The concept of anorexia of aging in late life depression: A cross-sectional analysis of a cohort study.

Aprahamian, Ivan; Romanini, C; Lima, Natália Almeida; An, Vinicius Nakajima; Aguirre, Bianca Nobre; Galdeano, Júlia Riccetto; Costa, Daniela Lima da; Petrella, Marina; Ribeiro, Sandra Maria Lima; Borges, Marcus Kiiti; Morley, John E.; Voshaar, Richard C. Oude

doi:10.1016/j.archger.2021.104410

Cited by 18 publications

(16 citation statements)

References 30 publications

(36 reference statements)

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“…In the group with poor appetite, without the appetite item included in the scale, the median score was exactly the cut-point of 16, reflecting individuals at risk for clinical depression. The association of depression and depressive symptoms with poor appetite has been reported in several previous studies in community-dwelling [15,18,22,23] and institutionalised [20,21,41] older adults. Interestingly, age, multimorbidity, present pain, fair/poor self-perceived health, anxiety symptoms, reduced cognitive function and memory complaints, sometimes feeling lonely, alcohol consumption, smoking and poor sleep quality were all significantly associated with poor appetite in the single-domain models, but no longer in the final multidomain model, despite plausible theoretical connections and some evidence of associations with poor appetite in previous studies [18,19,22,24,42,43].…”

Section: Discussionsupporting

confidence: 59%

“…Accordingly, physical factors which can affect appetite include polypharmacy [12,13], chewing problems [14,15], functional [16] and sensory impairment [17], poor oral health [16,18] and chronic pain [19]. Depression is an emotional factor associated with poor appetite in older adults [15,[20][21][22][23]. Cognitive factors such as cognitive impairment and dementia [16,22] as well as the social factor "living alone" [16] and the lifestyle factors "current smoking" [23] and "poor sleep quality" [24] have also been described in relation to a poor appetite in older adults.…”

Section: Introductionmentioning

confidence: 99%

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Characterisation of community-dwelling older adults with poor appetite

et al. 2023

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Purpose A poor appetite affects up to 27% of community-dwelling older adults in Europe and is an early predictor of malnutrition. Little is known about the factors associated with poor appetite. The present study, therefore, aims to characterise older adults with poor appetite. Methods As part of the European JPI project APPETITE, data from 850 participants, aged ≥ 70 years of the Longitudinal Ageing Study Amsterdam (LASA) from 2015/16 were analysed. Appetite during the last week was assessed with a five-point scale and dichotomised into "normal" and "poor". Binary logistic regression was used to examine associations between 25 characteristics from 5 domains—physiological, emotional, cognitive, social, and lifestyle—and appetite. First, domain-specific models were calculated using stepwise backward selection. Second, all variables contributing to poor appetite were combined in a multi-domain model. Results The prevalence of self-reported poor appetite was 15.6%. Fourteen parameters from all five single-domain models contributed to poor appetite and were entered into the multi-domain model. Here, female sex (total prevalence: 56.1%, odds ratio: 1.95 [95% confidence interval 1.10–3.44]), self-reported chewing problems (2.4%, 5.69 [1.88–17.20]), any unintended weight loss in the last 6 months (6.7%, 3.07 [1.36–6.94]), polypharmacy defined as ≥ 5 medications in the past 2 weeks (38.4%, 1.87 [1.04–3.39]), and depressive symptoms (Centre for Epidemiologic Studies Depression Scale without appetite item) (1.12 [1.04–1.21]) were associated with an increased likelihood of having poor appetite. Conclusion According to this analysis, older people with the characteristics described above are more likely to have a poor appetite.

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Section: Discussionsupporting

confidence: 59%

Section: Introductionmentioning

confidence: 99%

Characterisation of community-dwelling older adults with poor appetite

et al. 2023

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“…Four regression models were calculated, model 1 was unadjusted. In the three adjusted models, potential confounders were selected based on the literature ( Yeh and Schuster, 1999 ; Morley, 2002 ; McDade et al, 2006 ; O’Connor et al, 2009 ; Cox et al, 2020 ; Aprahamian et al, 2021 ). Model 2 was adjusted for demographics variables (age and sex), model 3 was further adjusted for health variables (waist circumference, leptin, GDS score, and the number of medications), and in model 4 other inflammation markers (IL-6 and TNF- α) were added.…”

