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Introduction

Dietary assessment in older adults presents many unique problems due to the diversity of health states and capabilities that span the population group. Additional complications are created by variations in intakes due to illnesses, medications affecting appetite, altered sensory modalities and cognition, and the variety of living arrangements. Although a good deal is known about dietary intakes, body composition, and nutritional status among the “young old” (arbitrarily defined as 65–74), who tend to be relatively free of chronic degenerative diseases and conditions, very little is known about those 75+ and particularly the very old (85 and older). These individuals are often affected by multiple morbidities, polypharmacy, functional deficits, and alterations in body composition that all increase with age, and all of these have potent impacts on nutritional status and complicate dietary assessment. Many of the common medications older adults take regularly affect nutritional status, so information on medications must also be taken into account in assessments.

Many individuals aged 80 years and older are generally able to perform well in dietary studies; however, some may report food habits from earlier in life. Identifying those older adults who may not able to respond correctly to standard intake assessment approaches, such as 24-hour recalls or food frequency questionnaires (FFQs), will require adapted techniques, such as observation of intakes and outputs in hospitalized patients and other food records. Such challenges to accurate dietary assessment warrant exploration of better methodologies to support both basic and translational research on older adults.

A virtual workshop series titled Assessing Intake of Food and Dietary Supplements in Older Adults was convened in spring 2022 by the Food and Nutrition Board, Health and Medicine Division, National Academies of Sciences, Engineering, and Medicine. The series was planned by a committee¹ of experts and included four virtual workshops (held April 8, April 22, April 29, and May 6) intended to provide guidance to researchers and clinicians. The workshops aimed to outline considerations relating to different methods of assessing intakes of food and dietary supplements in older adults, with special emphasis on those 75 and older. The broad topics covered included current status of dietary and nutrition assessment of older adults and advances and key issues in this topic; nutritional screening of older adults; and nutritional practices, challenges, and policies that affect older adults. The workshop’s statement of task is in Box 1-1.²

ORGANIZATION OF THIS PROCEEDINGS

This proceedings follows the order of the four workshop agendas (Appendix A), chronicling each workshop in its own chapter. Chapter 2 explores demographic trends and the current state of research on nutritional assessment in aging populations (workshop 1); Chapter 3 examines recent studies and developments in creating and applying dietary assessment tools for aging populations (workshop 2); Chapter 4 reviews recent research on screening for undernutrition in aging populations (workshop 3); and Chapter 5 explores the broader landscape and policies surrounding the nutritional assessment of older adults (workshop 4). Appendix B is a list of acronyms used in this proceedings, and Appendix C provides biographical sketches of each workshop’s speakers and planning committee members.

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¹ The planning committee’s role was limited to planning the workshop, and the Proceedings of a Workshop has been prepared by the workshop rapporteurs as a factual summary of what occurred at the workshop. Statements, recommendations, and opinions expressed are those of individual presenters and participants, and are not necessarily endorsed or verified by the National Academies of Sciences, Engineering, and Medicine, and they should not be construed as reflecting any group consensus.

² The workshop agenda, presentations, and other materials are available at https://www.nationalacademies.org/our-work/assessing-intake-of-food-and-dietary-supplements-in-older-adults-a-workshop-series.

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