Skip to main content

Advertisement

SpringerLink
Log in

Anorexia

Aetiology, Epidemiology and Management in Older People

  • Review Article
  • Published:
Drugs & Aging Aims and scope Submit manuscript

Abstract

The loss of appetite is termed ‘anorexia’. Dramatic and poorly understood alterations occur in the physiological regulation of appetite in older adults, who frequently exhibit less hunger and earlier satiety. Appetite regulation (and, therefore, food intake) is affected by a number of social, cultural and psychological factors, as well as by acute and chronic disease states, drugs, dementia or mood disorders. Self-reported anorexia has been reported by approximately one-third of older men and women. Recent development of validated measures of appetite aid in the approach to the problem. The differential diagnostic approach for appetite disturbances should follow from an understanding of the physiological, social, psychological and pathophysiological causes of anorexia. Emerging understanding of the association between proinflammatory cytokines and the anorexia/cachexia syndrome indicates that this process is the most commonly encountered underlying reason for anorexia in acute and chronically ill older persons. Despite the changes in appetite regulation in older persons, the response to social and psychological stimulants in this age group is similar to that in younger adults. Pharmacological stimulants of appetite appear to be a promising intervention for anorexia.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Table I
Table II
Table III
Fig. 1
Table IV
Table V

Similar content being viewed by others

References

  1. Murden RA, Ainslie NK. Recent weight loss is related to short-term mortality in nursing homes. J Gen Intern Med 1994; 9(11): 648–50

    Article  PubMed  CAS  Google Scholar 

  2. Weinsier RL, Hunker EM, Krumdieck CL, et al. Hospital malnutrition: a prospective evaluation of general medical patients during the course of hospitalization. Am J Clin Nutr 1979; 32(2): 418–26

    PubMed  CAS  Google Scholar 

  3. Morley JE, Thomas DR. Anorexia and aging: pathophysiology. Nutrition 1999; 15(6): 499–503

    Article  PubMed  CAS  Google Scholar 

  4. Morley JE. Decreased food intake with aging. J Gerontol A Biol Sci Med Sci 2001; 56: 81–8

    Article  PubMed  Google Scholar 

  5. Roberts SB, Fuss P, Heyman MB, et al. Control of food intake in older men. JAMA 1994; 272: 1601–6

    Article  PubMed  CAS  Google Scholar 

  6. Morley JE. Anorexia, sarcopenia, and aging. Nutrition 2001; 17: 660–3

    Article  PubMed  CAS  Google Scholar 

  7. Morley JE. Anorexia in older persons: epidemiology and optimal treatment. Drugs Aging 1996; 8(2): 134–55

    Article  PubMed  CAS  Google Scholar 

  8. McGandy RB, Barrows Jr CH, Spanias A, et al. Nutrient intake and energy expenditure in men of different ages. J Gerontology 1966; 21: 581–7

    Article  CAS  Google Scholar 

  9. Ritchie CR, Thomas DR. Aging. In: Heimburger DC, Weinsier RL, editors. Handbook of clinical nutrition. 3rd ed. St Louis (MO): Mosby, 1997

    Google Scholar 

  10. Abraham S, Carroll MD, Dresser CM, et al. Dietary intake of persons 1–74 years of age in the United States. Advance data from Vital and Health Statistics of the National Center for Health Statistics no. G. Rockville (MD): Public Health Service, 1977 Mar 30

    Google Scholar 

  11. De Castro JM. How can eating behavior be regulated in the complex environments of free-living humans? Neurosci Biobehav Rev 1996; 20: 119–31

    Article  PubMed  Google Scholar 

  12. Thomas DR. Unintended weight loss in older adults. Aging Health 2008; 4(2): 191–200

    Article  Google Scholar 

  13. Thomas DR. Nutritional requirements in older adults. Chapter 6. In: Morley JE, Thomas DR, editors. Geriatric nutrition. Boca Raton (FL): CRC Press, 2007: 131–6