Section: Methodsmentioning

confidence: 99%

Association Between Inflammation and Appetite in Healthy Community-Dwelling Older Adults—An enable Study

et al. 2022

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Aging is associated with reduced appetite as well as a slight increase in pro-inflammatory status, which both might contribute to the development of malnutrition. We aimed to evaluate the association between inflammation based on serum C-reactive protein (CRP), and appetite in healthy community-dwelling older adults. In this cross-sectional study of 158 healthy and non-smoking persons (aged 75–85 years), appetite was assessed in personal interviews by a single question with five answer categories. As nobody reported (very) poor appetite, the remaining three categories were dichotomised into “(very) good” and “moderate” appetite. Fasting serum CRP was analysed according to standard procedures, values ≥ 5.0 mg/L were considered as inflammation. The association between inflammation and appetite was examined by binary logistic regression, unadjusted and adjusted for age, sex, waist circumference, leptin, depressive mood, number of medications, interleukin-6 and tumor necrosis factor-α. Appetite was very good in 27.8%, good in 58.9%, and moderate in 13.3% of participants. Inflammation was present in 10.8% overall, in 8.8% of those with (very) good and in 23.8% of those with moderate appetite (p = 0.038). In the unadjusted model, participants with inflammation were 3.2 times more likely to have moderate appetite (95%CI: 1.01–10.44, p = 0.047). In the adjusted model, the odds of having moderate appetite was 3.7 times higher in participants with inflammation, but no longer significant (95%CI: 0.77–18.55, p = 0.102). In healthy older people, we found hints for a potential association between increased levels of CRP and a slightly reduced appetite. More studies in larger samples are needed.

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“…Next to nutritional parameters further assessments were chosen to test convergent validity: (1) As reported in a cross-sectional study of depression in geriatric patients, SNAQ was expected to correlate with depressive symptoms. 28 Depressive symptoms in this study were assessed using the German version of the Geriatric Depression Scale (GDS-15) with a cut-off value of ≥5 to detect depressive symptoms. 29 (2) Although scales and methods were assessed differently, previous studies showed that decline in appetite was associated with an increased risk of frailty in older adults.…”

Section: Convergent Validitymentioning

confidence: 99%

Validation of a telephone‐based administration of the simplified nutritional appetite questionnaire

Thai,

Bauer,

Eidam

et al. 2023

J cachexia sarcopenia muscle

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Background Anorexia of aging is characterized by an age‐associated reduction of appetite, whose aetiology in most cases is multifactorial and which often triggers malnutrition. The Simplified Nutritional Appetite Questionnaire (SNAQ) is an established screening tool. This study aimed to investigate reliability, validity, and feasibility of its telephone administration (T‐SNAQ) in German community‐dwelling older adults. Methods This cross‐sectional single‐centre study recruited participants from April 2021 to September 2021. First, the SNAQ was translated into German according to an established methodology. After translation, reliability, construct validity, and feasibility of the T‐SNAQ were analysed. A convenience sample of community‐dwelling older adults aged ≥70 years was recruited. The following measurements were applied to all participants: T‐SNAQ, Mini Nutritional Assessment – Short Form (MNA‐SF), six‐item Katz index of independence in activities of daily living (ADL), eight‐item Lawton instrumental activities of daily living (IADL), telephone Montreal Cognitive Assessment (T‐MoCA); FRAIL scale, Geriatric Depression Scale (GDS‐15) and Charlson co‐morbidity index as well as daily caloric and protein intake. Results One hundred twenty participants (59.2% female) with a mean age of 78.0 ± 5.8 years were included in the present study. The percentage of participants identified with poor appetite based on T‐SNAQ was 20.8% (n = 25). T‐SNAQ showed a good internal reliability with a Cronbach's alpha coefficient of 0.64 and a good test–retest reliability [intraclass coefficient of 0.95 (P < 0.05)]. Regarding construct validity, T‐SNAQ was significantly positively correlated with MNA‐SF (r = 0.213), T‐MoCA (r = 0.225), daily energy (r = 0.222) and protein intake (r = 0.252) (P < 0.05). It also demonstrated a significant negative association with GDS‐15 (r = −0.361), FRAIL scale (r = −0.203) and Charlson co‐morbidity index (r = −0.272). Regarding applicability, the mean time for T‐SNAQ was 95 s and completion rate was 100%. Conclusions The T‐SNAQ is a feasible screening instrument for anorexia of aging in community‐dwelling older adults via telephone interviews.

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The concept of anorexia of aging in late life depression: A cross-sectional analysis of a cohort study.

Cited by 18 publications

References 30 publications

Characterisation of community-dwelling older adults with poor appetite

Characterisation of community-dwelling older adults with poor appetite

Association Between Inflammation and Appetite in Healthy Community-Dwelling Older Adults—An enable Study

Validation of a telephone‐based administration of the simplified nutritional appetite questionnaire

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