Management of malnutrition in older adults with cancer

Purpose of review Older adults with cancer are a vulnerable population at heightened risk of malnutrition. Given its association with adverse outcomes, and the growing burden of cancer with an ageing population, this review summarizes key practical considerations when managing malnutrition in this cohort. Recent findings Malnutrition in this cohort is driven by cancer-related, treatment-related, age-related and patient-related factors. This can lead to nutrition impact symptoms (NIS) that propagate the development of cancer cachexia, sarcopenia, and frailty, and adversely affect prognosis and quality of life. To mitigate these complications, early and repeated screening and assessment for malnutrition and its associated syndromes with validated tools should be embedded within a multidisciplinary framework. Interventions should involve regular education of the individual and their caregiver(s), underpinned by exercise and individualized dietary counselling with consideration of nutritional supplementation. This should be supported by strategies to mitigate NIS, with consideration of the psychosocial determinants of malnutrition that can often be unique to this cohort. Summary Older adults with cancer require multidisciplinary strategies for the management of malnutrition. Systematic screening and individualized interventions may improve prognosis and quality of life. Practical considerations reviewed here should refine best-practice onco-geriatric models, ensuring nutrition is integrated into standard care.