    Chapter  Google Scholar 

  14. Doty RL, Shaman P, Applebaum SL, et al. Smell identification ability: changes with age. Science 1984; 226: 1441–3

    Article  PubMed  CAS  Google Scholar 

  15. Schiffman S. Food recognition by the elderly. J Gerontol 1977; 32: 586–92

    Article  PubMed  CAS  Google Scholar 

  16. Buckler DA, Kelber ST, Goodwin JS. The use of dietary restrictions in malnourished nursing home patients. J Am Geriatr Soc 1994; 42: 1100–2

    PubMed  CAS  Google Scholar 

  17. Tariq S, Karcic E, Thomas DR, et al. The use of a no-concentrated-sweets diet in the management of type 2 diabetes in nursing home patients. J Am Diet Assoc 2001; 101(12): 1463–6

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  19. Morley JE. Decreased food intake with aging. J Gerontol A Biol Sci Med Sci 2002; 57(1): M2–6

    Article  PubMed  Google Scholar 

  20. Donini LM, Savina C, Cannella C. Eating habits and appetite control in the elderly: the anorexia of aging. Int Psychogeriatr 2003; 15: 73–87

    Article  PubMed  Google Scholar 

  21. Hotaling DL. Nutritional considerations for the pureed diet texture in dysphagic elderly. Dysphagia 1992; 7: 81–5

    Article  PubMed  CAS  Google Scholar 

  22. Johnson RM, Smiciklas-Wright H, Soucy IM, et al. Nutrient intake of nursing home residents receiving pureed foods or a regular diet. J Am Geriatr Soc 1995; 43: 344–8

    PubMed  CAS  Google Scholar 

  23. Kayser-Jones J. Mealtime in nursing homes: the importance of individualized care. J Gerontol Nurs 1996; 22: 26–31

    PubMed  CAS  Google Scholar 

  24. Fitten LJ, Morley JE, Gross PI, et al. Depression. J Am Geriatr Soc 1989; 37(5): 459–72

    PubMed  CAS  Google Scholar 

  25. Blaum CS, Fries BE, Fiatarone MA. Factors associated with low body mass index and weight loss in nursing home residents. J Gerontol 1995; 50:M162–8

    CAS  Google Scholar 

  26. Kaye WH, Klump KL, Frank GKW, et al. Anorexia and bulimia nervosa. Annu Rev Med 2000; 51: 299–313

    Article  PubMed  CAS  Google Scholar 

  27. Plata-Salaman CR. Anorexia during acute and chronic disease. Nutrition 1996; 12(2): 69–78

    Article  PubMed  CAS  Google Scholar 

  28. Hedlund J, Hansson LO, Ortqvist A. Short- and long-term prognosis for middle-aged and elderly patients hospitalized with community-acquired pneumonia: impact of nutritional and inflammatory factors. Scand J Infect Dis 1995; 27(1): 32–7

    Article  PubMed  CAS  Google Scholar 

  29. Plata-Salaman CR. Anorexia during acute and chronic disease. Nutrition 1996; 12: 69–76

    Article  PubMed  CAS  Google Scholar 

  30. Mowe M, Bohmer T, Kindt E. Reduced nutritional status in an elderly population (>70y) is probable before disease and possibly contributes to the development of disease. Am J Clin Nutr 1994; 59(2): 317–24

    PubMed  CAS  Google Scholar 

  31. Evans WJ, Morley JE, Argiles J, et al. Cachexia: a new definition. Clin Nutr 2008; 27(6): 793–9

    Article  PubMed  CAS  Google Scholar 

  32. Baumgartner RN, Waters DL, Gallagher D, et al. Predictors of skeletal muscle mass in elderly men and women. Mech Ageing Dev 1999; 107: 123–36

    Article  PubMed  CAS  Google Scholar 

  33. Baumgartner RN, Koehler KM, Gallagher D, et al. Epidemiology of sarcopenia among the elderly in New Mexico. Am J Epidemiol 1998; 147: 755–63

    Article  PubMed  CAS  Google Scholar 

  34. Seruga B, Zhang H, Bernstein LJ, et al. Cytokines and their relationship to the symptoms and outcome of cancer. Nat Rev Cancer 2008; 8(11): 887–99

