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Anorexia of Aging - An Updated Short Review

Abstract

The anorexia of aging affects approximately a quarter of older people and is a major contributor to the development of under-nutrition and many other adverse health outcomes in older people. Despite the high prevalence, the anorexia of aging is frequently overlooked by clinicians and, of even more concern, it is commonly accepted as inevitable and a part of ‘normal’ aging. Early identification of risk coupled with efforts to mitigate these risks through appropriate interventions might stem the deleterious consequences of the anorexia of aging. This review aims to provide an update on the current knowledge base whilst making some practical suggestions that may be of use in clinical practice. Interventions such as exercise and good nutrition remain the preferred treatment while pharmacological options, whilst they continue to be trialed, are not currently recommended for routine clinical use.

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References

  1. 1.

    Nations U. World Population Ageing Department of Economic and Social Affairs, Population Division. 2015 (ST/ESA/SER.A/390).

    Google Scholar 

  2. 2.

    Morley JE, Silver AJ. Anorexia in the elderly. Neurobiol Aging. 1988;9 (1):9–16.

    PubMed  CAS  Article  Google Scholar 

  3. 3.

    Martone AM, Onder G, Vetrano DL, Ortolani E, Tosato M, Marzetti E, et al. Anorexia of aging: a modifiable risk factor for frailty. Nutrients. 2013;5 (10):4126–4133.

    PubMed  PubMed Central  Article  Google Scholar 

  4. 4.

    Landi F, Calvani R, Tosato M, Martone AM, Ortolani E, Savera G, et al. Anorexia of Aging: Risk Factors, Consequences, and Potential Treatments. Nutrients. 2016;8 (2):69.

    PubMed  PubMed Central  Article  Google Scholar 

  5. 5.

    MacIntosh C, Morley JE, Chapman IM. The anorexia of aging. Nutrition. 2000;16 (10):983–995.

    PubMed  CAS  Article  Google Scholar 

  6. 6.

    Sanford AM. Anorexia of aging and its role for frailty. Curr Opin Clin Nutr Metab Care. 2017;20 (1):54–60.

    PubMed  Article  Google Scholar 

  7. 7.

    Saajanaho M, Rantakokko M, Portegijs E, Törmäkangas T, Eronen J, Tsai L-T, et al. Life resources and personal goals in old age. Eur J Ageing. 2016;13 (3):195–208.

    PubMed  PubMed Central  Article  Google Scholar 

  8. 8.

    Donini LM, Dominguez LJ, Barbagallo M, Savina C, Castellaneta E, Cucinotta D, et al. Senile anorexia in different geriatric settings in Italy. J Nutr Health Aging. 2011;15 (9):775–781.

    PubMed  CAS  Article  Google Scholar 

  9. 9.

    Donini LM, Savina C, Piredda M, Cucinotta D, Fiorito A, Inelmen EM, et al. Senile anorexia in acute-ward and rehabilitations settings. J Nutr Health Aging. 2008;12 (8):511–517.

    PubMed  CAS  Article  Google Scholar 

  10. 10.

    Donini LM, Poggiogalle E, Piredda M, Pinto A, Barbagallo M, Cucinotta D, et al. Anorexia and Eating Patterns in the Elderly. PLoS ONE. 2013;8 (5):e63539.

    PubMed  PubMed Central  CAS  Article  Google Scholar 

  11. 11.

    Minciullo PL, Catalano A, Mandraffino G, Casciaro M, Crucitti A, Maltese G, et al. Inflammaging and Anti-Inflammaging: The Role of Cytokines in Extreme Longevity. Arch Immunol Ther Exp (Warsz). 2016;64 (2):111–126.

    PubMed  CAS  Article  Google Scholar 

  12. 12.

    Wysokiński A, Sobów T, Kłoszewska I, Kostka T. Mechanisms of the anorexia of aging - a review. Age. 2015;37 (4):81.

    PubMed Central  Article  Google Scholar 

  13. 13.

    Morley JE. Peptides and aging: Their role in anorexia and memory. Peptides. 2015;72:112–118.

