Nutritional problems in the elderly are complex and individually diverse, and therefore a differentiated approach ist mandatory. Interactions of social, psychological and biological factors in the nutrition of the elderly are discussed in four clinical cases: problems of procurement and preparation of food in a patient with sensory aphasia and mild organic brain syndrome; problems of food intake and mastication in a patient with stroke; problems surrounding nutritional requirements and absorption of nutrients in a patient with osteoporosis, and problems relating to nutritional components in a patient with constipation. The clinical vignettes illustrate the difficulty of changing eating habits in elderly people. Nutritional policy for the aged involves a dilemma: on one hand, their survival attests to the essential adequacy of their life-long eating practices. On the other hand, the biological, psychological and social changes of old age appear to make some individually tailored adaptation of nutrition appropriate.