Anorexia of aging: physiologic and pathologic

Morley, John E.

doi:10.1093/ajcn/66.4.760

Cited by 660 publications

(426 citation statements)

References 154 publications

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“…One study reported a 25 % decrease in daily calorie consumption from 40 to 70 years of age (Di Francesco et al 2007). This decline in energy intake is predominantly due to a decrease in fat calories with a small increase in the percent of calories ingested as carbohydrate (Morley 1997). These changes are also found in healthy older people, in the presence of adequate food supply.…”

Section: Physiological Causes Of the Anorexia Of Agingmentioning

confidence: 87%

“…The high rate of anosmia in the elderly is suspected to be due to several factors, such as changes in the olfactory epithelium, reduced mucus secretion, changes in airway structure or epithelial thickness, and reduced regeneration rate in olfactory receptors (Welge-Lussen 2009). Also, the number and sensitivity of taste papillae is reduced with aging (Morley 1997). Reduced fat intake (and consequently reduced amount of body fat) in the elderly may be partly explained by the fact that fat affects the hedonic qualities of food to a lesser degree compared to younger adults (Kohl et al 2013).…”

Section: Decline Of Sensesmentioning

confidence: 99%

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Mechanisms of the anorexia of aging—a review

Wysokiński

Sobów

Kłoszewska

et al. 2015

AGE

172

139

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Many, even healthy, older people fail to adequately regulate food intake and experience loss of weight. Aging-associated changes in the regulation of appetite and the lack of hunger have been termed as the anorexia of aging. The etiology of the anorexia of aging is multi-factorial and includes a combination of physiological changes associated with aging (decline in smell and taste, reduced central and peripheral drive to eat, delayed gastric emptying), pathological conditions (depression, dementia, somatic diseases, medications and iatrogenic interventions, oral-health status), and social factors (poverty, loneliness). However, exact mechanisms of the anorexia of aging remain to be elucidated. Many neurobiological mechanisms may be secondary to age-related changes in body composition and not associated with anorexia per se. Therefore, further studies on pathophysiological mechanisms of the anorexia of aging should employ accurate measurement of body fat and lean mass. The anorexia of aging is associated with protein-energy malnutrition, sarcopenia, frailty, functional deterioration, morbidity, and mortality. Since this symptom can lead to dramatic consequences, early identification and effective interventions are needed. One of the most important goals in the geriatric care is to optimize nutritional status of the elderly.

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Section: Physiological Causes Of the Anorexia Of Agingmentioning

confidence: 87%

Section: Decline Of Sensesmentioning

confidence: 99%

Mechanisms of the anorexia of aging—a review

Wysokiński

Sobów

Kłoszewska

et al. 2015

AGE

172

139

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“…30,31 These age-related changes in energy regulation are thought to be due to altered hormonal signals, such as cholecystokinin (CCK), glucagon-like peptide 1 (GLP-1) and peptide YY (PYY), and impaired senses of taste and smell. [32][33][34] Potentially, changes in energy-regulating hormones during aging may result in changes in eating patterns that are associated with long-term body weight and fat changes. 21,[35][36][37] Only a few studies, however, have specifically examined age-related changes in eating patterns.…”

Section: Introductionmentioning

confidence: 99%

Eating patterns and dietary composition in relation to BMI in younger and older adults

et al. 2006

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Objective: To compare relative associations of eating patterns and dietary composition with body mass index (BMI) in younger (aged 20-59 years, n ¼ 1792) and older (aged 60-90 years, n ¼ 893) participants in the Continuing Survey of Food Intakes by Individuals, collected 1994Individuals, collected -1996. Methods: Data from two 24-h dietary recalls from individuals reporting physiologically plausible energy intake (within 722% of predicted energy requirements, based on previously published methods) were used. Results: Mean reported energy intake was 96 and 95% of predicted energy requirements in younger and older subjects, respectively. Older subjects were less likely than younger subjects to skip a meal, but snacking was common in both age groups. Fiber density was significantly higher in the older group. A higher BMI in both age groups was associated with a higher total daily energy intake, and higher energy intakes at all eating occasions. In both age groups, eating frequency was positively associated with energy intake, and eating more than three times a day was associated with being overweight or obese. In the younger group but not the older group, a lower fiber density coupled with higher percentage of energy from fat was independently associated with having a higher BMI. Conclusions: While no one eating occasion contributes more than any other to excess adiposity, eating more often than three times a day may play a role in overweight and obesity in both younger and older persons. A reduced satiety response to dietary fiber in addition to lower energy expenditure may potentially further contribute to weight gain in older persons.

