Consequences of Anorexia of Aging in Hospital Settings: An Updated Review

Abstract

The anorexia of aging is a widespread problem amongst older people, particularly in the hospital setting with up to 60% affected. Despite its high prevalence anorexia often goes undiagnosed in hospital, due to a lack of standardized assessment and evidence-based management, but also lack of knowledge regarding consequences. This review summarizes current evidence for anorexia of aging specific to the hospital setting, giving an overview of correlates of appetite in hospital and consequences of anorexia. It highlights an overall scarcity of research on this important clinical problem for hospitalized cohorts. The few studies point to the importance of anorexia of aging in major health burdens for older people, namely malnutrition, sarcopenia and reduced physical performance, as well as higher mortality. Further research is needed to assess temporal sequence in pathways of causality and to develop effective interventions to combat anorexia.

Keywords:

• appetite
• older people
• outcomes
• sarcopenia

Abbreviations

ADL-KTAZ6, Modified Katz Index Scale-6; BMI, Body Mass Index; CNAQ, Council on Nutrition Appetite Questionnaire; ESAS, Edmonton Symptom Assessment System; FIM, Functional Independence Measure; GLIM, Global Leadership Initiative on Malnutrition; IDDSI, International Dysphagia Diet Standardization Initiative; MUST, Malnutrition Universal Screening Tool; OHAT, Oral Health Assessment Tool; PASE, Physical Activity Scale for the Elderly; SNAQ, Simplified Nutritional Appetite Questionnaire; SNAQ(M), Short Nutritional Assessment Questionnaire; SPPB, Short Physical Performance Battery.

Acknowledgments

N.J.C. receives support from the National Institute for Health Research (NIHR) Applied Research Collaborative (ARC) Wessex and the NIHR Clinical Academic Training Scheme. The views expressed are those of the author and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.

Disclosure

The author reports no conflicts of interest in this work.