    Article  PubMed  CAS  Google Scholar 

  35. Laviano A, Meguid MM, Rossi-Fanelli F. Cancer anorexia: clinical implications, pathogenesis, and therapeutic strategies. Lancet Oncol 2003; 4: 686–94

    Article  PubMed  CAS  Google Scholar 

  36. Illman J, Corringham R, Robinson Jr D, et al. Are inflammatory cytokines the common link between cancer-associated cachexia and depression? J Support Oncol 2005; 3: 37–50

    PubMed  CAS  Google Scholar 

  37. Rote NS. Inflammation. In: McCance KL, Huether SE, editors. Pathophysiology: the biological basis for disease in adults and children. St Louis (MO): Mosby, 1998: 205–36

    Google Scholar 

  38. Plata-Salaman CR. Strategies for potential manipulation of anorexia during acute and chronic disease. Nutrition 1995; 11:702–4

    PubMed  CAS  Google Scholar 

  39. Espat NJ, Moldawer LL, Copeland 3rd EM. Cytokine-mediated alterations in host metabolism prevent nutritional repletion in cachectic cancer patients. J Surg Oncol 1995; 58: 77–82

    Article  PubMed  CAS  Google Scholar 

  40. Thomas DR. Loss of skeletal muscle mass in aging: examining the relationship of starvation, sarcopenia and cachexia. Clin Nutr 2007; 26(4): 389–99

    Article  PubMed  Google Scholar 

  41. Westerblad H, Allen DG. Recent advances in the understanding of skeletal muscle fatigue. Curr Opin Rheumatol 2002; 14(6): 648–52

    Article  PubMed  CAS  Google Scholar 

  42. Mitch WE. Mechanisms causing loss of lean body mass in kidney disease. Am J Clin Nutr 1998; 67: 359–66

    PubMed  CAS  Google Scholar 

  43. Toth MJ, Gottlieb SS, Goran MI, et al. Daily energy expenditure in free-living heart failure patients. Am J Physiol 1997; 272: 469–75

    Google Scholar 

  44. Roubenoff R, Roubenoff RA, Cannon JG, et al. Rheumatoid cachexia: cytokine-driven hypermetabolism accompanying reduced body cell mass in chronic inflammation. J Clin Invest 1994; 93: 2379–86

    Article  PubMed  CAS  Google Scholar 

  45. Kotler DP, Wang J, Pierson RN. Body composition studies in patients with the acquired immunodeficiency syndrome. Am J Clin Nutr 1985; 42: 1255–65

    PubMed  CAS  Google Scholar 

  46. Donini LM, Savina C, Piredda M, et al. Senile anorexia in acute-ward and rehabilitation settings. J Nutr Health Aging 2008; 12(8): 511–7

    Article  PubMed  CAS  Google Scholar 

  47. Serra Prat M, Fernandez X, Ribo L, et al. Loss of appetite in elderly people in the community and its relationship with functional capacity. Med Clin (Barc) 2008; 130(14): 531–3

    Article  Google Scholar 

  48. Milne AC, Potter J, Avenell A. Protein and energy supplementation in elderly people at risk from malnutrition. Cochrane Database Syst Rev 2002; (3): CD003288

    Google Scholar 

  49. Lauque S, Arnaud-Battandier F, Mansourian R, et al. Protein-energy oral supplementation in malnourished nursing-home residents: a controlled trial. Age Aging 2000; 29: 51–6

    Article  CAS  Google Scholar 

  50. Guigoz Y, Vellas B. Assessing the nutritional status of the elderly: the Mini Nutritional Assessment as part of the geriatric evaluation. Nutr Rev 1998; 54: S59–65

    Article  Google Scholar 

  51. Keller HH, McKenzie JD, Goy RE. Construct validation and test-retest reliability of the seniors in the community: risk evaluation for eating and nutrition questionnaire. J Gerontol A Biol Sci Med Sci 2001; 56: M552–8

