As you age, maintaining good nutrition becomes increasingly vital for overall health, independence, and quality of life. Older adults often face unique challenges such as chronic disease management, medication interactions, and physical changes that affect nutritional status. Registered Dietitian Nutritionists (RDNs) play a crucial role in supporting older adults through personalized, evidence-based nutrition care that helps prevent disease, manage existing health conditions, and promote wellness.
Who Are Registered Dietitian Nutritionists (RDNs)?
Registered Dietitian Nutritionists (RDNs) use an evidence-based approach to help prevent or delay disease and to manage both acute and chronic conditions. They are food and nutrition experts who provide individualized, evidence-based guidance based on a patient's medical history, lifestyle, and dietary habits.1 Their role is to help patients understand how food nourishes the body, make informed decisions, build realistic habits, and collaborate with other healthcare providers to deliver medical nutrition therapy.
RDNs collaborate closely with other healthcare providers to ensure comprehensive, well-rounded care. Their expertise helps patients make informed food choices, manage symptoms, and maintain optimal health outcomes.
Individualized Nutritional Care
Every person’s nutritional needs are different, especially in older adulthood. RDNs provide individualized nutritional care, tailoring nutrition education and counseling to each patient’s needs, preferences, and goals.2
Key elements of individualized care include:
- Understanding what matters to patients: RDNs engage in open conversations to understand the patient’s experiences, needs, preferences, and values.
- Shared decision making: RDNs co-create personally relevant goals with patients and support them in making informed decisions about their nutritional care.
- Evidence informed nutritional care: RDNs use evidence-informed nutrition intervention that meets the patient’s needs, preferences, and goals based on thorough assessment and diagnosis.
- Monitor outcomes: RDNs foster ongoing relationships and continuity of nutritional care, monitor progress towards co-created goals, and encourage self-monitoring to support adherence.
Managing Chronic Conditions
Nutrition plays a central role in managing chronic conditions, which affects most older adults. According to the National Council on Aging, nearly 93% of adults aged 65 and older have at least one chronic condition, and about 79% live with two or more.3 The most common conditions include:
- Hypertension
- High cholesterol
- Arthritis
- Obesity
- Diabetes
- Cancer
- Heart disease
- Depression
- Chronic Obstructive Pulmonary Disease (COPD)
- Asthma
RDNs can help manage these conditions through specific nutrition dietary interventions and potentially reducing the need for medications related to the diagnosed conditions.
Addressing Age-Related Physical Changes
Nutrition is important as we age because the body is undergoing age-related physical changes that affect overall health and quality of life. RDNs are trained to identify and address these challenges through individualized dietary strategies. Common age-related physical changes that nutrition can help partially address include:
Sarcopenia (Muscle Loss)3,4
Sarcopenia, or age-related muscle loss, is a common condition associated with physical aging. It involves the gradual loss of skeletal muscle and function, which can contribute to:
- Weakness and reduced strength
- Balance and gait problems
- Increased risk of falls and fractures
- Difficulty with daily tasks
Over time, these changes can lead to functional limitations, disability, and an increased risk of mortality.
Digestive Changes4
The digestive system naturally changes with age. Other medical conditions such as diabetes, liver disease, or cancer can also affect digestion. The network of nerves that helps move food through the digestive tract can weaken over time, potentially leading to:
- Difficulty swallowing (dysphagia)
- Heartburn or acid reflux
- Constipation
In addition, stomach acid levels often decrease with age. Lower acid levels can make it easier for bacteria to grow in the small intestine, which may cause bloating, diarrhea, or poor nutrient absorption.
Decreased Immune Function5
Aging is associated with a gradual decline in immune function, leading to an increased risk of infections, cancer, autoimmune disorders, slower wound healing, and a weaker response to vaccines.
Bone Health6
As people get older, bones naturally become thinner and weaker. After about age 50, bone loss happens faster than new bone can form, increasing the risk of fractures. Factors that affect bone health include:
- Hormonal changes: lower estrogen after menopause and declining testosterone in men can accelerate bone loss
- Poor nutrition: Not getting enough calcium, vitamin D, or overall nutrients needed for bone maintenance can lead to bone loss.
- Lifestyle choices: Inactivity or prolonged bed rest can weaken bones and muscles
- Family history: A family history of osteoporosis or fractures increases risk.
- Certain medications: Long-term use of corticosteroids and some other medications can reduce bone density.
Difficulty Chewing or Swallowing7
Dysphagia can happen at any age, but it’s more common in older adults but not considered a typical sign of aging. The cause of swallowing problems varies, and treatment depends on the cause. Difficulty chewing or swallowing can be caused by several different factors.
- Natural aging processes lead to muscle weakness and slower reflexes in the mouth and throat.
- Neurological conditions such as stroke, Parkinson’s disease, and dementia can impair swallowing muscles.
- Tooth loss and poorly fitting dentures can make chewing difficult and affect a person’s diet.
Common symptoms of chewing and swallowing difficulties include pain while swallowing, feeling as if food is stuck in the throat or chest, drooling, weight loss, coughing or gagging, and inability to swallow.
Conclusion
RDNs play a crucial role in helping older adults maintain their health, independence, and quality of life through nutritional care. By addressing the unique challenges that come with aging, RDNs support older adults in achieving their health and wellness goals. Through collaboration with healthcare teams and evidence-based guidance, dietitians empower older adults to make informed choices that promote longevity, vitality, and overall well-being.
Learn more about what an RDN can do for you at EatRight.org.
This article was written by Alexandria Dow, Winthrop University Dietetic Intern, in collaboration with the SC Department of Public Health.
References
1. Academy of Nutrition and Dietetics. Working with RDNs. Academy of Nutrition and Dietetics website. https://www.eatrightpro.org/about-us/our-members/working-with-rdns. Accessed Oct 6, 2025.
2. Holdoway A, Page F, Bauer J, Dervan N, Maier AB. Individualized nutritional care for disease-related malnutrition: Improving outcomes by focusing on what matters to patients. Nutrients. 2022;14(17):3534. https://pmc.ncbi.nlm.nih.gov/articles/PMC9460401/. Accessed Oct 6, 2025. doi: 10.3390/nu14173534.
3. The top 10 most common chronic conditions in older adults National Council on Aging website. https://www.ncoa.org/article/the-top-10-most-common-chronic-conditions-in-older-adults/. Updated 2025.
4. Ahmed T, Haboubi N. Assessment and management of nutrition in older people and its importance to health. Clin Interv Aging. 2010;5:207–216. https://pmc.ncbi.nlm.nih.gov/articles/PMC2920201/. Accessed Oct 6, 2025. doi: 10.2147/cia.s9664.
5. Weyand CM, Goronzy JJ. Aging of the immune system. mechanisms and therapeutic targets. Ann Am Thorac Soc. 2016;13(Suppl 5):S422–S428. https://pmc.ncbi.nlm.nih.gov/articles/PMC5291468/. Accessed Oct 6, 2025. doi: 10.1513/AnnalsATS.201602-095AW.
6. Osteoporosis: What you need to know as you agehttps://www.hopkinsmedicine.org/health/conditions-and-diseases/osteoporosis/osteoporosis-what-you-need-to-know-as-you-age. Updated 2025. Accessed Oct 6, 2025.
7. Mayo Clinic Staff. Dysphagia. Mayo Clinic website. https://www.mayoclinic.org/diseases-conditions/dysphagia/symptoms-causes/syc-20372028. Updated 2024.