Appetite In Older Adults Research Articles

Understanding age-related changes: exploring the interplay of protein intake, physical activity and appetite in the ageing population.

Globally, we are currently facing a rapid demographic shift leading to an increase in the proportion of older adults within the population. This raises concerns about the potential increase in age-related diseases and their impact on our ability to provide adequate health and end-of-life care. To apply appropriate interventions, understanding the changes that happen with ageing becomes essential. Ageing is often accompanied by a decrease in appetite and physical activity, which may lead to malnutrition, resulting in decreased muscle mass, physical capabilities and independence. To preserve muscle mass, older adults are advised to increase protein intake and physical activity. However, protein's high satiating effect may cause reduced energy intake. Physical activity is also advised to maintain or enhance older adult's appetite. This review paper aims to discuss appetite-related changes that occur with ageing and their consequences. In particular, it will focus on investigating the relationship between protein intake and physical activity and their impact on appetite and energy intake in the ageing population. Recent studies suggest that physical activity might contribute to maintaining or enhancing appetite in older adults. Nevertheless, establishing a definitive consensus on the satiating effect of protein in ageing remains a work in progress, despite some promising results in the existing literature.

The associations between sleep quality, mood, pain and appetite in community dwelling older adults: a daily experience study.

To investigate the daily life experiences of sleep, mood, and pain in relation to appetite in community-dwelling older adults aged 75 years and older, stratified by sex. Existing data from a daily experience study embedded in the Longitudinal Aging Study Amsterdam (LASA) among the oldest-old (≥75 years). LASA is an ongoing cohort study of a nationally representative sample of older adults aged ≥55 years from three culturally distinct regions in the Netherlands. 434 community-dwelling older adults aged ≥75 years. Participants filled-out a one-week diary on daily experience of pain, mood, last night sleep (10-point Likert scale), and appetite (5-point Likert scale) on five measurement occasions between 2016 and 2021. (Hybrid) linear mixed models were used to investigate overall, within-subject and between-subject association between mood, sleep, and pain (independent variables) and appetite (dependent variable), while correcting between-subject associations for season, age, educational level, partner status, body mass index, alcohol consumption, physical activity level, smoking status, chronic diseases and use of nervous system medication, stratified by sex. Averaged over all days, males reported a poor appetite on 12% of the days and females on 19% of the days. Statistically significant between-subject associations with a poorer appetite were found for lower mood (unstandardized b = 0.084 [95% CI 0.043-0.126] (males), (b = 0.126 [95% CI 0.082-0.170] (females)), poorer sleep (b = 0.045 [95% CI 0.007-0.083] (males), (b = 0.51 [95% CI 0.017-0.085] (females)) and more severe pain in males only (b = 0.026 [95% CI 0.002-0.051]). Except for pain, within-subject associations were somewhat weaker: mood: b = 0.038 [95% CI 0.016-0.060] (males), (b = 0.082 [95% CI 0.061-0.104] (females)); sleep: b = 0.029 [95% CI 0.008-0.050] (males), (b = 0.15 [95% CI 0.005-0.025] (females)); and pain (b = 0.032 [95% CI 0.004-0.059] (males)). This study found that poor sleep, low mood (more strongly in females) and more severe pain (males only) are associated with poor appetite in older adults on a daily level both within and between persons. Sex differences in factors related to poor appetite should be considered in future research.

Appetite and family and friends network among community-dwelling older adults: A cross-sectional study

ObjectivesThe aim of this study was to investigate the stronger correlate of appetite—family or friend networks—in community-dwelling older adults, given that undernutrition can impair physical function, increase mortality, and be influenced by social networks. MethodsA cross-sectional study was conducted in Kasugai City, Aichi Prefecture, and Nara City, Nara Prefecture, Japan, between August 2019 and March 2023. The analysis included 119 participants (women: 79%, mean age: 76.5 ± 5.6 y). A multiple regression analysis was performed, using the scores from the Japanese version of the Simplified Nutritional Appetite Questionnaire (SNAQ-J) as the dependent variable and family network and friend network as the independent variables. The analysis included social participation, living alone status, sex, age, body mass index, skeletal muscle mass index, grip strength, walking speed, and the Japanese version of the 15 Geriatric Depression Scale score as covariates to examine their relationship with appetite. ResultsThe mean value of the SNAQ-J score of the participants was 15.4 ± 1.2. Seven participants (6%) had a loss of appetite. Family network was significantly associated with appetite (B = 0.121, β = 0.266, P <0.05; 95% condidence interval [CI], 0.030–0.212). In the single regression analysis, the friend network was significantly associated with the total score of the SNAQ-J (B = 0.115, P <0.001; 95% CI, 0.052–0.177); however, this association was not observed in the multiple regression analysis (B = 0.002, β = 0.006, P = 0.954; 95% CI, –0.074–0.078). ConclusionAppetite was associated with family networks. Among social networks, focusing on family networks may help prevent the loss of appetite in older adults in Japan.