    PubMed  CAS  Article  Google Scholar 

  14. 14.

    Chauncey HH, Muench ME, Kapur KK, Wayler AH. The effect of the loss of teeth on diet and nutrition. Int Dent J. 1984;34 (2):98–104.

    PubMed  CAS  Google Scholar 

  15. 15.

    Blazer DG. Depression in late life: review and commentary. J Gerontol A Biol Sci Med Sci. 2003;58 (3):249–265.

    PubMed  Article  Google Scholar 

  16. 16.

    Pilgrim AL, Robinson SM, Sayer AA, Roberts HC. An overview of appetite decline in older people. Nurs Older People. 2015;27 (5):29–35.

    PubMed  PubMed Central  Article  Google Scholar 

  17. 17.

    Roy M, Gaudreau P, Payette H. A scoping review of anorexia of aging correlates and their relevance to population health interventions. Appetite. 2016;105:688–699.

    PubMed  Article  Google Scholar 

  18. 18.

    Wilson MM, Thomas DR, Rubenstein LZ, Chibnall JT, Anderson S, Baxi A, et al. Appetite assessment: simple appetite questionnaire predicts weight loss in communitydwelling adults and nursing home residents. Am J Clin Nutr. 2005;82 (5):1074–1081.

    PubMed  CAS  Article  Google Scholar 

  19. 19.

    Rolland Y, Perrin A, Gardette V, Filhol N, Vellas B. Screening older people at risk of malnutrition or malnourished using the Simplified Nutritional Appetite Questionnaire (SNAQ): a comparison with the Mini-Nutritional Assessment (MNA) tool. J Am Med Dir Assoc. 2012;13 (1):31–34.

    PubMed  Article  Google Scholar 

  20. 20.

    Visvanathan R. Anorexia of Aging. Clin Geriatr Med. 2015;31 (3):417–427.

    PubMed  Article  Google Scholar 

  21. 21.

    Morley JE. Rapid Geriatric Assessment. J Am Med Dir Assoc. 2015;16 (10):808–812.

    PubMed  Article  Google Scholar 

  22. 22.

    Morley JE, Malmstrom TK, Miller DK. A simple frailty questionnaire (FRAIL) predicts outcomes in middle aged african americans. J Nutr Health Aging. 2012;16 (7):601–608.

    PubMed  PubMed Central  CAS  Article  Google Scholar 

  23. 23.

    Woo J, Leung J, Morley JE. Validating the SARC-F: a suitable community screening tool for sarcopenia? J Am Med Dir Assoc. 2014;15 (9):630–634.

    PubMed  Article  Google Scholar 

  24. 24.

    Malmstrom TK, Voss VB, Cruz-Oliver DM, Cummings-Vaughn LA, Tumosa N, Grossberg GT. The Rapid Cognitive Screen (RCS): a point-of-care screening for dementia and mild cognitive impairment. J Nutr Health Aging. 2015;19 (7):741–744.

    PubMed  CAS  Article  Google Scholar 

  25. 25.

    Landi F, Picca A, Calvani R, Marzetti E. Anorexia of Aging: Assessment and Management. Clin Geriatr Med. 2017;33 (3):315–323.

    PubMed  Article  Google Scholar 

  26. 26.

    Zhang J, Yen ST. Physical Activity, Gender Difference, and Depressive Symptoms. Health Serv Res. 2015;50 (5):1550–1573.

    PubMed  PubMed Central  Article  Google Scholar 

  27. 27.

    Taylor D. Physical activity is medicine for older adults. Postgrad Med J. 2014;90(1059):26–32.

    PubMed  Article  Google Scholar 

  28. 28.

    Geda YE, Roberts RO, Knopman DS, Christianson TJH, Pankratz VS, Ivnik RJ, et al. Physical Exercise and Mild Cognitive Impairment: A Population-Based Study. Arch Neurol. 2010;67 (1):80–86.

    PubMed  PubMed Central  Article  Google Scholar 

  29. 29.

