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Poor Appetite Is Associated with Six Month Mortality in Hospitalised Older Men and Women

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Abstract

Objectives

Appetite loss is common in hospitalised older individuals but not routinely assessed. Poor appetite in hospital has previously been identified as predictive of greater mortality in the six months following discharge in a single study of female patients. The present study aimed to assess this association in a larger sample including both hospitalised men and women.

Design

Longitudinal observational study with six month follow up.

Setting

Acute hospital wards in a single large hospital in England.

Participants

Older inpatients aged over 70 years.

Measurements

Appetite was assessed using the Simplified Nutritional Appetite Questionnaire (SNAQ) during hospital stay. Deaths during six month follow-up period were recorded. Association between SNAQ score during hospital admission and death 6 months post-discharge was assessed using binary logistic regression in unadjusted and adjusted analysis.

Results

296 participants (43% female, mean age 83 years (SD 6.9)) were included in this study. Prevalence of poor appetite (SNAQ score <14) was 41%. In unadjusted analysis a SNAQ score of <14 was associated with a 2.47 increase in odds of mortality at six months (OR 2.47 (95% CI 1.27,4.82)). This association remained after adjusting for number of comorbidities (Charlson index), length of stay and gender (OR 2.62 (95% CI 1.30, 5.27)). In unadjusted continuous analysis, every one point decrease in SNAQ score led to a 1.20 fold increase in odds of mortality at six months (OR 1.20 (95% CI 1.06–1.36)). This association remained in adjusted analysis (OR 1.22 (95% CI 1.07–1.39)).

Conclusion

Poor appetite is common in hospitalised older people. We have confirmed the association, previously reported in older women, between poor appetite during hospital stay and greater mortality at six months post-discharge but in a larger study including older men and women. Further research is needed to understand the mechanisms of poor appetite, which lead to increased mortality.

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Funding

The National Institute for Health Research (NIHR) funded this research. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. NJ.C, H.C.R and H.M receive support from the NIHR Southampton Biomedical Research Centre. S.M.R and A.A.S receive support from the NIHR Newcastle Biomedical Research Centre. H.C.R receives support from the NTHR Applied Research Collaborative (ARC) Wessex. NJ.C has received support and S.E.R.L is supported by the NTHR Clinical Academic Training Scheme. The studies reported in this secondary data analysis were funded by the NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) Wessex.

Author information

Authors and Affiliations

  1. Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Tremona Road, Southampton, UK

    N. J. Cox, S. ER Lim, K. Ibrahim & H. C. Roberts

  2. NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK

    N. J. Cox, H. Moyses & H. C. Roberts

  3. Medicine for Older People, University Hospital Southampton NHS Foundation Trust, Southampton, UK

    F. Howson

  4. AGE Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK

    A. A. Sayer & S. M. Robinson

  5. NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University, Newcastle upon Tyne, UK

    A. A. Sayer & S. M. Robinson

  6. NIHR Applied Research Collaborative (ARC) Wessex, University of Southampton, Southampton, UK

    H. C. Roberts

Authors
  1. N. J. Cox
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  2. S. ER Lim
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  3. F. Howson
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  4. H. Moyses
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  5. K. Ibrahim
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  6. A. A. Sayer
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  7. H. C. Roberts
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  8. S. M. Robinson
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Contributions

Conceptualization and Methodology- NJ.C, H.M, K.I., H.C.R and S.M.R, Data Collection- S.E.R.L, F.H, Formal Analysis- NJ.C, H.M; Writing Original draft preparation- NJ.C Writing review & editing- All Authors, Supervision- A.A.S, H.C.R and S.M.R.

Corresponding author

Correspondence to N. J. Cox.

Ethics declarations

The studies reported in this secondary data analysis were approved by the UK Health Research Authority- Southampton Mealtime Assistance Roll-out Trial: London-Chelsea Research Ethics Committee (14/LO/1363); Southampton Mobility Volunteer Study: South East Coast—Surrey Research Ethics Committee (15/LO/2091).

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Conflict of Interest

The authors declare no conflict of interest.

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Cox, N.J., Lim, S.E., Howson, F. et al. Poor Appetite Is Associated with Six Month Mortality in Hospitalised Older Men and Women. J Nutr Health Aging 24, 1107–1110 (2020). https://doi.org/10.1007/s12603-020-1442-0

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  • DOI: https://doi.org/10.1007/s12603-020-1442-0

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