A pecan-enriched diet reduced postprandial appetite intensity and enhanced peptide YY secretion: A randomized control trial

Tree nuts have been shown to have satiating qualities; however, little is known concerning the effect of pecans on measures of appetite. The purpose of this study was to examine the impact of a pecan-enriched diet on subjective, physiological, and direct measures of appetite in older adults. This was a randomized, controlled trial in which healthy older adults (50-75y) were randomized to either consume 68g of pecans/day (pecan; n=21) or avoid all nuts (control; n=23) for 4 weeks. At pre- (V1) and post-diet (V2) visits body weight (BW) and body fat percentage (BF) were assessed and actual change in these outcomes for pecan were compared to theoretical changes if pecans were consumed without compensation. Subjective appetite was measured using visual analog scale (VAS), and blood was collected to assess changes in physiological appetite before and every 30min for 4h following a high-fat meal. Energy intake (EI) at a buffet meal was then assessed in the laboratory ("in-lab"). VAS assessments continued hourly for the next 7h and EI ("at-home") was self-reported. BW and BF did not change for pecan or control across the intervention and theoretical change in BW (theoretical: 2.2±0.1 vs. actual: 0.4±0.2kg; p<0.0001) and BF (theoretical: 0.4±0.04 vs. actual: 0.2±0.2%; p<0.0001) was significantly greater than actual change for pecan. From V1 to V2, there was an increase in fasting (pecan: 77.0±4.6 to 93.5±6.1 vs control: 76.0±5.0 to 72.5±5.0pg/mL; p=0.01) and postprandial peptide YY for pecan vs. control (p=0.04); however, fasting and postprandial cholecystokinin and ghrelin did not differ (p>0.05). There were no differences in the change in subjective appetite ratings at fasting, following the high-fat meal (in-lab), at-home, or across the full day between groups (p>0.05 for all). However, there was a significant suppression of peak desire to eat ratings for pecan vs. control (pecan: 67.9±4.6 to 57.1±5.2 vs. control: 61.9±4.2 to 60.6±4.3mm; p=0.04). Combined, buffet meal, and at-home EI did not differ significantly within pecan and control; however, there was a trend (p=0.11) for a between group difference in buffet meal EI driven by increased EI for control (+137±86kcal) vs. decreased EI for pecan (-45±77kcal). A 4-week pecan-enriched diet led to enhanced satietogenic metrics compared to a diet void of all nuts. As weight remained stable during the intervention, adding pecans to the daily diet may be beneficial to appetite control and weight maintenance in a healthy older population. ClinicalTrials.gov: NCT04385537.

Anorexia in Medicare Fee-for-Service Beneficiaries: A Claims-Based Analysis of Epidemiology and Mortality

