of aging but are linked to age-related challenges impacting an older person’s ability to eat and drink.
Age-Related Bodily Changes
As individuals age, physiological changes can impair nutrient and fluid intake. Sensory perception, such as taste and smell, often diminishes, making food less appealing and reducing the motivation to eat. This blunted sensory experience leads to decreased enjoyment of meals and lower food consumption.
A diminished sensation of thirst is common in older adults, even when fluids are needed. This reduced thirst response means older individuals may not recognize their need for water, leading to inadequate fluid intake and dehydration. Dental issues like tooth loss, gum disease, or ill-fitting dentures can make chewing painful or difficult, hindering adequate food intake.
The digestive system changes with age. Slower gastric emptying rates, though often not clinically significant, can contribute to early fullness, reducing food consumed. These subtle shifts, combined with other factors, can predispose older adults to deficiencies.
Chronic Health Conditions
Chronic health conditions common in older adults contribute to malnutrition and dehydration by affecting appetite, intake, or absorption. Neurological conditions like dementia can cause individuals to forget to eat or drink, struggle with meal preparation, or lose hunger or thirst cues. Parkinson’s disease can lead to dysphagia (difficulty swallowing), weakening chewing and swallowing muscles, increasing aspiration risk and reducing food intake.
Mental health conditions, such as depression, are linked to loss of appetite, lack of motivation to prepare meals, and social withdrawal, impacting nutritional status. Gastrointestinal disorders, including malabsorption syndromes or chronic constipation, interfere with the body’s ability to digest and absorb essential nutrients. Conditions like heart failure can cause nausea and fullness due to fluid accumulation around the digestive system, reducing appetite. Cancer and its treatments often result in cachexia, a wasting syndrome characterized by muscle and fat loss, often accompanied by loss of appetite and early satiety.
Medication Effects
The medications commonly prescribed to older adults can have significant side effects that contribute to malnutrition and dehydration. Polypharmacy (multiple medications) increases the risk of adverse effects due to cumulative impacts and drug interactions. Many medications can cause unpleasant side effects such as nausea, constipation, or diarrhea, deterring eating and leading to fluid loss.
Dry mouth (xerostomia) is a common side effect of over a thousand medications, including those for urinary incontinence, depression, and high blood pressure. Dry mouth makes chewing and swallowing difficult, reducing food and fluid intake. Some medications can alter taste perception, making food unappealing or suppressing appetite. Certain drugs can interfere with nutrient absorption or increase their excretion, leading to deficiencies. Diuretics, for instance, increase urine output, contributing to dehydration if fluid intake is insufficient.
Social and Environmental Factors
External circumstances and lifestyle factors present barriers to adequate nutrition and hydration in older adults. Social isolation and loneliness can diminish motivation to prepare or eat meals, as dining is often a social activity. Economic limitations, including poverty, can restrict access to nutritious food options or drinking water, forcing reliance on cheaper alternatives.
Physical limitations, such as reduced mobility or dexterity, can hinder ability to grocery shop, prepare meals, or even manage utensils and open food packaging. Lack of reliable transportation further complicates grocery shopping and community meal program participation. Living arrangements play a role; individuals living alone may be less inclined to cook for one, while those in institutional settings face rigid meal schedules or unappealing food choices. These non-clinical factors create a challenging environment that can compromise an older adult’s nutritional and hydration status.