Q. My mother is in her mid-80s and lives alone. I’m sure her diet is not very good. She doesn’t cook much any more, nibbles on chips, crackers and snack food. We’ve tried stocking her freezer with prepared foods that would be healthy for her, but she just won’t take the time to fix things. She complains of being tired and weak, but isn’t willing to go see the doctor. I’m afraid she is getting really anemic, but don’t know what to do.

A. Research is showing that even among middle-class Americans whose diets should be adequate, anemia can be a real problem. A study published in this month’s issue of the American Journal of Medicine found that anemia doubles the risk that an older person will develop serious physical declines that can erode the ability to live independently.

The study, supported by the National Institute on Aging and done by Wake Forest University School of Medicine, followed a group of more than 1,000 people 71 and older for four years, assessing their ability to perform three physical tasks: standing balance, a timed 8-foot walk and ability to rise from a chair. Those with anemia showed a much more rapid decline in ability than those whose hemoglobin levels where higher.

Anemia (characterized by either a low red blood cell or low hemoglobin count) can be caused by a poor diet, but it can also be caused by diseases.

So your mom’s lifestyle and symptoms are important for you to notice and track. For her own good, you may have to intervene a bit more insistently. She needs to see a doctor and have a comprehensive work-up so that you know just what her medical situation is. Only with that information, can you also with kind insistence help her modify her lifestyle.

Diet tips used to treat anemia include:

• Eating more foods that are good sources of iron, such as green, leafy vegetables; red meat, fish, wheat germ, dried fruits and iron-fortified cereals.
• Include foods high in vitamin C, like citrus fruits, tomatoes and strawberries, which help your body absorb iron from foods.
• Iron supplements may help but shouldn’t be added to the diet without consulting with a physician.

So get your mom to a doctor — whether she wants to go or not. To help her have a better diet, consider doing these things:

• Contact the Meals-on-Wheels group that serves your area. One good, nutritionally-balanced meal each day can go a long way to helping older adults maintain a proper diet.
• Eat with her as often as possible, and arrange for other friends or family members to do the same.
• When you cook for your family, make a portion for her. She will probably like this better than the frozen, prepared dinners that probably have too much salt for her taste.
• Help her choose snacks with good nutrition. Read the food labels with her so she can learn how to choose her snacks more wisely.