ObjectivesLoss of appetite in older adults can lead to malnutrition, weight loss, frailty, and death, but little is known about its epidemiology in the United States (US). The objective of this study was to estimate the annual prevalence and incidence of anorexia in older adults with Medicare fee-for-service (FFS) health insurance.DesignRetrospective and observational analysis of administrative health insurance claims data.SettingThis study included Medicare FFS claims from all settings (eg, hospital inpatient/outpatient, office, assisted living facility, skilled nursing facility, hospice, rehabilitation facility, home).ParticipantsThis study included all individuals aged 65 to 115 years old with continuous Medicare FFS medical coverage (Parts A and/or B) for at least one 12-month period from October 1, 2015, to September 30, 2021 (ie, approximately 30 million individuals each year).InterventionNot applicable.MeasurementsAnorexia was identified using medical claims with the ICD-10 diagnosis code “R63.0: Anorexia”. This study compared individuals with anorexia to a control group without anorexia with respect to demographics, comorbidities using the Charlson Comorbidity Index (CCI), Claims-based Frailty Index (CFI), and annual mortality. The annual prevalence and incidence of anorexia were estimated for each 12-month period from October 1, 2015, to September 30, 2021.ResultsThe number of individuals with anorexia ranged from 317,964 to 328,977 per year, a mean annual prevalence rate of 1.1%. The number of individuals newly diagnosed with anorexia ranged from 243,391 to 281,071 per year, a mean annual incidence rate of 0.9%. Individuals with anorexia had a mean (±standard deviation) age of 80.5±8.7 years (vs 74.9±7.5 years without anorexia; p<.001), 64.4% were female (vs 53.8%; p<.001), and 78.4% were White (vs 83.2%; p<.001). The most common CCI comorbidities for those with anorexia were chronic pulmonary disease (39.4%), dementia (38.3%), and peripheral vascular disease (38.0%). Median (interquartile range [IQR]) CCI with anorexia was 4 [5] (vs 1 [3] without anorexia; p<.001). The annual mortality rate among those with anorexia was 22.3% (vs 4.1% without anorexia; relative risk 5.49 [95% confidence interval, 5.45–5.53]).ConclusionApproximately 1% of all adults aged 65–115 years old with Medicare FFS insurance are diagnosed with anorexia each year based on ICD-10 codes reported in claims. These individuals have a higher comorbidity burden and an increased risk of annual mortality compared to those without a diagnosis of anorexia. Further analyses are needed to better understand the relationship between anorexia, comorbidities, frailty, mortality, and other health outcomes.

Texture-Modified Diets are Associated with Poor Appetite in Older Adults who are Admitted to a Post-Acute Rehabilitation Hospital

ObjectiveThis study aimed to clarify the association between texture-modified diets and poor appetite in older adults, as it is not fully understood. DesignCross-sectional study. Setting and ParticipantsWe included 208 inpatients who were aged ≥65 years (mean age 78.9 ± 7.6 years, 57.7% female) and admitted to a rehabilitation unit with stroke, musculoskeletal disease, or hospital-associated deconditioning covered by the Japanese insurance system, between January 2019 and January 2020. MethodsParticipants were divided into 2 groups according to their food texture level: International Dysphagia Diet Standardization Initiative (IDDSI) levels 3 to 5 for the texture-modified diet group and levels 6 and 7 for the normal diet group. Appetite was assessed using the Simplified Nutritional Appetite Questionnaire for the Japanese elderly, and a score ≤14 was defined as poor appetite. The relationship between IDDSI levels and poor appetite was analyzed using the Cochrane-Armitage trend test. Logistic regression analysis was used to investigate the relationship between the consumption of texture-modified diets and poor appetite. Statistical significance was set at P < .05. ResultsThe numbers of participants on modified diets according to the IDDSI framework were as follows: 4, 11, 41, 76, and 76 in levels 3, 4, 5, 6, and 7, respectively. In total, 152 and 56 patients were classified into the regular diet group and texture-modified diet group, respectively. A significantly higher prevalence of poor appetite was observed with the consumption of texture-modified diets (P < .001 for trend). Logistic regression analysis showed that poor appetite was independently associated with the consumption of texture-modified diets (odds ratio 3.443, P = .011). Conclusions and ImplicationsThese findings indicate that the consumption of texture-modified diets is associated with poor appetite. Further studies are required to verify whether a multimodal approach involving improvement in the appearance, taste, flavor, and nutrients of the food can improve poor appetite.

An Increase in Fat-Free Mass is Associated with Higher Appetite and Energy Intake in Older Adults: A Randomised Control Trial.

Cross-sectional studies in younger adults have demonstrated a positive association between energy intake (EI) and fat-free mass (FFM), with this relationship seemingly mediated by resting metabolic rate (RMR). Establishing a causal effect longitudinally would be prudent in older adults suffering from loss of appetite. We investigated the effects of FFM on RMR, appetite and EI in 39 healthy older adults (age: 66 ± 4 years, BMI: 25.1 ± 3.5 kg∙m2) assigned to either 12-week resistance training + protein supplementation group (RT + PRO) or control group (CON). Body composition, subjective appetite, leptin, insulin, RMR and laboratory-measured ad libitum EI were measured at baseline, weeks 6 and 12 of the intervention, while daily EI at baseline and week 12. FFM (+1.2 kg; p = 0.002), postprandial subjective appetite (+8 mm; p = 0.027), ad libitum EI (+119 kcal; p = 0.012) and daily EI (+133 kcal; p = 0.010) increased from baseline to week 12 in the RT + PRO. RMR, fasted subjective appetite, leptin and insulin concentrations remained unchanged (all p > 0.05). The increases ad libitum EI correlated with increases in FFM (r = 0.527, p = 0.001), with 54% of the change in EI attributed to FFM changes. In conclusion, FFM increases were associated with an increased ad libitum EI and postprandial appetite in older adults.