    Article  PubMed  CAS  Google Scholar 

  52. Ribaudo JM, Cella D, Hahn EA, et al. Re-validation and shortening of the functional assessment of anorexia/cachexia therapy (FAACT) questionnaire. Qual Life Res 2001; 9: 1137–46

    Article  Google Scholar 

  53. Thomas DR. Nutritional Assessment in long term care. Nutr Clin Pract 2008; 23: 383–7

    Article  PubMed  Google Scholar 

  54. Portenoy RK, Thaler HT, Kornblith AB, et al. The Memorial Symptom Assessment Scale: an instrument for the evaluation of symptom prevalence, characteristics and distress. Eur J Cancer 1994; 30A: 1326–36

    Article  PubMed  CAS  Google Scholar 

  55. Chang VT, Hwang SS, Feuerman M. Validation of the Edmonton Symptom Assessment Scale. Cancer 2000; 88: 2164–71

    Article  PubMed  CAS  Google Scholar 

  56. Cella DF, VonRoenn J, Lloyd S, et al. The Bristol-Myers Anorexia/Cachexia Recovery Instrument (BACRI): a brief assessment of patients’ subjective response to treatment for anorexia/cachexia. Qual Life Res 1995; 4: 221–31

    Article  PubMed  CAS  Google Scholar 

  57. Mathey MF. Assessing appetite in Dutch elderly with the Appetite, Hunger and Sensory Perception (AHSP) questionnaire. J Nutr Health Aging 2001; 5: 22–8

    PubMed  CAS  Google Scholar 

  58. Wilson MM, Thomas DR, Rubenstein LZ, et al. Appetite assessment: simple appetite questionnaire predicts weight loss in community-dwelling adults and nursing home residents. Am J Clin Nutr 2005; 82(5): 1074–81

    PubMed  CAS  Google Scholar 

  59. Thomas DR. Management of protein-energy under-nutrition in older adults, chapter 16. In: Morley JE, Thomas DR, editors. Geriatric nutrition. Boca Raton (FL): CRC Press, 2007: 267–90

    Chapter  Google Scholar 

  60. Thomas DR. Causes of protein-energy malnutrition. In: Seiler WO, Stähelin HB, editors. Malnutrition in the elderly. Darmstadt: Steinhopff Verlag, 1999: 59–68

    Chapter  Google Scholar 

  61. Thomas DR, Ashmen W, Morley JE, et al. Nutritional management in long-term care: development of a clinical guideline. J Gerontol A Biol Sci Med Sci 2000; 55: M725–34

    Article  PubMed  CAS  Google Scholar 

  62. Wilson MM, Vaswani S, Liu D, et al. Prevalence and causes of undernutrition in medical outpatients. Am J Med 1998; 104: 56–63

    Article  PubMed  CAS  Google Scholar 

  63. 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: 395–402

    Article  PubMed  CAS  Google Scholar 

  64. Yesavage JA, Brink TL, Rose TL, et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res 1982–1983; 17: 37–49

    Article  PubMed  Google Scholar 

  65. Fava M. Weight gain and antidepressants. J Clin Psychiatry 2000; 11S: 37–41

    Google Scholar 

  66. Gelenberg AJ, Laukes C, McGahuey C, et al. Mirtazapine substitution in SSRI-induced sexual dysfunction. J Clin Psychiatry 2000; 61: 356–60

    Article  PubMed  CAS  Google Scholar 

  67. Carpenter LL, Leon Z, Yasmin S, et al. Clinical experience with mirtazapine in the treatment of panic disorder. Ann Clin Psychiatry 1999; 11: 81–6

    PubMed  CAS  Google Scholar 

  68. Carpenter LL, Jocic Z, Hall JM, et al. Mirtazapine augmentation in the treatment of refractory depression. J Clin Psychiatry 1999; 60: 45–9

    Article  PubMed  CAS  Google Scholar 

  69. Gants R. Detection and correction of underweight problems in nursing home residents. J Gerontol Nurs 1997; 23: 26–31

    PubMed  CAS  Google Scholar 

  70. Dawe D, Moore-Orr R. Long-intensity range of motion exercise: invaluable nursing care for elderly patients. J Adv Nurs 1995; 21: 675–81

