Food safety and the elderly

03 November 2003

Although it is often not recognised, susceptibility to foodborne illness increases with age. Thus, food safety is a particular concern for the elderly.

One reason for this is that many of the body's functions become impaired with age. For example, problems with vision are common, making it difficult to read preparation instructions or expiry dates. A person who does not see well may not notice that a dish or utensil is not clean or that a food has changed colour.

The sense of smell becomes less acute with age; this may be made worse by medication or illness. Many spoilage agents cause unpleasant odours that serve as a warning that the food is not fit to eat. A person whose sense of smell is impaired may miss this warning. Fingers often lose strength and dexterity, making it difficult to peel vegetables, wrap food and open or close containers. It may be impossible to put on protective gloves for washing dishes; thus, they cannot be washed at the proper temperature.
Many elderly people cannot walk without assistance and find it hard to bend or to remain standing for long periods. They may find it impossible to clean cooking and food storage areas. They may also have difficulty getting to the store, and this may lead to food being kept past its expiry date.

Memory may also be impaired. This may lead to food being prepared incorrectly -- for example, missing a crucial step or applying the wrong time and temperature. In addition, the elderly are very vulnerable to illness, including food poisoning. Ageing weakens the immune system, as do chemotherapy, surgery and chronic conditions such as heart disease or diabetes. This means that they are likely to have complications with illnesses and to take longer to recover.

Many elderly people are malnourished. This also increases their susceptibility to infections, including those caused by pathogens in food. There are many reasons for this: medication, digestive disorders, chronic illnesses, physical disabilities and depression may cause appetite loss. The most obvious is the fact that many live on fixed incomes and food is the easiest cost to cut.

An increasing understanding of factors that contribute to poor nutrition in the elderly should enable the development of appropriate preventive and treatment strategies and improve the health of older people.
Another reason that older people are highly susceptible to food poisoning is that stomach acid decreases with age. That acid kills many pathogens before they enter the small intestine. The less the acidity, the greater the chance of being infected by a foodborne pathogen. Digestive processes also slow with age, giving some pathogens time to grow and form toxins in the gut.

Financial constraints may cause other food safety related problems for seniors. They may be reluctant to throw away food, even when it is in poor condition. They may be unable to replace damaged cookware or appliances that do not work properly.
Running a kitchen is such a routine task that it is easy to forget the hazards associated with it especially as we all get a little bit older every day.

References

  1. Ferry, M. Facteurs et déterminants des comportements alimentaires du sujet âgé -- aspects physiopathologiques et cliniques. In Nutrition et Vieillissement, ed. by M.C. Bertière, H. Payette, Y. Guigoz, and B. Vellas. Serdi Edition 1999.
  2. Parmley, Mary Ann. When an older person needs help in the kitchen, National Food Safety Database.
  3. Seniors need wisdom on food safety. Food Safety and Inspection Service, United States Department of Agriculture.
  4. Donini LM, Savina C and Cannella C (2003) Eating habits and appetite control in the elderly: the anorexia of aging. International Psychogeriatrics 15, 73-87.

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