Compounding Costs of Malnutrition in Elders

By  Beth Scholer, CC, CDM, CFPP

Malnutrition in the elderly population is an unrecognized and expensive problem that affects as many as one in four elders.  Poor nutritional status negatively affects the health and well-being of  older adults, adds to healthcare costs and is becoming a burden on social assistance programs. It often goes undetected because the focus is on treating their primary medical conditions.

The REAL Cost of Malnutrition

For older adults, not getting enough nutrition can lead to lost weight and strength and increased fatigue and fragility.  Malnourished elders are at higher risk for infections, anemia and breakdown of the skin.  Malnutrition exacerbates diseases and can lead to longer hospital stays and higher readmission rates.  One study suggests that malnourished patient’s hospital costs are $2,000-$10,000 higher.  Another study shows that the total economic impact of malnutrition in people 65 and older is $51.3 billon.

Malnutrition exacerbates diseases and can lead to longer hospital stays and higher readmission rates.

Risk Factors

Low income elders are not the only ones at risk. Physical, physiological, social and economic factors all play a role.  Below is a list of factors that may contribute to malnutrition:

  • ·         Chronic illness, especially COPD, congestive heart failure and dementia
  • ·         Taking multiple medications
  • ·         Decreased taste, smell and appetite with aging
  • ·         Oral health problems
  • ·         Depression, anxiety and loneliness
  • ·         Ability to shop for and prepare food
  • ·         Fixed income and other economic stresses

Are Your Clients at Risk?

What can you do if you suspect malnutrition with your clients? There are several screening tools that take into consideration each client’s unique situation.  When choosing an assessment, consider reliability, ease of use and access to laboratory data.  Two assessments that are recommended for elders include Mini Nutritional Assessment-Short Form and DETERMINE Your Nutritional Health.  Both assessments can quantify nutritional status and satisfy requirements for OASIS-C resources.

Simple Interventions

The first step is recognizing when an elder may be malnourished.  According to the Journal of Nursing, “nutrition assessment should be an essential part of the nursing assessment that is routinely completed in all older adults” (Maher & Eliadi, 2013)   Risk factors should be identified and changes should be made where appropriate. 

Changes to appetite, smell and taste of food is common in aging clients, but complications from malnutrition doesn’t need to be.  Implementing a nutrition screening tool with clients can improve the detection of malnutrition and lead to interventions that benefit everyone.


Chef Beth Scholer is certified by the American Culinary Federation and Association of Nutrition and Foodservice Professionals. She is a food scientist, culinary instructor, author and founder of Caregivers Kitchen. She can be reached at