• Involuntary weight loss
• Lower appetite
• Loss of muscle size and strength
• Lethargy/tiredness
• Lower interest in eating and drinking
• Mood changes
• Changes in the ability to prepare meals

Signs of poor nutrition can be difficult to spot and sometimes are not obvious until malnutrition is advanced. Unintentionally losing weight and losing the desire to eat when older is not a normal sign of ageing. It is not uncommon for older adults to not want to ask for help because it can make them feel vulnerable. If you recognise the symptoms above in yourself or a loved one, it is important to be supportive and seek the advice of your doctor.

• Conditions, such as dysphagia and cancer
• Nausea and other long term challenges with eating and drinking
• Cognitive impairment
• Anxiety and depression
• Social isolation and feeling low
• Medications and their effects, such as sickness and changes in taste and smell

(Bear in mind that these causes often coexist.)

Common consequences of malnutrition are:

• Poor immune system, leading to higher change of infections and slower wound healing
• Loss of muscle size and strength
• Higher risk of slips, trips and falls
• More time spent in hospital
• Lethargy and confusion
• Reduced independence with daily activities
• Lower quality of life

Identifying the signs and symptoms of malnutrition early can make a big difference in helping and supporting our most vulnerable ones.
Let’s dive deeper into each one of the signs of malnutrition listed at the beginning of this article.

Involuntary weight loss

• This is unplanned weight loss because of eating less or increased nutritional needs as a result of illness. It is most common and sometimes the easiest one to spot because it often comes with body changes, such as looser skin, sunken eyes and overall slimmer frame. Weight loss can also be identified when usual clothes and jewellery, such as a watch, feel looser than normal.

Lower appetite

• A decrease in appetite can have many causes and is not easy to spot. Nausea and vomiting can be easily identified. A less obvious example is lower portion size, as a result of swallowing difficulties or problems with dentures. Age and lower physical activity can naturally lead to decreased appetite. However, the combination of lower appetite and other signs of malnutrition, mainly weight loss, can be a red flag to take action and consult your doctor for advice.

Loss of muscle size and strength

• Giving your body less nutrients than needed will eventually lead to loss of muscle size and strength. Muscles produce heat and help regulate body temperature, so a loss in muscle size can lead to feeling colder than usual. This can be easily identified.
• The loss in muscle size gives way to the loss in muscle strength. Every day tasks, even the minor ones, become harder to complete. For example, a pot of yoghurt may become harder to open as the handgrip weakens. This may be harder to identify, but looking for challenges that arise when carrying out habitual tasks can give some cues. 

Lethargy/tiredness

• Over time, eating less can lead to having less energy and feel tired. Tiredness usually presents itself as a general lack of interest in daily activity and more time spent being idle. Being aware of these changes can help you identify malnutrition early.

Lower interest in eating and drinking

• Lower interest in eating and drinking can manifest as being less thoughtful over what to eat during the day, not wanting to cook food as usual, less interest in how appetising the food is and not enjoying food shopping as much. Lower interest in eating and drinking usually goes hand in hand with lower appetite and tiredness.

Mood changes

Changes in the ability to prepare meals

• Changes in the ability to eat is often secondary to other conditions. For example, muscle loss and feeling weaker can have an effect on how active you are and your ability to go shopping for food. Changes in smell and taste can also occur due to medications, and this can have an effect on the enjoyment of food.