Older people

In Germany, one in five adults belongs to the 65+ generation, and demographics suggest that the proportion of older people in Germany will continue to rise. 

The 65+ generation is diverse: the aging process differs from person to person. Age-related physical changes, behavioural and social factors influence the nutrition and health of older people.

The health and life situation is decisive for the challenges associated with ageing. People aged 65 and over are therefore given special consideration in the risk assessment in certain respects.

In a society where people are getting older and older, healthy ageing is a high priority. Nevertheless, the body changes with age:

• The total body water sinks.
• Muscle mass and bone substance decrease and body fat mass increases. Building and maintaining muscle strength becomes more important than muscle mass itself.
• Memory performance changes: long-term memory remains stable and can even develop positively; working memory, on the other hand, slows down.

In addition, the probability of chronic diseases and multiple illnesses increases with age. Cardiovascular diseases, cancer, chronic lung diseases, musculoskeletal diseases and diabetes mellitus are particularly common amongst older people - for example, according to figures from the cancer register, over 50 per cent of cancer patients are between 60 and 79 years old, and the Robert Koch Institute's health monitoring shows that the risk of developing osteoporosis increases significantly, especially amongst women aged 65 and over. 

Many healthy senior citizens who eat a varied and balanced diet and have an active lifestyle with sufficient time spent outdoors are adequately supplied with energy and the nutrients their bodies need. 

However, physical changes typical of old age and chronic illnesses can lead to a change in the need for and/or intake of vitamins and minerals. 

Due to the age-related decrease in muscle mass, the German Nutrition Society (DGE) recommends favouring foods with a high nutrient density and low energy density, even in old age. 

Older people who live independently have good opportunities to adapt their nutrition to age-related changes in nutritional needs. Declining mental and physical abilities, chronic physical (multiple) illnesses, mental illnesses, but also inadequate care in the event of a need for nursing care can lead to nutritional intake not meeting individual needs. For senior citizens in need of care in hospitals or long-term care facilities, nutrition and nutrient supply should be carefully planned, monitored and, if necessary, adjusted in order to avoid energy and nutrient deficiencies. 

In any case, it is important to ensure a balanced micronutrient intake in order to maintain health and quality of life in old age.

When choosing food, it is important to bear in mind that the immune systems of senior citizens may be weakened against pathogens in food due to old age or pre-existing medical conditions and medication. Certain foods may contain bacteria or other pathogens in quantities that do not harm healthy adults, but can pose a serious health risk to senior citizens. To prevent foodborne infections, food from animals should be heated sufficiently before consumption (at least 70 °Cshort fordegrees Celsius for two minutes at all points of the food). Fruit, vegetables and herbs should also be washed thoroughly and prepared immediately before consumption if possible. Of course, compliance with the general rules of kitchen and food hygiene is particularly important for this group of people.

Poisoning in old age often happens unintentionally. Medication is mixed up or taken in too high a dose. Cosmetic products or cleaning agents are mistaken for food and therefore consumed. Inhaling products containing soap or foaming cosmetics also poses a hazard for senior citizens.

This is often caused by a decline in physical and mental performance.

Diseases such as dementia, but also side effects of medication (e.g. benzodiazepines) can lead to mental impairments such as confusion, forgetfulness and disorientation. This increases the probability of falls, but also the possibility of confusion or an overdose of medication. A diminished sense of smell and taste also contribute to substances that are not suitable for consumption being eaten or drunk by mistake, e.g. because a bitter taste is not perceived. Declining eyesight can also lead to confusion.

Of course, it should be noted that people over the age of 65 should also be considered in a differentiated manner with regard to the risk of poisoning, as physical and mental changes are only loosely linked to chronological age. However, very old people (approx. 80 years and older) tend to be more affected by these age-specific poisoning risks than the so-called ”oung old” (approx. 60-79 years).

In principle, poisoning can have more severe effects in older people than in younger adults. This is partly due to a change in metabolism. Medication, but also harmful substances, tend to be broken down and excreted from the body more slowly in old age, for example because the performance of the kidneys and liver decreases. Furthermore, older people suffer more frequently from chronic illnesses and take more medication than younger people. This also makes them less resistant to negative external influences. In the event of poisoning, older patients, especially the very elderly, are therefore more likely to suffer severe complications, including death.

The good news is that these poisonings are often preventable, for example through clear labelling of products. In the event of mental impairment, e.g. temporary confusion or forgetfulness, medicines and other potentially hazardous products should be kept out of reach of patients and medication should be taken under supervision.

According to figures from the Max Rubner Institute's (MRIshort forMax Rubner Institute) National Nutrition Survey II, women between the ages of 65-80 are the population group most likely to take food supplements. According to the KPRA Age Study, 54 per cent of women and 34 per cent of men in this age group take food supplements.

From the BfRshort forGerman Federal Institute for Risk Assessment's point of view, dietary supplements as an additional measure for the refinement of the nutrient supply should ideally be taken under medical supervision, as an additional intake of micronutrients in excess of requirements should not be necessary for healthy people who are sufficiently supplied with nutrients. Long-term high-dose intake of food supplements can be associated with health risks in such cases, e.g:

• Excessive intake of vitamins and minerals can lead to undesirable health effects.
• Interactions may occur between ingredients from food supplements and drugs or medicines, which can also lead to a weakening or strengthening of the effect of medicines.
• There may be a (temporary) falsification of laboratory tests due to the intake of certain food supplements, e.g. with biotin.

In certain cases, however, an additional supply of vitamins and/or minerals via food supplements can be useful. Reasons for this can be nutritional or circumstance-related deficiencies, but also chronic illnesses. In these cases, consultation with a doctor is recommended.

Status: 20/03/2025