There are several reasons working with a dietitian or nutritionist for older adults may beneficial.

It is important to know who you are getting advice from so let’s also discuss the difference between a dietitian for older adults and nutritionist for older adults.

What’s the Difference Between a Dietitian and a Nutritionist?

There is overlap in the use of the terms ‘dietitian’ and ‘nutritionist’ and while they are often used interchangeably there are differences between the professionals.  Dietitian, or registered dietitian or RD, is a protected title meaning on those who use it have met standard education, training, and registration requirements: a dietitian has completed an undergraduate university degree in nutrition and food science and an internship.  In the United States, registered dietitian nutritionist or RDN is synonymous with registered dietitian.  

Nutritionist can be but is not always a protected term, meaning anyone may be able to call themselves a nutritionist regardless of education, training, or registration.  It is possible a nutritionist has completed formal education in nutrition but it is also possible that a nutritionist has no formal nutrition related education.  

The education and training of a registered dietitian enables them to work with a wider scope of practice. Dietitians will often be found in health care settings such are hospitals or long term care centers or in roles related to public health, food service management, and research.  

Dietitian versus Dietician

Have you ever seen the spelling dietician? Dietitian is the current and more widely used spelling recognized by professionals.  Dietician was the original spelling (back in 1845!) but by 1899 dietitian was the preferred term.  

What Do Dietitians Do?

Dietitians are health professionals who specialize in nutrition and help people make food choices to improve their overall health and well-being.  

Dietitians translate nutrition science into practical information that can be applied to one’s eating habits.  Eating habits refers to why and how people eat, what people eat, and with whom people eat.  Eating habits may also include the way people get, store, use, and discard food.  

More specifically, dietitians assess a clients nutritional needs based on their medical history, lifestyle, and food preferences. The assessment of a clients nutritional needs can then be used to provide education, counselling, and/or develop a personalized menu.

Dietitians provide education on nutrition and healthy habit to promote health and well-being.

Dietitians create recipes and menus suitable for different populations and nutrition needs.

The Importance of a Dietitian for Older Adults

Working with a dietitian can be beneficial for older adults who want to optimize their nutrition and improve their overall health and well-being. Dietitians are trained professionals who specialize in nutrition and can help older adults navigate the complex world of food and nutrition.

There are several reasons older adults would benefit from working with a dietitian:

1. Increasing risk of malnutrition which can increase vulnerability to illness, injury, and infection with declining biological resilience (ability to recover). A dietitian can help older adults minimize risk of malnutrition and subsequently vulnerability to maintaining health and well-being.
2. Age related changes. There are many changes associated with aging that both impact nutrition and are impacted by nutrition. A dietitian can help older adults understand these changes and provide appropriate dietary recommendations.
3. Chronic diseases. As a result of aging, there is increased prevalence of chronic disease.   Management of chronic diseases can get complex with increasing diagnoses.  A dietitian can help older adults managed their condition(s) through dietary changes.
4. Food safety. As we age, our immune system weakens making us more vulnerable to potential food borne illnesses. A dietitian can provide guidance on food safety.
5. Medication interactions. Older adults are often on a greater number of medications that can interact and affect nutrient absorption. A dietitian can help older adults understand potential interactions and advise on dietary adjustments as necessary.
6. Weight management. Any unintentional weight change in older adults could be concerning. A dietitian can help older adults address any weight changes.

Malnutrition Risk of Older Adults

Malnutrition results from an imbalance of nutrients. Malnutrition can be the result of undernutrition or overnutrition. Undernutrition results from insufficient intake of nutrients. Overnutrition results from excessive nutrient intake. Undernutrition is often the clinical focus for older adults.

Malnutrition in older adults can lead to:

• Weakened immune system making older adults more vulnerable to illness and infection.
• Loss of muscle mass and subsequently strength leading to weakness that increases the risk of falls with injury.
• Cognitive decline.
• Increased risk of hospitalization and increase length of stay if hospitalized.
• Nutrient deficiencies.
• Increased risk of skin breakdown causing wounds and delayed healing of wounds.

Age Related Changes

There are many changes associated with aging that both impact nutrition and are impacted by nutrition. 

Changes to Sense of Taste, Smell, and Sight

Declining taste, smell, and vision can cause a reduction in the amount and variety of food eaten.

Body Composition Changes

A decline in muscle mass in combination with an increase in fat mass contribute to the risk of frailty and malnutrition.

Frailty is syndrome in older adults characterized by a decline in function, strength, and reserves that increases vulnerability.

Oral Health

Poor oral health, changes in dentition, reduced saliva flow, and chewing difficulty can all contribute to decreased taste and declining appetite. Reduced appetite can cause insufficient intake of nutrients.

Physical Change

Reduced activity levels, physical or cognitive changes may affect the ability to shop, prepare, and eat. As a result older adults may rely on convenience foods or limited variety of foods which may not provide adequate nutrition.

Psychological

Depression and loneliness are common issues that can have a significant impact on health and well-being. Older adults may be more vulnerable to depression and loneliness because of social isolation, loss of loved one, change in mobility, and chronic health conditions.

Chronic Diseases

As a result of aging, there is increased prevalence of chronic disease: 8/10 older adults have at least one chronic condition, 5/10 have two or more chronic diseases.  Management of chronic diseases can get complex with increasing diagnoses.  

Some common chronic disease diagnosis in older adults in Canada include hypertension or high blood pressure, periodontal disease, osteoarthritis, ischemic heart disease, diabetes, osteoporosis, cancer, chronic obstructive pulmonary disease (COPD), asthma, mood and anxiety disorders.

Food Safety

Food safety is particularly important for older adults, who may have a weakened immune system and be more susceptible to foodborne illnesses. Identifying food that has spoiled is more challenging for older adults because their sense of smell is diminishing.

Medications

Medications can interfere with the body’s ability to absorb nutrients or alter the way nutrients are processed by the body.

Medications can:

• Affect appetite
• Change taste or smell
• Deplete nutrients
• Interfere with nutrient absoprtion
• Interact with food
• Impact digestion

Weight Management

Unintentional weight loss can lead to malnutrition, weakness and frailty, cognitive impairment and increased risk of infections. Significant weight changes is defined as a 5% change within 6 months.

Dietitians work to identify the underlying cause of unintentional weight changes and develop a plan to address it.

Conclusion

Dietitians are health care professionals who specialize in nutrition to promote health and manage disease. Nutritionists may not have any formal nutrition education or training.

As we age, there are changes to our bodies, our nutritional needs, and our health. Dietitians can help navigate these changes to optimize nutrition for health and well-being. Dietitians can also help older adults manage disease(s).