Karen L. Smith, MSc, Kunin Lunenfeld Applied Research Unit, Baycrest and Department of Nutritional Sciences, University of Toronto, Toronto, ON.
Carol Greenwood, PhD, Kunin Lunenfeld Applied Research Unit, Baycrest and Department of Nutritional Sciences, University of Toronto, Toronto, ON.
Helene Payette, PhD, Director, Research Center on Aging, Health & Social Services Centre - University Institute of Geriatrics of Sherbrooke, Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, QC.
Shabbir M.H. Alibhai, MD, MSc, Division of General Internal Medicine & Clinical Epidemiology, University Health Network; Geriatric Program, Toronto Rehabilitation Institute; Departments of Medicine and Health Policy, Management and Evaluation, University of Toronto, Toronto, ON.

Unintentional weight loss is common among older adults and is associated with significant adverse health outcomes, increased mortality, and progressive disability. The diagnosis is often associated with an underlying illness; however, in as many as one in four older adults with unintentional weight loss, no obvious medical cause can be identified. A variety of nonpharmacologic interventions may improve energy intake and lead to weight gain. The most common approach to the treatment of weight loss among older adults is consumption of high-energy/protein oral supplements between meals as a means of increasing daily energy intake. Involving other health professionals, including a dietitian, may be helpful in the assessment and management plan. In addition, a number of pharmacologic treatments have been investigated, but the potential benefit of these treatments remains unclear.
Key words: weight loss, older adults, malnutrition, oral nutritional supplementation, megestrol.

Philip Dopp, BSc

The nutritional status of the elderly can be helpful in examining the health of this population. One study found that malnutrition among the elderly is associated with a variety of problems such as the development of pressure sores and fractured femurs.¹ Others have found that poor nutrition predisposes the elderly to infections, as those who are malnourished are 3.3 times more likely to be infected with a community-acquired bacterial pneu-monia.² Of even greater importance, is the demonstrated fact that poor nutritional status, as measured by body mass index, is an important predictor of mortality in the elderly.³ Given that studies have found that among population of seniors, the prevalence of malnutrition can be as high as 60%, and considering the consequences which can ensue, malnutrition represents a problem that warrants concern.⁴ In an attempt to deal with this problem, programmes such as Meals on Wheels® (MOW) have been developed to provide nutritional services for the elderly.