A Look at Loss of Appetite in Older Adults

Our desire to eat is a basic instinct. But it's known that as many as one in three people lose their appetite as they age, especially women and those living in personal care homes. Read on for tips to help your aging loved one regain their appetite and remain healthy.

The basics

Our digestive, endocrine, and nervous systems communicate through hormonal signals to fulfill our basic instinct to eat. These intricate signals initiate, monitor, and turn off our interest in food. Increasing age alters the number of hormones produced and the body’s responsiveness to them. We remain unaware of such subtle changes until weight loss is evident. A lack of appetite is called anorexia.

Homeostasis is the body’s attempt to maintain a balance between what we consume and the energy we burn. The components that drive the amount we take in are:

• Hunger – the signal that the body needs fuel.
• Satiation – the signal that the body is full.
• Satiety – the satisfaction that lasts between meals.
• Pleasure – also known as hedonism.

These states respond to changes in the body as we grow older. Our relationship with food is vulnerable to biochemical, emotional, and environmental alterations throughout our life span. Examples of these shifts are developmental growth, amount of physical activity, diet adjustments, and the presence of disease.

Causes of decreased appetite

Psychosocial changes

Loneliness and depression are top reasons that appetite declines. The older we get, the more likely we are to lose people or become isolated. Depression is not uncommon when these transitions occur.

Financial challenges

Depending on one’s retirement income, the price of groceries and eating out can be burdensome. A poll by the University of Michigan finds that 37% of adults aged 50 to 80 say rising food costs are negatively affecting their ability to eat well. Having someone else prepare meals isn’t available to many, and paying for meal delivery is often cost-prohibitive. Older adults may acclimate to eating less based on what is affordable.

Environmental factors

Where we live often determines our access to food as well as our ability to move and socialize. Appetite is often stimulated by physical activity and social interaction. If we are alone or surrounded by unhealthy or undesirable conditions, our motivation to eat often lessens.

Physical factors

As stated earlier, there is evidence that the aging body responds differently to hunger cues. With age, saliva production declines, affecting how food tastes and is broken down.

Many medical conditions cause either a loss of appetite, the mechanical inability to eat well, or may even accelerate the body’s metabolism so that it is difficult to maintain weight. Examples include:

Other contributing factors

Medications are known to produce unpleasant side effects that dampen the appetite of elders. Exploring this issue is beyond the scope of this article but should be discussed with a person’s medical provider or pharmacist.

Symptoms are physical responses to a condition, illness, injury, or drug. Symptoms that often result in anorexia include:

• Pain
• Nausea and vomiting
• Bloating and constipation
• Reduced senses of taste, smell, and sight

Resulting problems

A host of health problems like weakness and fatigue may result in elders with poor appetites. Extended nutritional deficiencies from inadequate intake can lead to reduced muscle and bone mass as well as blood disorders like anemia. Unintentional weight loss contributes to frailty in older adults. Frailty is not synonymous with maturity, but rather is a syndrome associated with a higher risk of disability or death.

Tips for improvement

Psychosocial

Whom we eat with matters, as it affects our experience with food. Eating with others is shown to improve appetite, especially in elders. Invite someone to dinner! Check with local churches and senior centers to see if they are serving meals at a community place. Often there are options for transportation assistance.

Financial

Programs that address food insecurity are available in most communities. Starting with local churches or your area council on aging is a good idea. National programs such as Meals on Wheels and Supplemental Nutrition Assistance Program (SNAP) are worth investigating. Some Medicare Advantage plans offer frozen meal delivery.

Environmental

If where you live is a barrier to eating adequately, ask for help. Health care providers, family, and friends may not be aware and can connect you with resources. Difficulty with appliances or home cleanliness can be addressed with the landlord. If more assistance is needed, try your local council on aging, department of social services, or legal aid.

Physical

Your primary care provider is the place to start with any changes in appetite. Investigating anorexia and any unintentional weight loss are vital to prevent the progression of any underlying illness. Often, evaluating dietary needs and nutritional preferences can be done by a registered dietician. A speech therapist can evaluate swallowing issues. Your health care team will know what to do.