    Article  PubMed  CAS  Google Scholar 

  71. Ruuskanen JM, Ruoppila I. Physical activity and physiologic well being among people 65–84 years. Age Ageing 1995; 24: 292–6

    Article  PubMed  CAS  Google Scholar 

  72. Fiatarone MA, Marks EC, Ryan ND, et al. High-intensity training in nonogenarians: effects on skeletal muscle. JAMA 1990; 263: 3029–34

    Article  PubMed  CAS  Google Scholar 

  73. Johnson LE, Dooley PA, Gleick JB. Oral nutritional supplement use in elderly nursing home patients. J Am Geriatr Soc 1993; 41: 947–52

    PubMed  CAS  Google Scholar 

  74. Elmstahl S, Steen B. Hospital nutrition in geriatric long-term care medicine: II. Effects of dietary supplements. Age Ageing 1987; 16: 73–80

    CAS  Google Scholar 

  75. Wilson MM, Purushothaman R, Morley JE. Effect of liquid dietary supplements on energy intake in the elderly. Am J Clin Nutr 2002; 75(5): 944–7

    PubMed  CAS  Google Scholar 

  76. Milne AC, Avenell A, Potter J. Meta-analysis: protein and energy supplementation in older people. Ann Intern Med 2006; 144(1): 37–48

    PubMed  CAS  Google Scholar 

  77. Lauque S, Arnaud-Battandier F, Gillette S, et al. Improvement of weight and fat-free mass with oral nutritional supplementation in patients with Alzheimer’s disease at risk of malnutrition: a prospective randomized study. J Am Geriatr Soc 2004; 52(10): 1702–7

    Article  PubMed  Google Scholar 

  78. Thomas DR. Guidelines for the use of orexigenic drugs in longterm care. Nutr Clin Pract 2006; 21(1): 82–7

    Article  PubMed  Google Scholar 

  79. Moertel C, Schutt AG, Reiteneier RJ, et al. Corticosteroid therapy of pre-terminal gastrointestinal cancer. Cancer 1974; 33: 1607–9

    Article  PubMed  CAS  Google Scholar 

  80. Willox J, Corr J, Shaw J, et al. Prednisolone as an appetite stimulant in patients with cancer. Br Med J (Clin Res Ed) 1984; 288(6410): 27

    Article  CAS  Google Scholar 

  81. Bruera E, Roca E, Cedaro L, et al. Action of oral methylprednisolone in terminal cancer patients: a prospective randomized double blind study. Cancer Treat Rep 1985; 69: 751–4

    PubMed  CAS  Google Scholar 

  82. Robusteli Della Cuna G, Pellegrini A, Piazzi M. Effect of methylprednisolone sodium succinate on quality of life in pre-terminal cancer patients: a placebo controlled multicenter study. Eur J Cancer Clin Oncol 1989; 25: 1823–9

    Article  Google Scholar 

  83. Popiela T, Lucchi R, Giongo F. Methylprednisolone as palliative therapy for female terminal cancer patients. Eur J Cancer Clin Oncol 1989; 25: 1823–4

    Article  PubMed  CAS  Google Scholar 

  84. Nelson K, Walsh D, Deeter P, et al. A phase II study of delta-nine-tetrahydrocannabinol for appetite stimulation in cancer-associated anorexia. J Palliat Care 1994; 10: 14–8

    PubMed  CAS  Google Scholar 

  85. Kardinal C, Loprinzi CL, Schaid DJ, et al. A controlled trial of cyproheptadine in cancer patients with anorexia and/or cachexia. Cancer 1990; 65: 2657–62

    Article  PubMed  CAS  Google Scholar 

  86. Tchekmedyian S, Tait N, Moody M, et al. High dose megestrol acetate: a possible treatment of cachexia. JAMA 1987; 257: 1195–9

    Article  PubMed  CAS  Google Scholar 

  87. Cruz JM, Muss HB, Brockschmidt JK, et al. Weight changes in women with metastatic breast cancer treated with megestrol acetate: a comparison of standard vs. a high does therapy. Semin Oncol 1990; 17 Suppl.: 63–7