Gastrointestinal Tolerance and Microbiome Response to Snacks Fortified with Pea Hull Fiber: A Randomized Trial in Older Adults.

ABSTRACTBackgroundConsuming foods with added fiber may help older adults achieve fiber recommendations; however, many high-fiber ingredients have little effect on laxation and may contribute to unpleasant gastrointestinal side effects.ObjectivesThe aim of the study was to determine the effects of consuming snacks fortified with pea hull fiber (PHF) on stool frequency and form, gastrointestinal symptoms, and appetite in older adults. An exploratory aim was to determine if PHF altered the microbiota profile.MethodsA 10-wk, randomized, blinded, crossover study was carried out. Following a 2-wk baseline period, participants [aged (mean ± SD) 69.7 ± 6.5 y; n = 31; 14 men, 17 women] consumed snacks providing 10 g/d of PHF or a control, each for 2-wk periods followed by 2-wk washouts. Participants used the Bristol Stool Form Scale (BSFS) to record daily stool frequency and gastrointestinal symptoms, and completed the Gastrointestinal Symptom Rating Scale (GSRS) and Simplified Nutritional Appetite Questionnaire (SNAQ) biweekly. One stool was collected per period for 16S ribosomal RNA high-throughput amplicon sequencing of the fecal microbiota profile.ResultsParticipants reported 1.63 ± 0.05 stools/d and 76.6% normal transit stool form at baseline and no change with PHF. GSRS syndrome scores were similarly unchanged. Daily abdominal noises and bloating were higher for PHF versus control, and flatulence was higher for PHF versus baseline, suggesting fermentation in some individuals. There was no evidence to suggest a common PHF-induced microbiome response for the group as a whole; however, a subgroup of participants (n = 7) who responded with increased flatulence (fermenters), harbored many different taxa than nonfermenters, and demonstrated lower abundance of Clostridiales with PHF. Appetite was unchanged with PHF.ConclusionsPHF did not modulate stool form or frequency in older adults with normal bowel habits. Because snacks fortified with PHF did not suppress appetite, PHF may be an appropriate fiber source for older adults at nutritional risk. Microbiome profile may be predictive of gastrointestinal symptom response to PHF. This trial was registered at www.clinicaltrials.gov as NCT02778230.

The effect of a walking based physical activity intervention on appetite in older adults: A pilot study

The effect of a walking based physical activity intervention on appetite in older adults: A pilot study

Poor Appetite and Dietary Intake in Community-Dwelling Older Adults.

Poor appetite in older adults leads to sub-optimal food intake and increases the risk of undernutrition. The impact of poor appetite on food intake in older adults is unknown. The aim of this study was to examine the differences in food intake among older community-dwelling adults with different reported appetite levels. Cross-sectional analysis of data from a longitudinal prospective study. Health, aging, and body composition study performed in the USA. 2,597 community-dwelling adults aged 70-79. A semi-quantitative, interviewer-administered, 108-item food frequency questionnaire designed to estimate dietary intake. Poor appetite was defined as the report of a moderate, poor, or very poor appetite in the past month and was compared with good or very good appetite. The mean age of the study sample was 74.5 ± 2.8 years; 48.2% were men, 37.7% were black, and 21.8% reported a poor appetite. After adjustment for total energy intake and potential confounders (including biting/chewing problems), participants with a poor appetite had a significantly lower consumption of protein and dietary fiber, solid foods, protein rich foods, whole grains, fruits, and vegetables, but a higher consumption of dairy foods, fats, oils, sweets, and sodas compared to participants with very good appetite. In addition, they were less likely to report consumption of significant larger portion sizes. Older adults reporting a poor appetite showed a different dietary intake pattern compared to those with (very) good appetite. Better understanding of the specific dietary intake pattern related to a poor appetite in older adults can be used for nutrition interventions to enhance food intake, diet variety, and diet quality.

Pre-meal inulin consumption does not affect acute energy intake in overweight and obese middle-aged and older adults: A randomized controlled crossover pilot trial.

