Causes of Weight Loss in the Elderly
The causes of weight loss in the elderly are varied, and it’s important to be aware of them. Weight loss in older adults can be dangerous, leading to illness, weakness, and even falls. It is important to know what the causes of weight loss are so that elders can be given the support they need to prevent or reverse weight loss.
I’ll go through several reasons that weight loss is more common in older adults.
Loss of Appetite + Lower Intake
Loss of appetite is a really wide category that is one of the main causes of weight loss in the elderly. Appetite changes vary from person to person. Anorexia of aging is the term used to describe the many age-related body changes that cause a person to lose their appetite and eat less. This eventually leads to weight loss and undernutrition (1).
Below, I’ll list some common reasons that appetite and intake drop as a person ages. But, know that this is not a complete list, nor does it describe what’s happening for 100% of people.
-Loss of smell and taste
One reason people may experience anorexia of aging is that foods don’t smell or taste as good as they usually do. Favorite foods may also smell bad when once they smelled good! Part of this is because of decreases in taste and smell, and it is a big cause of weight loss in the elderly!
One reason this happens is that the smell receptors in the nose are damaged and lost with aging (2). A history of cigarette smoking, experiencing a stroke, or upper respiratory infection can also lower the sense of smell.
Men have been found to have a greater decline in taste sensitivity than women (3). This infographic from the National Institute on Deafness and Other Communication Disorders (NIDCD) is really helpful to understand more about the changes in the sense of smell (3).
-Slowing Gastrointestinal (GI) System
Another reason for decreased appetite is that the gastrointestinal (GI) system slows down with aging. This causes food to stay in the stomach longer. As a result, you feel fuller for longer.
Constipation is another impact of a slowing GI system. Constipation is a common complaint heard from older people and can cause lower appetite. It’s hard to eat when you feel “backed up!”
Movement (for those that are able) and more fiber + fluids in the diet are the safest and best ways to help ease constipation. These are not always used by those suffering from constipation, so laxatives are commonly used.
-Hormone and Neurotransmitter Changes
There are also hormone and neurotransmitter changes that happen with aging. Some of these changes impact the appetite and hunger response in a negative way (1). For example, cholecystokinin increases in circulation and can cause the body to be more sensitive to how quickly it becomes “full” when eating (1).
Poorly Managed Illness
With aging comes more risk of disease. Common diseases that impact older people more than younger people include diabetes, kidney conditions, cancer, stroke, and dementia (or Alzheimer’s disease). These diseases and how they’re managed are major causes of weight loss in the elderly.
-Diabetes
I’ll focus on diabetes first since it’s so common. In 2019, 24.4% of adults in the United States aged 65 years or older had diabetes (4). That’s 13.3 million elders! Plus, another 2.6 million older adults in the US have undiagnosed diabetes(4)! (I’ll address undiagnosed illnesses in the next point.)
Diabetes can be a tricky disease to manage, especially for older people. If your hands are unsteady, your vision is poor, you are confused, or you live alone (like many elderly people), it will be harder to administer insulin or track what you’re eating.
When diabetes is poorly managed, blood sugar can rise to dangerous levels. A side effect of high blood sugar is weight loss.
-Kidney Conditions
Kidney conditions can also cause weight loss in the elderly. This may be due to fluid changes within the body. Or, it can cause weakness and poor appetite.
-Cancer
Cancer also can cause weight loss in the elderly. For many reasons, including side effects of treatment, taste changes, poor appetite, and weakness, preventing weight loss can be challenging for someone with cancer. It isn’t easy to support someone with a cancer diagnosis, and sometimes it’s better to focus on encouraging nutrition before and after cancer treatment.
-Stroke
Strokes impact several pieces of a person’s life. One of those is mobility. I’ll talk more specifically about mobility later. Strokes can also cause swallowing problems and make safe eating a challenge. A strong support team can make positive impacts on nutrition status after a person has a stroke, and can help prevent weight loss!
-Dementia
Dementia, or even more common age-related confusion and memory loss, can cause weight loss. When a person is forgetful, nutrition impacts are forgotten meals, too small portion sizes, and a diet lacking variety. A person is at nutrition risk and risk of weight loss if they aren’t eating enough of the right foods. Without disease management and someone there to support and help with nutrition, the elder is at risk of weight loss.
Undiagnosed Illness
As I mentioned above, an estimated 2.6 million people over 65 years old have diabetes but don’t know it. These people are carrying along all of the diabetes risks I already spoke about, but can’t do anything about it!
A common clue that someone has diabetes is rapid weight loss. For other diseases, weight may go up rapidly at first, but weight is lost long term. Because weight loss (and sometimes weight gain) is a clue for diagnosing disease, it is important to monitor an elder’s weight to be able to catch any large weight changes.
Mobility Changes + Weakness
Arthritis and weakness are just two common reasons that mobility changes with advanced age. If an older person is unable to walk to the fridge or make themself lunch, they are at risk of weight loss. Weakness may also cause an elder to get tired quickly so that they aren’t able to finish meals.
With mobility changes and weakness, having a person providing support can be so important! The support person can provide meals and snacks, go shopping for groceries, and even give encouragement during meals!
Mental Changes
I touched on mental changes a bit earlier, but this topic deserves more focus. Large and small mental changes are common in older people. Those small mental changes could even be overlooked by loved ones. Forgetfulness on a large scale can mean forgotten meals, being unsure of what to eat, or even walking away from a meal. On a smaller scale, it could simply be eating too little or eating inappropriate amounts of a variety of food.
Whatever the case may be, elders with forgetfulness are at higher risk of weight loss. Support from someone else is needed to prepare meals, set reminders to eat or check how much was eaten. Being vigilant can make a huge difference!
Conclusion
Weight loss in the elderly can be caused by many different reasons. The common ones I’ve discussed above. Hopefully, it’s given you some insight into the elders in your life. Most importantly, I want you to know that you can do something to help!
Related post: Dehydration in the Elderly
Sources
- Chapman IM. The anorexia of aging. Clin Geriatr Med. 2007 Nov;23(4):735-56, v. doi: 10.1016/j.cger.2007.06.001. PMID: 17923335.
- Schumm LP, McClintock M, Williams S, Leitsch S, Lundstrom J, Hummel T, Lindau ST. Assessment of sensory function in the National Social Life, Health, and Aging Project. J Gerontol B Psychol Sci Soc Sci. 2009 Nov;64 Suppl 1(Suppl 1):i76-85. doi: 10.1093/geronb/gbp048. Epub 2009 Jun 23. PMID: 19549923; PMCID: PMC2981468.
- National Institute on Deafness and Other Communication Disorders. Smell Disorders. https://www.nidcd.nih.gov/news/multimedia/sense-smell-us-adults-over-age-40
- Centers for Disease Control and Prevention. National Diabetes Fact Sheet: General Information and National Estimates on Diabetes in the United States. Data source: 2017–March 2020 National Health and Nutrition Examination Survey. https://www.cdc.gov/diabetes/data/statistics-report/diagnosed-undiagnosed-diabetes.html