The Singapore Family Physician

Back to issue Vol 47 No. 6 - Update: Malnutrition, Muscle Loss and Sarcopenia

Management of Malnutrition in Community-Dwelling Older Adults: The Importance of Screening and Interventions to Improve Nutritional and Functional Outcomes

Tey Siew Ling
The Singapore Family Physician Vol 47 No 6 - Update: Malnutrition, Muscle Loss and Sarcopenia
13 - 18
1 May 2021
The worldwide population is ageing rapidly, and the number of people aged ≥65 years is expected to double by 2050. Prevalence of risk of malnutrition is high among community-dwelling older adults and is associated with adverse health outcomes and higher costs of care. Anorexia of ageing is a major cause, characterized by unintentional loss of appetite and reduced oral intake. Achieving energy, protein and micronutrient requirements is important to maintaining health and functional independence. Older adults require a minimum of 1.0 to 1.2 g/kg body weight/day of protein to maintain muscle health. The only exception to this recommendation is older adults with advanced kidney disease and not on dialysis. Nutritional supplementation, in addition to diet, is often required. Several international guidelines recommend oral nutritional supplements (ONS) and dietary advice for older people with malnutrition. ONS containing β-hydroxy-β-methylbutyrate (HMB) has been shown to improve nutritional and functional outcomes in community-dwelling older adults with or at risk of malnutrition. As such, early screening for malnutrition risk in older adults is an important public health strategy. Such screening enables early identification, intervention and best clinical outcomes. Raising awareness on the importance of nutritional health in older people is key, in order to maintain physical function and independent living for as long as possible, preserve quality of life and reduce burdens of unhealthy ageing on healthcare systems.