Three-fourths of adults older than 55 years in the United States are overweight or obese. Prebiotics including inulin-type fructans may benefit with weight management. We aimed to investigate the acute effects of pre-meal inulin consumption on energy intake (EI) and appetite in older adults. Sedentary, overweight or obese middle-aged and older adults ( n = 7, 60.9 ± 4.4 years, BMI 32.9 ± 4.3 kg/m2) ingested inulin (10 g) or a water preload before each test period in a randomly assigned order. EI, appetite and gastrointestinal symptoms were monitored during the following 24 h. No differences in EI were noted between conditions (inulin: 14744 ± 5552 kJ, control: 13924 ± 4904 kJ, p > 0.05). Rumbling was increased with inulin consumption ( p < 0.05). Pre-meal inulin consumption does not acutely decrease EI or suppress appetite in older adults. Further research should address individual differences among diets, eating behaviors, and microbiota profiles.

Differences in chewing behaviors between healthy fully dentate young and older adults assessed by electromyographic recordings

To characterize changes in chewing behaviors associated with healthy aging, 10 young and 10 older fully dentate healthy participants were enrolled in this study. They chewed carrot samples that differed in hardness until their normal swallowing threshold. Their chewing behaviors were assessed using an electromyographic recording device. Adjusting for gender and body mass index, older adults had a higher number of chewing cycles (p = 0.020), a longer chewing duration (p < 0.001), a slower chewing rate (p = 0.002), a greater maximal electromyographic voltage (p = 0.003) and a greater muscle activity (p = 0.002) before they could comfortably swallow the food bolus. A statistically significant main effect of food hardness on the number of chewing cycles, chewing duration, chewing rate and muscle activity was also observed (p < 0.001 for all). These results suggest that reduced mastication efficiency is associated with healthy aging in fully dentate adults. This ingestive behavior may contribute to aging-related reduction in appetite in older adults.

Specific food preferences of older adults with a poor appetite. A forced-choice test conducted in various care settings

A poor appetite in older adults is an important determinant of reduced food intake and undernutrition. Food preferences may influence food intake. The aim of this study was to investigate food preferences of older adults with a poor appetite and compare these with preferences of older adults with a good appetite. Older adults (n = 349, aged 65–101 years) in nursing/residential care homes, hospitals or at home receiving home care participated in a computer-based forced-choice food preference assessment. Self-reported appetite in the past week was classified as ‘good’ or ‘poor’ using a validated instrument. Food preferences were determined by counting the relative frequency of choices for food images according to 11 dichotomous categories: high/low 1) protein; 2) fat; 3) carbohydrates; 4) fiber; 5) variation; and 6) animal/vegetarian proteins; 7) sweet/savory taste; 8) solid/liquid texture; 9) dairy/non-dairy; with/without 10) sauce or 11) color variation. Specific food preferences in participants with a poor appetite were identified by one-sample t-tests comparing frequencies to the expected value of 48. Preference differences between those with a good and a poor appetite were analyzed using GLM adjusting for confounders. The results showed that older adults with a poor appetite (n = 113; 32.4%) preferred variation (51.6 vs. 48, P < 0.001), color variation (55.9 vs. 48, P < 0.01), non-dairy (53.0 vs. 48, P < 0.001), high-fiber (51.8 vs. 48, P < 0.05), and solid texture (53.5 vs. 48, P < 0.05). Participants with a poor appetite had a higher frequency score for variation than participants with a good appetite (51.6 vs. 48.5, P < 0.001). In conclusion, older adults with a poor appetite may have specific food preferences. Their preference for variation differs from those with a good appetite. These results may be used to develop meals that are preferred by older adults with poor appetite in order to increase food intake and prevent undernutrition.

Discomfort in dementia: identifying and managing pain

Discomfort in dementia: identifying and managing pain

Hardiness, Depression, and Emotional Well-Being and Their Association with Appetite in Older Adults

