Abstract
The ingestion of food has at least three functions: to (a) satisfy hunger and promote survival (physiologic hunger), (b) offer pleasure to satisfy an emotional attachment to food (hedonic hunger), and (c) perform a social obligation with family and friends (social dining or social hunger).
The demographic shift globally, in which we see a rapid increase in the number of older adults, comes with a responsibility for the society to keep older adults healthy while satisfying the three functions of a meal mentioned above.
Although preventable in most cases, malnutrition in older adults is a growing problem even in affluent nations. Even short durations of poor eating in older adults can lead to protein energy-wasting, frailty, and multiple nutritional deficiency disorders. Undernutrition and malnutrition of older adults are often missed by clinicians who are currently more concerned about obesity, a major epidemic receiving much attention. Although neglected, malnutrition in older adults is a real problem with varying severity and prevalence.
Weight loss in the older adult has a greater impact on the overall health, immunity status and quality of life, compared to the younger adults. The consequences of malnutrition in older adults are frailty, falls, immunodeficiency, and worsening of other comorbidities decreasing the life span.
The combination of hunger, taste, appetite, and satiety is inter-related and regulated by the hypothalamus with stimuli arising from the brain as well as from an elaborate enteric hormonal system. Anorexia of aging (AOA) plays a major role in the pathogenesis of nutritional deficiency states. Multiple mechanisms individually or more often collectively influence the incidence and severity of AOA. In this chapter, the authors have brought to light the hidden problem of malnutrition in the older adult as a result of AOA, discussed the pathophysiological basis of regulation of taste, appetite, and satiety, and address the clinical implications of AOA with potential preventive measures.
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Pitchumoni, C.S., Chaudhari, R. (2021). Anorexia, Appetite, Hunger, and Satiety in Older Adults. In: Pitchumoni, C.S., Dharmarajan, T. (eds) Geriatric Gastroenterology. Springer, Cham. https://doi.org/10.1007/978-3-030-30192-7_14
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