Can Poor Nutrition Increase The Risk Of Falls In Older Adults
Good nutrition is important at every age, but our nutritional needs and eating habits can change considerably as we get older.

For older adults living in care homes, nutrition is linked to fall risk in ways families may not immediately be aware of.

So, how are nutrition and falls connected, and what should care homes and families be looking out for?

Can Poor Nutrition Increase the Risk of Falls in Older Adults?

Yes. Poor nutrition increases the risk of falls in older adults by contributing to muscle loss and weakness, which can affect strength and balance. Dehydration also causes dizziness and low blood pressure, while nutrient deficiencies, such as vitamin D, can affect muscle and bone health.

How Poor Nutrition Can Increase Falls Risk

When an older adult is not eating enough, one of the biggest concerns will be the amount of muscle loss they’ll experience.

That’s because the body needs sufficient energy and protein to maintain muscle tissue, and a prolonged shortfall can contribute to the loss of muscle mass and strength, which is harder to repair as we get older, affecting everyday movements and causing balance problems and falls.

This is called sarcopenia, the age-related loss of muscle mass and strength and poor nutritional intake can make it more difficult to maintain muscle mass.

For example, a resident with muscle loss might start using their arms to push themselves out of a chair, find it harder to lift their feet properly when walking or have less strength to steady themselves after a stumble.

Residents who are already frail or have limited mobility may feel the effects of further muscle loss more acutely.

There are several nutritional issues that can be relevant to falls risk, including:

  • Not eating enough protein can make it harder to maintain muscle mass. Protein needs can be met through foods such as fish, meat, dairy products, beans and lentils, depending on the resident’s diet and nutritional requirements.
  • Eating too little overall means the body may not receive enough energy to maintain weight and muscle. Unplanned weight loss can be an important warning sign.
  • Dehydration can cause dizziness, weakness and light-headedness. This is particularly concerning if a resident feels dizzy when they stand up.
  • Vitamin D deficiency can cause muscle weakness and affect bone health. Older adults who rarely spend time outdoors are at greater risk of deficiency.

Why Older Adults Might Not Be Eating Enough

If a resident has a reduced appetite, it might be due to a period of illness or recovery. But there might be other reasons a resident’s food intake changes.

Sometimes the problem is with eating itself.

Painful or poorly fitting dentures can make tougher foods uncomfortable to chew. A dry mouth can make eating and swallowing more difficult, while changes to taste and smell can make previously enjoyed meals less appealing. Certain medications can also affect appetite, taste or cause nausea.

Swallowing difficulties can show signs such as coughing or choking during meals, taking much longer to eat, repeatedly clearing the throat or developing a wet-sounding voice after eating or drinking. If dysphagia is suspected, the resident may need assessment by a speech and language therapist so food and drinks can be provided at a safe and appropriate consistency.

Dementia can make eating challenging, as a resident may forget they have not eaten, struggle to recognise food, lose the ability to use cutlery or find a busy dining environment distracting.

It also might be something as simple as a resident not being able to comfortably cut their food, open packaging or lift a full cup and may eat and drink less unless the right assistance is available.

Finding the reason for reduced intake is what carers will focus on and they will never put a larger meal in front of a resident without addressing the problem, whether it’s caused by painful dentures, difficulty swallowing or needing physical assistance to eat.

Dehydration and Falls in Older Adults

Older adults are more vulnerable to dehydration because the sensation of thirst can become weaker with age.

Reduced fluid intake can sometimes be linked to practical difficulties. A resident may deliberately drink less because getting to the toilet is difficult or they are worried about incontinence. Reduced mobility or problems with grip can also make it harder to reach, pour or hold a drink without assistance.

When fluid intake is too low, blood volume decreases and blood pressure falls, causing dizziness or light-headedness, particularly when getting up from a bed or chair. A sudden drop in blood pressure after standing is known as postural hypotension and it could leave a resident feeling unsteady or, in more severe cases, cause them to faint.

To prevent dehydration, care homes offer more ways to get fluid into residents throughout the day. If a resident regularly leaves drinks untouched, the care team needs to understand why. Is it because they struggle to hold a cup? Or forget to drink or dislike the drinks being offered or need support to reach them. Whatever the reason, care homes will tackle the issue to ensure residents are well hydrated.

Families can also look out for changes such as drinking considerably less than usual, increased tiredness, dizziness or urine becoming darker and more concentrated.

Any noticeable change should be reported to the care team, particularly if the resident has also become unsteady or has recently experienced a fall.

How Care Homes Can Support Nutrition and Reduce Falls Risk

Nutrition is part of a resident’s broader falls-prevention plan, particularly when issues such as poor intake, weight loss or reduced strength have been identified as concerns.

Care homes can support residents by:

Monitoring weight and nutritional risk

Regular monitoring can identify unplanned weight loss that may otherwise be difficult to spot. Tools such as the Malnutrition Universal Screening Tool, also known as MUST, can be used to assess adults’ risk of malnutrition.

Making meals work for the individual resident

This could mean offering smaller portions more frequently when appetite is poor, providing suitable higher-energy or higher-protein options or adapting meals, following professional advice, when chewing or swallowing is difficult.

Providing the right level of assistance

Some residents may need food cut into manageable pieces, adapted cutlery or physical assistance during meals. Others may need prompting and encouragement, particularly if dementia affects their awareness of food and drink.

Keeping an accurate picture of intake

If there are concerns, recording what a resident actually eats and drinks can reveal patterns that might otherwise be missed. For example, a resident may eat breakfast well but consistently leave most of their evening meal.

Acting on unexplained changes

Weight loss, a sudden reduction in appetite or increasing difficulty eating should prompt further investigation. Depending on the concern, this may involve a GP, dietitian, dentist or speech and language therapist.

Supporting Better Nutrition and Safer Mobility in Later Life

Good nutrition is an important part of keeping older adults strong and supporting their mobility as they age.

For residents at risk of falls, changes in appetite and weight are something carers and families should pay attention to, particularly when they happen alongside increasing weakness or difficulty getting around.

If you’re noticing that your loved one is eating or drinking less than usual, losing weight or finding everyday movements more difficult, speak to their care team so the right support can be put in place and any underlying health concerns can be investigated.

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