Factors
Contributing to Malnutrition in the Elderly
Return to Notes
Return to Tables
BIOLOGICAL FACTORS
Integumentary System
deficiencies
-decreased vitamin D
production -> decreased calcium absorption by the small intestine
Circulatory System
deficiencies
-atherosclerosis reduces
blood flow through the digestive system -> reduced digestion and absorption
of various nutrients
-atherosclerosis and
high blood pressure -> greatly altered diet (salt, water, lipid
restrictions)
Respiratory System
deficiencies
-emphysema ->
difficulty obtaining, preparing, and eating proper diet
Nervous System
deficiencies
-dementias or strokes
-> disabilities -> difficulty planning, obtaining, preparing, and eating
proper diet
-decreased sense of
smell from aging, Alzheimer's, Parkinson's -> loss of interest in eating
-age changes in flavor
preferences -> altered diet
-decreased sensory
function and coordination -> difficulty obtaining, preparing, and eating
proper diet
-decreased thirst
sensation -> water deficiency
Eyes and Ears
deficiencies
-decline in vision ->
difficulty obtaining, preparing, and eating proper diet including reading
labels for instructions and nutrient content
Muscle System and Exercise
deficiencies
-weakness and decreased
exercise -> decreased eating to prevent weight gain
excesses
-weakness and decreased
exercise -> excess energy intake for body needs
Skeletal System
deficiencies
-disabilities
(fractures, arthritis) -> difficulty obtaining, preparing, and eating proper
diet, more reliance on prepared foods -> less fresh fruits and vegetables,
less activity -> less kcals used -> obesity
excesses
-disabilities
(fractures, arthritis) -> decreased exercise -> lower energy use ->
obesity
Digestive System
deficiencies
-mouth region
-slower healing of oral mucosa -> sores -> discomfort -> less eating
-tooth disease or loss -> altered or bad tastes, discomfort when eating,
trouble eating firm (fruits and vegetables) or drier foods, swallowing large
pieces -> less eating, less fiber intake, indigestion and maldigestion
-decreased saliva from infected salivary ducts, diabetes, medications,
radiation therapy -> dry mouth, decreased taste -> less eating
-esophagus
-slowed and spastic peristalsis, refluxing from stomach -> discomfort,
difficulty swallowing -> less eating
-esophageal rings and webs -> difficulty swallowing (discomfort) ->
limited food selection and less eating
-sliding hiatal hernia -> refluxing, esophagitis -> less eating
-diabetes -> slower peristalsis -> difficulty swallowing -> less
eating
-stomach
-decreased HCl -> altered small intestine bacterial flora -> altered
digestion and absorption of many nutrient
-decreased intrinsic factor production -> decreased vitamin B-12 absorption
by small intestine
-acute gastritis -> discomfort -> less eating
-atrophic gastritis -> decreased production of HCl, intrinsic factor, and
pepsin -> decreased protein digestion -> indigestion -> decreased
eating and protein maldigestion -> protein deficiency
-gastric peptic ulcer -> pain with eating -> less eating, need for
altered diet, obstruction, antacid use -> deficiencies, obstruction ->
malnutrition, use of certain antacids (containing Mg)
-small intestine
-decrease in absorption of vitamins A, D, and K, and zinc
-decreased lactase -> lactose intolerance -> decreased dairy intake
-decreased vitamin D production by skin and activation by kidneys ->
decreased calcium absorption
-large intestine
-constipation -> laxative use (depending on type) -> water, mineral, and
vitamin A, D, E, and K deficiencies. -very high fiber diets -> decreased
mineral absorption
-diarrhea -> water and mineral deficiencies
-fecal incontinence -> less ability to obtain foods (shopping), social
isolation -> less or altered eating
-diseases (diverticulitis, cancer) -> altered diets -> malnutrition
-liver
-slight decrease in vitamin C storage -> increased risk of vitamin C
deficiency (Note that vitamin C is not stored well in the body.)
-cirrhosis -> liver malfunction -> poor storage and conversion of
nutrients, decreased vitamin D activation and bile production -> poor fat
digestion and vitamin A, D, E, and K absorption
-gall bladder
-stones -> pain (especially with fats) and decreased fat digestion ->
discomfort (less eating), decreased fat and vitamin A, D, E, and K absorption
-pancreas
-pancreatitis -> decreased protein and fat digestion, diabetes (slowed
peristalsis)
excesses
-peptic ulcer -> antacids with magnesium -> magnesium excess
Urinary System
deficiencies
-urinary incontinence
-> less ability to obtain foods (shopping), social isolation -> less or
altered eating
-kidney disease ->
less protein intake to decrease nitrogen wastes in blood (BUN)
Endocrine System
deficiencies
-hyperparathyroidism ->
decreased appetite -> less eating
-hyperthyroidism ->
increased metabolic rate -> excess energy use -> underweight
excesses
-non-insulin dependent
diabetes mellitus (NIDDM) -> excess eating -> obesity
Immune System
deficiencies
-various autoimmune
disorders -> malfunctions in salivary glands, stomach, small intestine, and
large intestine functioning) -> altered taste and decreased absorption
(e.g., vitamin B-12, vitamin K, Fe, Ca, Zn)
Alcoholism
deficiencies and excesses
-alcohol -> less
eating, decreased functioning of the liver and other digestive organs, altered
the absorption and utilization of several nutrients -> certain deficiencies
and excesses (See page 10-51+)
Medications
deficiencies and excesses
-from altered appetite,
diet, absorption, utilization, and elimination
Cancer
deficiencies
- growth of cancer -> loss
of appetite and excess nutrient use (cachexia)
SOCIAL FACTORS
Deficiencies
-cultural limitations on food choices
-religious factors
-transportation to food sources
Deficiencies and Excesses
-loss of companionship (spouse, other family members,
friends, retirement) -> altered appetite -> less eating or over eating
-institutionalization -> imposed diets, foods
overcooked or heated for extended periods
-inadequate educational opportunities
-inadequate social programs -> inadequate social
contact, assistance with food preparation and eating, or exercise
PSYCHOLOGICAL FACTORS
Deficiencies and Excesses
-depression -> altered appetite -> less eating
or over eating, slowed peristalsis -> constipation -> laxative use
-stress, loneliness, boredom, grief -> less eating
or over eating
-ignorance -> poor diet planning
-eating habits -> excess eating after activity
levels decline
ECONOMIC FACTORS
Deficiencies and Excesses
-fixed income, limited income, retirement, high
medical bills, -> less money -> cannot afford proper diet
-advertising
-availability and price of proper and varied foods
-cost of food storage and preparation facilities
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Salisbury University, Maryland
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