    PubMed  CAS  Google Scholar 

  88. Bruerra E, Macmillan K, Hanson J, et al. A controlled trial of megestrol acetate on appetite, caloric intake, nutritional status, and other symptoms in patients with advanced cancer. Cancer 1990; 66: 1279–82

    Article  Google Scholar 

  89. Loprinzi CL, Ellison NM, Schaid DJ, et al. Controlled trial of megestrol acetate for the treatment of cancer, anorexia and cachexia. J Natl Cancer Inst 1990; 82: 1127–32

    Article  PubMed  CAS  Google Scholar 

  90. Schmoll E, Wilke H, Thole R. Megestrol acetate in cancer cachexia. Semin Oncol 1991; 1Suppl. 2: 32–4

    Google Scholar 

  91. Heckmayr M, Gatzenneier U. Treatment of cancer weight loss in patients with advanced lung cancer. Oncology 1992; 49Suppl. 2: 32–4

    Article  PubMed  Google Scholar 

  92. Feliu J, Gonzalez-Baron M, Berrocal A. Usefulness of megestrol acetate in cancer cachexia and anorexia. Am J Clin Oncol 1992; 15: 436–40

    Article  PubMed  CAS  Google Scholar 

  93. Azona C, Castro L, Crespo E, et al. Megestrol acetate therapy for anorexia and weight loss in children with malignant solid tumors. Aliment Pharmacol Ther 1996; 10(4): 577–86

    Article  Google Scholar 

  94. Mantovani G, Maccio A, Bianchi A, et al. Megestrol acetate in neoplastic anorexia/cachexia: clinical evaluation and comparison with cytokine levels in patients with head and neck carcinoma treated with neoadjuvant chemotherapy. Int J Clin Lab Res 1995; 25: 135–41

    Article  PubMed  CAS  Google Scholar 

  95. Tchekmedyian S, Hakman M, Siau J, et al. Megestrol acetate in cancer anorexia and weight loss. Cancer 1992; 69: 1268–74

    Article  PubMed  CAS  Google Scholar 

  96. Beller E, Tattersail M, Lumley T, et al. Improved quality of life with megestrol acetate in patients with endocrine-insensitive advanced cancer: a randomized placebo-control trial. Ann Oncol 1997; 8: 277–83

    Article  PubMed  CAS  Google Scholar 

  97. Bruera E, Ernst S, Hagen N, et al. Effectiveness of megestrol acetate in patients with advanced cancer: a randomized, double-blind, crossover study. Cancer Prev Control 1998; 2(2): 74–8

    PubMed  CAS  Google Scholar 

  98. Fietkau R, Riepl M, Kettner H. Supportive use of megestrol acetate in patients with head and neck cancer during radio (chemo)therapy. Eur J Cancer 1997; 33: 75–9

    Article  PubMed  CAS  Google Scholar 

  99. McMillan DC, Wigmore SJ, Fearon KC, et al. A prospective randomized study of megestrol acetate and ibuprofen in gastrointestinal cancer patients with weight loss. Br J Cancer 1999; 79: 495–500

    Article  PubMed  CAS  Google Scholar 

  100. Gebbia V, Testa A, Gebbia N. Prospective randomized trial of two dose levels of megestrol acetate in the management of anorexia-cachexia syndrome in patients with metastatic cancer. Br J Cancer 1996; 73(12): 1576–80

    Article  PubMed  CAS  Google Scholar 

  101. Plassee TF, Gorter RW, Krasnow SH, et al. Recent clinical experience with dronabinol. Pharmacol Biochem Behav 1991; 40: 695–700

    Article  Google Scholar 

  102. Beal JE, Olson R, Lefkowitz L, et al. Long-term efficacy and safety of dronabinol for acquired immunodeficiency syndrome-associated anorexia. J Pain Symptom Manage 1997; 14: 7–14

    Article  PubMed  CAS  Google Scholar 

  103. Jatoi A, Windschitl HE, Loprinzi CL, et al. Dronabinol versus megestrol acetate versus combination therapy for cancer-associated anorexia: a North Central Cancer Treatment Group Study. J Clin Oncol 1002; 20: 567–73

