An overview of appetite decline in older people

Abstract

Poor appetite is a common problem in older people living at home and in care homes, as well as hospital inpatients. It can contribute to weight loss and nutritional deficiencies, and associated poor healthcare outcomes, including increased mortality. Understanding the causes of reduced appetite and knowing how to measure it will enable nurses and other clinical staff working in a range of community and hospital settings to identify patients with impaired appetite. A range of strategies can be used to promote better appetite and increase food intake.Before reading this article do time out 1. IntroductionAppetite is the desire to fulfil a bodily need and can be divided into three components: hunger, satiation and satiety. Hunger is the sensation that promotes food consumption, satiation is the sensation of fullness during eating that leads to meal termination and satiety is the fullness that exists between eating occasions (Mattes et al., 2005). Control of appetiteAppetite regulation is complex and not completely understood. It has control systems linking the brain, digestive system, endocrine system and sensory nerves. These systems act to govern appetite both in the short term and the long term. In the short term appetite is Correspondence alp@mrc.soton.ac.uk.

A holistic approach to healthy ageing: how can people live longer, healthier lives?

“…Changes to the GI tract and its microbiota, appetite and also dentition can mean that individuals' diets become restricted, potentially opening a role for nutrient supplementation (72,73) . Changes to the GI tract and its microbiota, appetite and also dentition can mean that individuals' diets become restricted, potentially opening a role for nutrient supplementation (72,73) .…”

“…Healthcare professionals and individuals need to be aware of the broader impact of changes related to ageing that may impact on a person's ability to meet nutritional demands. Changes to the GI tract and its microbiota, appetite and also dentition can mean that individuals' diets become restricted, potentially opening a role for nutrient supplementation (72,73) . Although this advice may appear potentially simple, there should also be consideration of the interactions between nutrients, as well as with other factors such as medication, and an evaluation of potential risks (82) .…”

“…2. Degradation of the senses as a result of ageing may lead to changes in the ability to taste and smell food, which, when combined with a reduction in secretion of appetite hormones (72) , may impact levels of food consumption and choice of diets. If people self-select smaller meals or choose not to eat, there is an increased risk of undernutrition, which presents further health risks.…”

“…Difficulty swallowing food, often alongside poor dentitition or wearing of dentures, may result in fewer fruit and vegetables being consumed, which, ultimately, not only has a nutritional impact on many systems, but also on gut health and function. The structure and functionality of the intestinal microbiome changes with age (72) and long-term changes in diet can with other lifestyle factors drive either acute or chronic changes in intestinal microbial ecology that are detrimental to the health of their host.…”

A Review of Socially Conducive Eating Environment

“…In other case, problem of eating that suffers geriatric patients has called for Melin and Gotestam [22] to find a solution, and they found that manipulating the furniture in their ward has improved the patients' intention to eat and willingness to choose the meal composition according to their taste. Pilgrim and Robinson [23] noted that living and eating alone for most elderly has made them less willing to prepare food and appetite to eat. As a result, many cases show that older people has suffered from problem of malnutrition.…”