GENERATIONS – Journal of the American Society on Aging

CBOs’ Role in Addressing Malnutrition in Community-Dwelling Older Adults By Brenda Schmitthenner, Andrea Morris, Jessa K. Engelberg, Amy Herr, and Cheryl Hassoldt Community-based organizations can prevent, identify, and manage malnutrition and malnutrition risk.

M alnutrition, one of the greatest threats to suc- cessful aging, is a growing and costly health problem among older Americans that is prevent- able and can be better managed in the home with support from community-based organizations (CBO). Up to 50 percent of older adults are at risk for becoming malnourished or already are (Izawa et al., 2006; Kaiser et al., 2010), and it is estimated that the annual cost of disease-associated malnu- trition in the older adult population is more than $51 billion (Snider et al., 2014). Diseases, including cancer, diabetes, and gastrointestinal, pulmonary, and heart diseases and their treatments can impact both appetite and absorption of nutrients, which can lead to malnutrition (The Malnutrition Quality Collaborative, 2017). Malnutrition is a complicated and detrimen- tal condition associated with numerous causes and risk factors (National Academies of Sciences, Engi- neering, andMedicine, 2016). For example, older adults with chronic conditions; functional, sensory, mood, and cognitive impairments; polypharmacy; and oral health problems are at risk for malnutri-

tion. Additionally, with unmet social needs (also referred to as the social determinants of health), such as lack of transportation, food insecurity, pov- erty, social isolation, and limited or no access to public benefit programs and other essential sup- portive services, they are at an increased risk for malnutrition. Complicating matters further, these medical and social risks often co-occur, making malnutrition support difficult across the care con- tinuum. As a result, comprehensive malnutrition care requires collaboration between and among healthcare and CBO stakeholders. Malnutrition has long been recognized as a public health crisis in the pediatric population. According to the Academy of Nutrition and Dietetics, it con- tributes to approximately 45 percent of all child deaths globally, and in the United States, an esti- mated one in ten households with children strug- gle with food insecurity. Though malnutrition is pervasive and costly in the older adult population, Social Determinants of Health and Malnutrition

abstract Older adult malnutrition is a debilitating and costly condition that can be prevented through engagement from community-based organizations (CBO) that provide care transitions assistance, disease and falls prevention, and health promotion programs. By incorporating screenings for malnutrition and other social risk factors into their programs, CBOs can aid in preventing and treating malnutrition and help older adults to successfully age in their homes and communities, while advancing population health management strategies and demonstrating value to healthcare partners. | key words : senior and older adult malnutrition, community-based organizations, care transitions, disease prevention, health promotion, social determinants of health, social risk factors

58 | Spring 2019

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