    Article  Google Scholar 

  104. Volicer L, Stelly M, Morris J, et al. Effects of dronabinol on anorexia and disturbed behavior in patients with Alzheimer’s disease. Int J Geriatr Psychiatry 1997; 12: 913–9

    Article  PubMed  CAS  Google Scholar 

  105. Gonzalez-Rosales F, Walsh D. Intractable nausea and vomiting due to gastrointestinal mucosal metastases relieved by tetrahydrocannabinol (dronabinol). J Pain Symptom Manage 1997; 14: 311–4

    Article  PubMed  CAS  Google Scholar 

  106. Reyes-Teran G, Sieira-Madero JG, Martinez Del Cerro V, et al. Effects of thalidomide on HIV-associated wasting syndrome: a randomized, double-blind, placebo-controlled clinical trial. AIDS 1996; 10: 1501–7

    Article  PubMed  CAS  Google Scholar 

  107. Standards options and recommendations for the use of appetite stimulants in oncology. Work group. Federation of the French Cancer Centres (FNCLCC). Bull Cancer 2000; 87: 315–28

    Google Scholar 

  108. Jatoi A, Rowland K, Loprinzi CL, et al. An eicosapentaenoic acid supplement versus megestrol acetate versus both for patients with cancer-associated wasting: a North Central Cancer Treatment Group and National Cancer Institute of Canada collaborative effort. J Clin Oncol 2004; 22: 2469–76

    Article  PubMed  CAS  Google Scholar 

  109. Morley JE, Kaiser FE, Perry HM, et al. Longitudinal changes in testosterone, luteinizing hormone, and follicle-stimulating hormone in healthy older men. Metabolism 1997; 46: 410–3

    Article  PubMed  CAS  Google Scholar 

  110. Morley JE, Distiller LA, Lissoos I, et al. Testicular function in patients with spinal cord damage. Horm Metab Res 1979; 11:679–82

    Article  PubMed  CAS  Google Scholar 

  111. Rudman D, Mattson DE, Nagraj HS, et al. Plasma testosterone in nursing home men. J Clin Epidemiol 1988; 41: 231–6

    Article  PubMed  CAS  Google Scholar 

  112. Snyder PJ, Peachey H, Berlin JA, et al. Effects of testosterone replacement in hypogonadal men. J Clin Endocrinol Metab 2000; 85: 2670–7

    Article  PubMed  CAS  Google Scholar 

  113. Morley JE, Perry 3rd HM, Kaiser FE, et al. Effects of testosterone replacement therapy in old hypogonadal males: a preliminary study. J Am Geriatr Soc 1993; 41: 149–52

    PubMed  CAS  Google Scholar 

  114. Sih R, Morley JE, Kaiser FE, et al. Testosterone replacement in older hypogonadal men: a 12-month randomized controlled trial. J Clin Endocrinol Metab 1997; 82: 1661–7

    Article  PubMed  CAS  Google Scholar 

  115. Borst SE, Mulligan T. Testosterone replacement therapy for older men. Clin Interv Aging 2007; 2(4): 561–6

    PubMed  CAS  Google Scholar 

  116. Hengge UR, Baumann M, Maleba R, et al. Oxymetholone promotes weight gain in patients with advanced human immunodeficiency virus (HIV-1) infection. Br J Nutr 1996; 75(1): 129–38

    Article  PubMed  CAS  Google Scholar 

  117. Pengelly CD. Oxymetholone in the chemotherapy of malignant disease. Curr Med Res Opin 1973; 1(7): 401–6

    Article  PubMed  CAS  Google Scholar 

  118. Schambelan M, Mulligan K, Grunfeld C, et al. Recombinant human growth hormone in patients with HIV-associated wasting: a randomized, placebo-controlled trial. Ann Intern Med 1996; 125: 873–82

    PubMed  CAS  Google Scholar 

  119. Kaiser FE, Silver AJ, Morley JE. The effect of recombinant human growth hormone on malnourished older individuals. J Am Geriatr Soc 1991; 39: 235–40

