A decrease in appetite is not pickiness, but a natural part of aging. As the years pass, the centers of the brain that regulate feelings of hunger and thirst function less effectively. The sense of smell deteriorates, saliva production decreases, sweet and savory tastes are perceived less intensely, and many medications have the side effect of reducing appetite.
According to Dr. Klára Gadó, Director of the Center for Geriatric Care and Nursing Science at Semmelweis University, all of this leads to older people often eating and drinking less than their bodies need. However, family members and caregivers can make a big difference by paying attention to the pleasure of eating and ensuring adequate fluid intake. This will help keep our loved ones mentally sharper and more active in old age.
According to the geriatrician, a meal can be more stimulating if it engages multiple senses. Colorful, high-contrast plates improve the perception of food even when visual acuity is impaired, while diverse colors, shapes, and aromas make dishes more appealing.
Culinary herbs, such as thyme, parsley, and rosemary, enhance flavors, while sour ingredients, including vinegar, lemon, or kefir, stimulate saliva production and appetite. For this reason, it is a good idea to drink a sour beverage such as lemon water or apple cider vinegar lemonade before a meal.
For the elderly, sour and umami flavors, such as tomatoes, mushrooms, aged cheese, or broth, are particularly beneficial because they add to the enjoyment of food even when sweet and savory flavors are less noticeable. It may be advisable for patients to eat smaller quantities several times a day rather than large portions.
Since thirst perception decreases with age, it is better to offer elderly people small amounts of fluids regularly, every hour, and to supplement water with soups, fruits, and yogurts.
Dr. Klára Gadó recommends an easy-to-remember method for stimulating appetite, known as the “Five S” rule. Food should be (i) showy, i.e., served in a colorful and high-contrast manner. It should be (ii) soft, i.e., easy to chew and swallow, as well as (iii) succulent, so that the dish also contributes to fluid intake. It is important that mealtimes are (iv) stimulating, i.e., favorite dishes should be served regularly, and finally, they should take place in a (v) slow, calm, stress-free environment.
When it comes to eating in old age, the link between nutrition and dementia deserves special attention. Dementia is not only associated with memory loss but can also lead to a decrease in appetite and difficulty in swallowing. The latter, also called dysphagia, can make eating difficult for many elderly patients.
The expert points out that in such cases it is particularly important that the consistency of the food is adapted to the patient’s abilities: Cream soups, puréed or soft-cooked dishes are safer options. Liquids can also be thickened to prevent choking, and in more severe cases, jellied water may be a solution.
A growing body of research suggests that certain dietary patterns have a protective effect on brain function.
The benefits of walnuts are also being studied at Semmelweis University’s Faculty of Health Sciences (ETK). In addition, a diet rich in antioxidants and anti-inflammatory foods that supports circulation may reduce the risk of developing Alzheimer’s disease and other forms of dementia.
One promising example is the MIND diet, which combines elements of the DASH diet – designed to control hypertension – and the Mediterranean diet. Dr. Klára Gadó says this diet includes lots of vegetables, berries, fish, olive oil, nuts, and legumes, while eliminating red meat, cheese, sweets, and fast food.
The director emphasizes that tube (enteral) feeding may be an option for patients who are no longer able to consume sufficient nutrients orally, but whose digestive system is still functioning. However, individual consideration is always required. The patient’s overall condition, the course of their illness, their ability to cooperate (e.g., whether they will remove the tube), and ethical considerations must be taken into account.
Orsolya Dávid
Translation: Judit Szabados-Dőtsch
Photos by Attila Kovács – Semmelweis University; cover (illustration): freepik.com
