Appetite loss in older adults without undernutrition: associated factors and clinical implications

The aim of this study was to investigate the clinical implications of appetite loss in older adults with normal nutritional status, prior to the development of malnutrition.

This study included a total of 755 older outpatients with normal nutritional status as determined by the Mini Nutritional Assessment (MNA ≥ 24). Council on Nutrition Appetite Questionnaire was used to assess appetite status. Patients with a CNAQ score of ≤ 28/40 were identified as having a reduced appetite. Sociodemographic characteristics, anthropometric measurements, comorbidities, number of drugs, and laboratory data at the time of outpatient clinic admission were recorded. A comprehensive geriatric assessment was performed for all patients.

The mean age was 78.6 ± 7.7 years, and 66.8% were female. A total of 192 patients (25.4%) were identified with appetite loss. Individuals with appetite loss were older, more likely to be female, and more likely to have chronic kidney disease than those without appetite loss were (p < 0.05), while their educational level was lower. In the multivariate logistic regression, after adjusting for age, sex, years of education, and chronic kidney disease, there was an association between lower Tinetti Balance and Gait Scale scores, higher Geriatric Depression Scale-15 scores, and the number of medications associated with appetite loss (p < 0.05).

Appetite loss was observed in one out of four older adults with normal nutritional status (MNA ≥ 24). Appetite loss was associated with advanced age, female sex, lower educational level, chronic kidney disease, and polypharmacy. Older patients with appetite loss had more balance and gait disturbances and depressive symptoms even if they were well nourished.

Not applicable. This study is observational and not a clinical trial.