Factors Influencing Food Intake in Older Adults
Changes in social relationships influence food intake. Eating alone can be a difficult adjustment for a widow(er). Loss of close friends or nearby family, changes in the neighborhood, or fear of the future reduce interest in eating. Financial losses and rising prices present difficult choices on a fixed income that must cover living expenses and medications. Food choices can be dictated more by available money than need for nutrients. Many older adults are eligible for the Supplemental Nutrition Assistance Program (the food stamp program), but relatively few apply.
Physical infirmity makes food shopping challenging, and if transportation or food delivery is infrequent, access to fresh produce and milk is curtailed. Severe arthritis interferes with food preparation and opening packages of pre-prepared foods. Attempting to manage chronic conditions with a highly restrictive diet is most often counterproductive. Meal patterns including familiar foods with attention to frequency and portion control are more successful. Chewing is painful for edentulous elderly with ill-fitting dentures or periodontal disease, and left untreated, periodontal disease leads to systemic infection.
Loss of taste and smell or distorted taste related to normal aging, radiation therapy, or medications discourage eating. Bitter medications delivered to the taste receptors via the blood may flavor the saliva and affect appetite. The interaction of nutrition and drugs is discussed more completely in Chap. 34.
Dry mouth (xerostomia) makes eating and swallowing difficult. The loss of saliva associated with this condition enables rapid bacterial growth with ulceration if continued. Dysphagia or difficulty swallowing and fear of choking influence the types of food that can be handled comfortably. Swallowing can be troublesome for those with neurological impairment as occurs with Parkinson’s disease, diabetes, or radiation treatment.