    PubMed  CAS  Google Scholar 

  120. Takala J, Ruokonen E, Webster NR, et al. Increased mortality associated with growth hormone treatment in critically ill adults. N Engl J Med 1999; 341: 785–92

    Article  PubMed  CAS  Google Scholar 

  121. Deans C, Wigmore SJ. Systemic inflammation, cachexia and prognosis in patients with cancer. Curr Opin Clin Nutr Metabol Care 2005; 8: 265–9

    Article  CAS  Google Scholar 

  122. Yeh SS, Wu SY, Levine DM, et al. The correlation of cytokine levels with body weight after megestrol acetate treatment in geriatric patients. J Gerontol A Biol Sci Med Sci 2001; 56: M48–54

    Article  PubMed  CAS  Google Scholar 

  123. Yeh SS, Hafner A, Schuster MW, et al. Relationship between body composition and cytokines in cachectic patients with chronic obstructive pulmonary disease. J Am Geriatr Soc 2003; 51: 1365–2389

    Article  Google Scholar 

  124. Gordon JN, Trebble TM, Ellis RD, et al. Thalidomide in the treatment of cancer cachexia: a randomised placebo controlled trial. Gut 2005; 54: 540–5

    Article  PubMed  CAS  Google Scholar 

  125. Fearon KC, Von Meyenfeldt MF, Moses AG, et al. Effect of a protein and energy dense N-3 fatty acid enriched oral supplement on loss of weight and lean tissue in cancer cachexia: a randomised double blind trial. Gut 2003; 52: 1479–86

    Article  PubMed  CAS  Google Scholar 

  126. Yarasheski KE. Growth hormone effects on metabolism, body composition, muscle mass, and strength. Exerc Sport Sci Rev 1994; 22: 285–312

    Article  PubMed  CAS  Google Scholar 

  127. Berenstein EG, Ortiz Z. Megestrol acetate for the treatment of anorexia-cachexia syndrome. Cochrane Database Syst Rev 2005 Apr 18; (2): CD004310

    Google Scholar 

  128. Loprinzi C, Jensen M, Jiang N, et al. Effect of megestrol acetate on the human pituitary-adrenal axis. Mayo Clin Proc 1992; 67: 1160–2

    Article  PubMed  CAS  Google Scholar 

  129. Koller E, Gibert C, Green L, et al. Thrombotic events associated with megestrol acetate in patients with AIDS cachexia. Nutrition 1999; 15: 294–8

    Article  PubMed  CAS  Google Scholar 

  130. Thomas DR. Incidence of venous thromboembolism in megestrol acetate users. J Am Med Dir Assoc 2004; 5: 65–7

    Article  PubMed  Google Scholar 

  131. Hansson PO, Welin L, Tibblin G, et al. Deep vein thrombosis and pulmonary embolism in the general population. Arch Intern Med 1997; 157: 1665–70

    Article  PubMed  CAS  Google Scholar 

  132. Kniffin Jr WD, Baron JA, Barrett J, et al. The epidemiology of diagnosed pulmonary embolism and deep venous thrombosis in the elderly. Arch Intern Med 1992; 232: 155–60

    Google Scholar 

  133. Spitzer WO, Lewis MA, Heinemann LA, et al. Third generation oral contraceptives and risk of venous thrombotic disorders: an international case control study. Transnational Research Group on Oral Contraceptives and the Health of Young Women. BMJ 1996; 312(7023): 83–8

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

No sources of funding were used to assist in the preparation of this review. The author has no conflicts of interest that are directly relevant to the content of this review.

Author information

Authors and Affiliations

  1. Division of Geriatric Medicine, Saint Louis, Missouri, 63104, USA

    David R. Thomas

Authors
  1. David R. Thomas
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to David R. Thomas.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Thomas, D.R. Anorexia. Drugs Aging 26, 557–570 (2009). https://doi.org/10.2165/11316360-000000000-00000

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/11316360-000000000-00000

Keywords

Search

Navigation