    Theou O, Stathokostas L, Roland KP, Jakobi JM, Patterson C, Vandervoort AA, et al. The effectiveness of exercise interventions for the management of frailty: a systematic review. J Aging Res. 2011;2011:569194.

    PubMed  PubMed Central  Article  Google Scholar 

  30. 30.

    Jadczak AD, Makwana N, Luscombe-Marsh N, Visvanathan R, Schultz TJ. Effectiveness of exercise interventions on physical function in community-dwelling frail older people: an umbrella review of systematic reviews. JBI Database System Rev Implement Rep. 2018;16 (3):752–775.

    PubMed  Article  Google Scholar 

  31. 31.

    Liu CK, Fielding RA. Exercise as an intervention for frailty. Clin Geriatr Med. 2011;27 (1):101–110.

    PubMed  PubMed Central  CAS  Article  Google Scholar 

  32. 32.

    Jadczak AD, Dollard J, Mahajan N, Visvanathan R. The perspectives of pre-frail and frail older people on being advised about exercise: a qualitative study. Fam Pract. 2018;35 (3):330–335.

    PubMed  Article  Google Scholar 

  33. 33.

    Rennie MJ, Wackerhage H, Spangenburg EE, Booth FW. Control of the size of the human muscle mass. Annu Rev Physiol. 2004;66:799–828.

    PubMed  CAS  Article  Google Scholar 

  34. 34.

    Iolascon G, Di Pietro G, Gimigliano F, Mauro GL, Moretti A, Giamattei MT, et al. Physical exercise and sarcopenia in older people: position paper of the Italian Society of Orthopaedics and Medicine (OrtoMed). Clin Cases Miner Bone Metab. 2014;11 (3):215–221.

    PubMed  PubMed Central  Google Scholar 

  35. 35.

    Martone AM, Lattanzio F, Abbatecola AM, La Carpia D, Tosato M, Marzetti E, et al. Treating Sarcopenia In Older And Oldest Old. Curr Pharm Des. 2015;21 (13):1715–1722.

    PubMed  CAS  Article  Google Scholar 

  36. 36.

    Konopka AR, Harber MP. Skeletal muscle hypertrophy after aerobic exercise training. Exerc Sport Sci Rev. 2014;42 (2):53–61.

    PubMed  PubMed Central  Article  Google Scholar 

  37. 37.

    Mohler MJ, Wendel CS, Taylor-Piliae RE, Toosizadeh N, Najafi B. Motor Performance and Physical Activity as Predictors of Prospective Falls in Community-Dwelling Older Adults by Frailty Level: Application of Wearable Technology. Gerontology. 2016;62 (6):654–664.

    PubMed  PubMed Central  Article  Google Scholar 

  38. 38.

    Watt JR, Jackson K, Franz JR, Dicharry J, Evans J, Kerrigan DC. Effect of a supervised hip flexor stretching program on gait in frail elderly patients. PMR. 2011;3 (4):330–335.

    Article  Google Scholar 

  39. 39.

    Bauer J, Biolo G, Cederholm T, Cesari M, Cruz-Jentoft AJ, Morley JE, et al. Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE Study Group. J Am Med Dir Assoc. 2013;14 (8):542–559.

    PubMed  Article  Google Scholar 

  40. 40.

    Scott D, Blizzard L, Fell J, Giles G, Jones G. Associations between dietary nutrient intake and muscle mass and strength in community-dwelling older adults: the Tasmanian Older Adult Cohort Study. J Am Geriatr Soc. 2010;58 (11):2129–2134.

    PubMed  Article  Google Scholar 

  41. 41.

    Deutz NE, Wolfe RR. Is there a maximal anabolic response to protein intake with a meal? Clin Nutr. 2013;32 (2):309–313.

    PubMed  CAS  Article  Google Scholar 

  42. 42.

    Bouillanne O, Curis E, Hamon-Vilcot B, Nicolis I, Chretien P, Schauer N, et al. Impact of protein pulse feeding on lean mass in malnourished and at-risk hospitalized elderly patients: a randomized controlled trial. Clin Nutr. 2013;32 (2):186–192.

