Malnutrition in older adults is more common—and more complex—than many people realize. It doesn’t always look like being underweight, and it isn’t always caused by simply “not eating enough.” In fact, malnutrition can affect people of all body sizes and often develops quietly due to changes in appetite, health conditions, medications, or access to nutritious food. Understanding the facts about malnutrition in seniors is an important first step toward protecting health, strength, and independence as we age.

Five essential facts about malnutrition risk, causes, and warning signs

Understanding these facts can help you spot nutrition problems early and take steps to protect health, strength, and independence as you age.

 

FACT 1: Malnourished people, including seniors, can come in all sizes.

• 0.4% of U.S. adults ages 60-74 are underweight.¹
• 41.5% of U.S. adults ages 60+ live with obesity.²

Malnourished individuals can come in all sizes. It may surprise you to know that people with malnutrition can be underweight or carry excess weight. Those living with obesity can—and often do—miss out on important nutrients. The food you eat can give you energy but still lack key nutrients to keep you healthy. For example, adequate protein is essential as we age, and if your body does not get enough, it's harder to maintain lean muscle mass and strength.

FACT 2: Older adults face a greater risk of malnutrition

• Roughly 7 million Americans age 60+ (1 in 11) faced food insecurity in 2022.³ 
• About 1 in every 2 older adults is at risk for malnutrition.⁴

Our body and nutrient needs also change when we get older. That's why it’s crucial to get the right amount of fluids, protein, and key nutrients like calcium and vitamin D. It is also recommended that we limit salt and saturated fats as we age, which can contribute to conditions like high cholesterol and high blood pressure.

Older adults are also at high risk for malnutrition due to natural age-related changes and other issues (more on that below).

FACT 3: Malnutrition can come from a number of factors

The factors below, plus others, can lead to malnutrition for seniors:

• Chronic conditions
• Limited income
• Trouble swallowing/chewing
• Poor dental health
• Changing taste buds
• Living alone
• Medication side effects
• Poor appetite
• Restricted diets
• Lack of mobility
• Depression
• Dementia
• Gastrointestinal disorders

Sometimes, poor diets are caused by physical or mental changes. Other times, they are affected by our personal circumstances—such as social isolation or an inability to get to the store or prepare healthy meals. Often, the medication we take can affect our appetite or our ability to absorb key nutrients. And some medical conditions like dysphagia, which makes swallowing difficult or painful, can lead to malnutrition.

These common nutrition challenges can quickly build on each other and make the problem worse. For example, if you’re not getting the right nutrients, you might become more tired. Being tired might make it harder for you to shop, cook, and exercise. Together, these factors can cause you to lose lean muscle mass. Add a hospitalization with surgery into the mix, and the impact on your health can worsen.

FACT 4: You can’t always prevent or treat malnutrition by just eating more

Malnutrition is an imbalance of nutrients—meaning your diet may be high in calories but low in the nutrients your body needs.

Adults who are malnourished should use a multi-faceted strategy to ensure they're getting the support they need:

• Adjust diet to focus on nutrient deficiencies.
• Exercise to build muscle and improve strength.
• Consult a Registered Dietitian Nutritionist (RDN).
• Consider using an oral nutritional supplement.

Physical activity paired with good nutrition can help combat malnutrition by increasing muscle strength and overall well-being. Making sure you get enough protein can help with recovery after exercise.

FACT 5: Malnutrition has many warning signs

The symptoms below can be a sign that you or someone you care for is experiencing malnutrition:

• Muscle weakness
• Fatigue
• Increased illness or infection
• Feeling irritable or depressed
• Unplanned weight loss
• Decreased appetite
• Easy bruising
• Dental issues

Concerned about malnutrition? Take these steps to get support and guidance

1. Speak to your doctor about your concerns.
2. Understand the warning signs and stay informed to avoid malnutrition.
3. Read these simple tips to learn how to eat healthier. If you're a caregiver, find out ways to help the older adult you care for boost their nutrition.
4. Visit BenefitsCheckUp.org to see if you qualify for programs like the Supplemental Nutrition Assistance Program (SNAP) that can help pay for food and other essentials. 

Sources

1. Fryar CD, Carroll MD, Afful J. Prevalence of underweight among adults aged 20 and over: United States, 1960–1962 through 2017–2018. NCHS Health E-Stats. 2020.

2. Centers for Disease Control (CDC). Adult Obesity Facts. Found on the internet at https://www.cdc.gov/obesity/adult-obesity-facts/index.html

3. Feeding America. Facts about senior hunger. Found on the internet at https://www.feedingamerica.org/hunger-in-america/senior-hunger-facts

4. Administration for Community Living. Malnutrition. Found on the internet at https://acl.gov/senior-nutrition/malnutrition

5. Dent E, Wright ORL, Woo J, Hoogendijk EO. Malnutrition in older adults. Lancet. 2023;401(10380):951-966. doi:10.1016/S0140-6736(22)02612-5