In spite of having knowledge of good nutrition and access to adequate food, many older adults have difficulty maintaining an acceptable intake of nutritious food. Risk factors for poor appetite, weight loss, and malnutrition may include: 

  • Impaired vision
  • Decreased functional status
  • Side-effects from medications that contribute to poor appetite
  • Dementia
  • Depression and anxiety
  • Poorly fitting dentures, missing teeth, mouth sores
  • Alcohol abuse
  • Overall medical condition
  • Swallowing problems—coughing, choking, or throat clearing after eating or drinking
  • Limited income
  • Lack of social/family support
  • Constipation—can cause decreased appetite and nausea

Usually the first (and most important) sign of inadequate intake is unintentional weight loss. Checking weight two to four times each month will help monitor weight status.

Possible Recommendations:

  • Manage/treat depression.
  • Obtain an evaluation by a speech pathologist to assess swallowing function if problems are suspected (physician referral needed).
  • Obtain an evaluation by a physical and/or occupational therapist if declining function is noted (physician referral needed) and adaptive equipment is needed.
  • Obtain a nutritional evaluation by a registered dietitian. (Physician referral may be needed, depending on insurance.)
  • Obtain a dental evaluation for possible dentures or denture modifications.
  • Provide feeding assistance, as indicated.
  • Evaluate possible medication-related causes of poor appetite (pharmacist and physician).
  • Maintain regular bowel function.
  • Increase activity level, if possible. This can build muscle, improve strength, and increase appetite.
  • Liberalize modified diets. Sometimes having an overly-restrictive diet can cause decreased intake.
  • Pay attention to food preferences.
  • Make mealtimes social events. Include family members and eat together when possible.
  • Provide softer foods if the older family member has chewing or swallowing problems. Use gravies and sauces to moisten drier foods.
  • Older adults with advanced dementia may need foods that they can eat with their fingers instead of using eating utensils.
  • Provide extra snacks between meals if the older adult can eat only small portions at regular mealtimes.
  • Add nutritional supplements or high calorie/high protein foods to improve overall intake.
  • Have larger meals earlier in the day. Older adults usually eat better at breakfast and lunch, but they want a lighter evening meal.