To examine the associations between hardiness (defined as the ability to manage stress), depression, and emotional well-being and appetite in older adults. Cross-sectional. Assisted-living facilities and senior centers in the Washington/Baltimore area. Two hundred ninety-two adults aged 60 and older. Depressive symptoms assessed using the 5-item Geriatric Depression Scale and categorized as 0 to 1 (normal, referent group) versus 2 to 5 (depressive symptoms present). Hardiness was measured using the 18-item Dispositional Resilience Scale II modified based on interviews with older adults and categorized as 67 or less (low hardiness) versus greater than 67 (normal, referent group). Appetite was measured using the Simplified Nutritional Appetite Questionnaire and categorized as 4 to 14 (poor appetite) versus 15 to 20 (normal, referent group). Emotional well-being was measured using a single question. Depression, hardiness, and emotional well-being were all significantly associated with appetite. In models controlling for confounders (data collection site, age, educational attainment, self-reported health, race, presence of chronic disease), fair to poor emotional well-being was most significantly associated with poor appetite (odds ratio (OR)=5.60, 95% confidence interval (CI)=2.60-12.07) and low commitment (a component of hardiness that indicates an individual's involvement in life) was also significantly associated with poor appetite (OR=1.35, 95% CI=1.13-1.61). These associations further elucidate the components of mental health that contribute to poor appetite in this population. Simple measures of self-reported mental health administered to older adults may predict poor appetite and lend themselves to potential interventions to prevent malnutrition and negative health outcomes.

Age-related functional changes in gustatory and reward processing regions: An fMRI study

Changes in appetite in older adults may result in unhealthy weight change and negatively affect overall nutrition. Research examining gustatory processing in young adults has linked changes in patterns of the hemodynamic response of gustatory and motivation related brain regions to the physiological states of hunger and satiety. Whether the same brain regions are involved in taste processing in older adults is unknown. The current study used functional magnetic resonance imaging (fMRI) to examine age-related changes in gustatory processing during hedonic assessment. Caffeine, citric acid, sucrose, and NaCl were administered orally during two event-related fMRI sessions, one during hunger and one after a pre-load. Participants assessed the pleasantness of the solutions in each session. Increased activity of the insula was seen in both age groups during hunger. Activity of secondary and higher order taste processing and reward regions such as the orbitofrontal cortex, amygdala, hippocampus, thalamus, and caudate nucleus was also observed. Hunger and satiety differentially affected the hemodynamic response, resulting in positive global activation during hunger and negative during satiety in both age groups. While in a state of hunger, the frequency and consistency of positive activation in gustatory and reward processing regions was greater in older adults. Additional regions not commonly associated with taste processing were also activated in older adults. Investigating the neurological response of older adults to taste stimuli under conditions of hunger and satiety may aid in understanding appetite, health, and functional changes in this population.

Fitness Is Associated With Better Appetite In Older Adults With Memory Loss

Fitness Is Associated With Better Appetite In Older Adults With Memory Loss

Anorexia

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.

Depression and Hardiness and their Association with Appetite in Older Adults

BackgroundPoor appetite leads to increased morbidity in older adults, and can be influenced by many factors, including chronic disease and depression. However, the direction of influence of depression on appetite is unclear in this population. Hardiness is believed to be another risk factor that may influence appetite in older adults, and is defined as an ability to manage stress and having a positive outlook on life.PurposeThe aim of this research is to examine the associations of hardiness, depression, and emotional well‐being with appetite in older adults.MethodsA survey evaluating hardiness, depression and appetite was administered to 292 adults (≥60 years) in assisted‐living facilities or attending senior centers in the Washington D.C. area.ResultsIn univariate models, depression, hardiness, and emotional well‐being are associated with appetite. Fair/poor emotional well‐being increases risk for poor appetite (OR=5.13, 95% CI: 2.47‐10.67) whereas commitment (a dimension of hardiness which indicates an individual's involvement in life) is inversely associated with risk of poor appetite (OR=0.81, 95% CI: 0.68‐0.95). Both variables emerged as the strongest predictors of appetite in multivariate models.ImplicationsThese strong associations may further elucidate the components of mental health which contribute to poor appetite in this population. Funding provided by: ADA HADPGGrant Funding SourceADA HADPG Student Research Award

Factors Associated with Impaired Appetite in Well-Functioning Community-Dwelling Older Adults

Poor appetite in older adults is a common problem in clinical practice, but prevalence of this symptom and its risk factors in community-dwelling older adults are not well understood. As part of the Health, Aging and Body Composition Study, we ascertained self-reported impaired appetite and related factors in 2,169 older adults aged 70–79 years. About 12% of participants reported impaired appetite. Those reporting impaired appetite were more likely to be older, female, and black and to report having illness or physical conditions interfering with appetite than those not reporting impaired appetite. Hierarchical logistic regression suggested that multiple factors contributed to impaired appetite. In particular, symptomatic depression (OR (95% CI) = 2.5 (1.6–4.1)), poor self-reported health (2.4 (1.7–3.2)), current smoking, chewing problems, reported visual impairment, weight loss since age 50, and log (TNF-a) were significantly related to impaired appetite.