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What Influences Nutritional Status?



Jack is a 71 year old retired school teacher. He is divorced and lives alone in an apartment, but has many friends in the building with whom he socializes often. Jack’s mobility is limited by arthritis in his hips and knees. He is no longer able to drive and relies on his daughter or a friend for transportation. His financial situation is relatively good, but when unexpected expenses arise, he sometimes compromises on the quality or amount of food he buys in order to make ends meet.

Jack usually enjoys preparing food and has a good appetite. Sometimes when he is feeling particularly tired, he doesn’t feel like preparing meals, but usually does not go without eating. Jack wears dentures, but has no problems chewing or swallowing his food.


What are some factors that might contribute to a decrease in Jack’s nutritional status?


What are some factors that might be protective in terms of helping Jack maintain good nutrition?


How might Jack’s situation change if his arthritis became more disabling or he was no longer able to rely on his daughter or friends for assistance with transportation?

Jack’s situation illustrates that income, although important, is not the only determinant of nutritional status in older adults.  There are many factors that contribute to the risk of seniors not accessing adequate or appropriate food[1]:

  • Lack of money for food

  • Lack of food because of transportation limitations

  • Not enough food due to health or mobility limitations

  • Lack of motivation to cook and eat

In addition, confusion and memory loss may make it difficult for older adults to remember what, when and how much they have eaten and depression may decrease appetite.[4] A healthy mouth, teeth and gums are also important for proper eating and missing teeth and ill-fitting dentures may contribute to poor nutrition.[4] The ability to chew and swallow food is another important consideration.[4]

When there has been a clear division of domestic responsibilities along gender lines, the death or illness of a spouse can create significant problems, for both men and women.


1. Wolfe, WS, Frongillo, EA, Valois, P. Understanding the experience of food insecurity by elders suggests ways to improve its measurement. The Journal of Nutrition 2003;133:2762-9.

4. Wellman, NS, Weddle, DO, Kranz, S, Brain, CT. Elder insecurities: Poverty, hunger and malnutrition. Journal of the American Dietetic Association. 1997;97:S120-2.

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