    PubMed  CAS  Article  Google Scholar 

  43. 43.

    Cermak NM, Res PT, de Groot LC, Saris WH, van Loon LJ. Protein supplementation augments the adaptive response of skeletal muscle to resistance-type exercise training: a meta-analysis. Am J Clin Nutr. 2012;96 (6):1454–1464.

    PubMed  CAS  Article  Google Scholar 

  44. 44.

    Eijnde BO, Van Leemputte M, Goris M, Labarque V, Taes Y, Verbessem P, et al. Effects of creatine supplementation and exercise training on fitness in men 55–75 yr old. J Appl Physiol (1985). 2003;95 (2):818–828.

    CAS  Article  Google Scholar 

  45. 45.

    Alibhai SM, Greenwood C, Payette H. An approach to the management of unintentional weight loss in elderly people. CMAJ. 2005;172 (6):773–780.

    PubMed  PubMed Central  Article  Google Scholar 

  46. 46.

    Pouyssegur V, Brocker P, Schneider SM, Philip JL, Barat P, Reichert E, et al. An innovative solid oral nutritional supplement to fight weight loss and anorexia: open, randomised controlled trial of efficacy in institutionalised, malnourished older adults. Age Ageing. 2015;44 (2):245–251.

    PubMed  Article  Google Scholar 

  47. 47.

    Schiffman SS, Warwick ZS. Effect of flavor enhancement of foods for the elderly on nutritional status: food intake, biochemical indices, and anthropometric measures. Physiol Behav. 1993;53 (2):395–402.

    PubMed  CAS  Article  Google Scholar 

  48. 48.

    Beaudart C, Buckinx F, Rabenda V, Gillain S, Cavalier E, Slomian J, et al. The effects of vitamin D on skeletal muscle strength, muscle mass, and muscle power: a systematic review and meta-analysis of randomized controlled trials. J Clin Endocrinol Metab. 2014;99 (11):4336–4345.

    PubMed  CAS  Article  Google Scholar 

  49. 49.

    Morley JE, Argiles JM, Evans WJ, Bhasin S, Cella D, Deutz NE, et al. Nutritional recommendations for the management of sarcopenia. J Am Med Dir Assoc. 2010;11 (6):391–396.

    PubMed  PubMed Central  Article  Google Scholar 

  50. 50.

    Morley JE. Anorexia of aging: a true geriatric syndrome. J Nutr Health Aging. 2012;16 (5):422–425.

    PubMed  CAS  Article  Google Scholar 

  51. 51.

    Morley JE. Pathophysiology of the anorexia of aging. Curr Opin Clin Nutr Metab Care. 2013;16 (1):27–32.

    PubMed  CAS  Article  Google Scholar 

  52. 52.

    Luca A, Luca M, Calandra C. Eating Disorders in Late-life. Aging Dis. 2015;6 (1):48–55.

    PubMed  Article  Google Scholar 

  53. 53.

    Wilson MM, Philpot C, Morley JE. Anorexia of aging in long term care: is dronabinol an effective appetite stimulant?—a pilot study. J Nutr Health Aging. 2007;11 (2):195–198.

    PubMed  CAS  Google Scholar 

  54. 54.

    Karcic E, Philpot C, Morley JE. Treating malnutrition with megestrol acetate: literature review and review of our experience. J Nutr Health Aging. 2002;6 (3):191–200.

    PubMed  CAS  Google Scholar 

  55. 55.

    Morley JE, von Haehling S, Anker SD. Are we closer to having drugs to treat muscle wasting disease? Journal of Cachexia, Sarcopenia and Muscle. 2014;5 (2):83–87.

    PubMed  PubMed Central  Article  Google Scholar 

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Correspondence to Agathe Daria Jadczak.

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Jadczak, A.D., Visvanathan, R. Anorexia of Aging - An Updated Short Review. J Nutr Health Aging 23, 306–309 (2019). https://doi.org/10.1007/s12603-019-1159-0

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Key words

  • Anorexia
  • aging
  • weight loss
  • malnutrition