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“…Physiological aging is associated with a decline in food intake (63). Males decrease their food intake more than females in both relative and absolute amounts.…”

Section: Anorexia Of Aging: An Example Of Hormonal Dysregulationmentioning

confidence: 99%

“…Males decrease their food intake more than females in both relative and absolute amounts. Like so many aspects of aging, the pathogenetic factors are multiple (63) and include alterations in the hedonic qualities of food (taste and smell), in the satiating effects of food (due to changes in the mechanical and sensory properties of the gastrointestinal tract), in fat cell signaling of total body adiposity, and in the responsiveness of the brain to peripheral signals, [e.g. changes in the central opioid regulation of feeding (64,65)].…”

Section: Anorexia Of Aging: An Example Of Hormonal Dysregulationmentioning

confidence: 99%

Endocrine and metabolic changes in human aging

Banks

Morley

2000

AGE

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"Aging and death are inevitable. We have no desire to prolong life, if such prolongation entails only added days and years of misery and suffering. On the other hand, for the first time in history, man has within his grasp potent medications of many kinds, among the more important of which are specific hormones capable of retarding if not stopping some of the undesirable features of growing old". Thomas Hodge McGavack Geriatrics 18:181-191 (1963) ABSTRACT Numerous alterations in hormonal secretion occur with aging. In general, these tend towards a disintegration of the normal cyclic secretory patterns resulting in lower total circulating levels. In addition, declines in receptors and postreceptor function further decreases the ability of the hormonal orchestra to maintain coordinated function throughout the organism. Clues to some of these agerelated changes in humans may come from the study of simpler organisms where regulatory systems are known to modulate the aging process. In particular, the interactions among the environment, hormones, and insulin receptor genes have led to new insights into the genetic control of longevity and the development of syndrome X.It is now well established, as summarized in Table 1, that the levels of many hormones are altered with aging (1). Some hormonal levels decrease, reflecting endocrine gland failure, whereas others increase, often because of end organ failure due to a decrease in receptors or a failure of postreceptor function. In the last decade, it has become popular to look to hormone replacement therapy as a mechanism to reverse the aging process. It has become popular to consider this the "hormonal fountain of youth". With aging, dysregulation of food intake accompanied by sarcopenia ('wasting of the flesh") occurs (2). A number of hormonal mechanisms are related to the physiological anorexia of aging (3). In particular, recent studies have suggested that alterations in circulating testosterone levels lead in males to increased leptin levels and thus to anorexia (4).Another area of intense interest in understanding the mechanisms of aging in humans has been the alterations that occur in glucose metabolism with aging and the role of age-related glucose end products (AGE) in accelerating the aging process (5). This area has been closely linked with the changes in nutrition that occur with aging, with insulin resistance, and more recently, with the genes that encode for the insulin receptor. It is of interest that the hormonal changes produced by dietary restriction in rodents are similar to the agerelated hormonal changes in humans, as shown in Table 2 (6). This raises the possibility that these hormonal changes are protective, i,e. slow down metabolism and thus slow down the aging process. This creates a "chicken or egg" hypothesis, illustrated in Figure 1, which asks the question: do aging changes occur because of the decline in hormones or do high hormone levels produce aging changes?This review will briefly examine the available data in each of these areas and...

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Anorexia of aging: physiologic and pathologic

Cited by 660 publications

References 154 publications

Mechanisms of the anorexia of aging—a review

Mechanisms of the anorexia of aging—a review

Eating patterns and dietary composition in relation to BMI in younger and older adults

Endocrine and metabolic changes in human aging

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