Nutrition in Older Adults
Nutrition in older adults addresses how ageing changes nutritional requirements, intake, and risk. With age, body composition shifts toward less muscle and more fat, appetite and absorption can decline, and chronic disease and medication become more common, so older people are at heightened risk of both undernutrition and the progressive loss of muscle known as sarcopenia. Maintaining adequate protein and energy intake and good hydration becomes a particular concern.
Definition
Nutrition in older adults is the study of how ageing alters nutrient requirements, dietary intake, and nutritional risk, and of how nutritional status relates to muscle mass, function, frailty, and health outcomes in later life.
Scope
The topic covers the physiological changes of ageing that affect nutrition, the major nutritional risks in later life (undernutrition, sarcopenia, dehydration, and specific micronutrient concerns), and how nutritional status relates to function, frailty, and outcomes. It is a reference and clinical-nutrition entry, not a source of individualized dietary or supplementation prescriptions.
Core questions
- How does ageing change body composition and nutrient requirements?
- Why are older adults at increased risk of undernutrition and dehydration?
- What is sarcopenia and how is it related to nutrition and ageing?
- How does nutritional status relate to frailty and clinical outcomes in older people?
Key concepts
- Age-related change in body composition
- Sarcopenia (loss of muscle mass and strength)
- Protein-energy undernutrition
- Anorexia of ageing
- Dehydration risk
- Frailty
- Malnutrition screening and the GLIM criteria
Mechanisms
Ageing is accompanied by loss of skeletal muscle and a relative gain in fat (sarcopenia and altered body composition), reduced appetite (the anorexia of ageing), changes in taste, dentition, swallowing, and gastrointestinal absorption, and a blunted thirst response that raises dehydration risk. Polypharmacy and chronic illness further affect intake and nutrient needs. Inadequate protein and energy intake accelerates muscle loss and contributes to frailty, while screening tools and consensus criteria such as GLIM are used to identify malnutrition so that it can be addressed.
Clinical relevance
Nutritional risk is a routine concern in geriatric care because undernutrition, sarcopenia, and dehydration are associated with falls, slower recovery, and adverse outcomes. This entry describes the physiology, screening concepts, and population-level evidence; assessment and any nutritional intervention for an individual older adult should be carried out by qualified clinicians using validated tools.
Epidemiology
Undernutrition and the risk of malnutrition are common among older adults, particularly those who are hospitalised, in care homes, or frail, and sarcopenia prevalence rises with age. Frailty, to which poor nutrition contributes, is a strong correlate of adverse outcomes in older populations, and clinical guidelines emphasise systematic screening to detect risk early.
History
Geriatric nutrition emerged as a distinct concern as populations aged through the twentieth and twenty-first centuries. Recent consensus work has sharpened key constructs: European working groups produced operational definitions of sarcopenia, the global clinical-nutrition community published the GLIM criteria to standardise the diagnosis of malnutrition, and bodies such as ESPEN issued dedicated guidance on nutrition and hydration in older people.
Debates
- How should malnutrition and sarcopenia be defined and measured in older adults?
- Definitions and diagnostic cut-offs for malnutrition and sarcopenia have varied between groups, prompting consensus efforts such as GLIM and the revised European sarcopenia criteria; harmonising and validating these across settings remains an active area.
Key figures
- Tommy Cederholm
- Alfonso Cruz-Jentoft
- Dorothee Volkert
- Kenneth Rockwood
Related topics
Seminal works
- volkert-2019
- cruz-jentoft-2019
- cederholm-2019
- clegg-2013
Frequently asked questions
- What is sarcopenia?
- Sarcopenia is the age-related loss of skeletal muscle mass together with reduced muscle strength or function; it is associated with poorer physical performance and adverse outcomes and is influenced by nutrition, physical activity, and ageing itself.
- Why are older adults more prone to undernutrition?
- Ageing can reduce appetite, taste, and absorption, and is often accompanied by chronic illness, medication, dental and swallowing problems, and social factors, all of which can lower food intake and raise the risk of protein-energy undernutrition and dehydration.