Fast Five Quiz: Presentation and Diagnosis of Nutrition and Malnutrition in Older Adults

Nadia Ali, MD, MPH

Disclosures

July 13, 2021

Manifestations of malnutrition include thinning of the hair, thinning of enamel on the teeth, ecchymoses, angular stomatitis, spoon nails, dermatitis, petechiae, pallor, edema, bleeding gums, and glossitis.

Relevant examination findings are height, weight, and body mass index, as well as findings of soft-tissue wasting, hydration status, and evidence of vitamin and mineral deficiencies (older adults are at risk for marginal deficiencies of vitamins and trace elements). Many older adults do not get adequate vitamin B6, vitamin B12, and vitamin D, as well as folate, calcium, magnesium, and zinc.

Determining the mean corpuscular volume helps detect vitamin B12 and folate deficiency, a health problem common among housebound older patients. Vitamin B12 levels should be measured if malnutrition is suspected. Although osteoporosis may possibly develop due to malnutrition, vitamin D and ionized calcium levels can help determine if supplementation is needed to prevent further bone mineral decreases. A multivitamin with other necessary supplements can be beneficial in this situation, and selenium in particular can be supplemented for wound healing in severely malnourished patients.

Learn more about malnutrition in older adults.

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