Loss of Appetite in the Elderly

“Loss of Appetite in the Elderly” was written by Pavneet Kaur dietetic intern at Oregon Health Sciences University. Reviewed/edited by Katie Dodd, MS, RDN, CSG, LD, FAND.

What is loss of appetite?

Loss of appetite is defined as the decreased desire to eat, which can be due to underlying diseases and illnesses.  

It can often be related to any underlying problem. Examples of this include aging, depression, or smoking.

So, how does the decreased desire to eat affect the older adult population?

Why does loss of appetite in the elderly happen?

There are many reasons behind the loss of appetite in the elderly. Various medical conditions, medications, or medical treatments can be a factor.

It can be due to body changes because of aging like the sense of smell and taste, a decreased need for energy, or mental health impacts like depression (1).

Elderly experience loss of appetite due to mechanical impairments such as swallowing, chewing, and inability to eat independently.

Appetite Statistics

According to studies done by the American National Health and Nutrition Examination Survey (NHANES) III, there was a reported 38% decline in energy intake for men and 27% for women between the ages of 20–29 and 70–79 years (2).

Another study found that the elderly felt less hungry than younger adults. The elderly had a lower appetite even if they had not eaten for a while (2).

Loss of Appetite in the Elderly Risks

In the elderly, loss of appetite can be associated with many risks. These include malnutrition, weight loss, deficiencies, and increased mortality (1).

Fortunately, it can be beneficial to work with a geriatric dietitian about concerns with appetite and help recover and avoid these risks!

Unintended Weight loss

Unintended weight loss is defined as the involuntary decline in total body weight over time (3). In the elderly, this can be dangerous because it increases the risk of death and disability.

It can also affect the ability to do daily activities. Doing things like getting dressed, making meals, and managing the home. The things we need to do to remain independent in the home.

Without the desire to eat, unintended weight loss is an outcome and must be treated.

Quality of Life

In the elderly, losing weight can also mean losing muscle.

This can cause the normal functioning of daily activities harder to do, and more need for help from a caregiver or family member. As a result, the elderly may feel as though they lose a sense of independence.

Loss of Appetite Causes

So, what are some of the causes for loss of appetite in the elderly?

The body changes associated with aging, are associated with eating, medical conditions, medical treatments, as well as a combination of these factors.

Age/Taste

As we age, impairments with our senses such as taste, smell, and vision, can impact our appetite.

The taste makes our food enjoyable, smell stimulates our appetite, and vision makes our food look appealing (1).

Changes in taste and smell, including changes caused by certain medications, can be common in the elderly. As such, this can be a direct cause of a decreased desire for food (1).

Thankfully, there are many solutions available for these declines in senses that we will cover later in this article!

Dental Factors

The use of dentures may become a big factor in the eating ability of older adults. Chewing complications or difficulty swallowing (dysphagia) can cause a decline in appetite.

Medical Conditions

Various medical conditions like cancer, HIV/AIDS, Alzheimer’s disease, dementia, depression, or acute illnesses can contribute to taste and smell loss or change.

These illnesses can impact or change an older person’s relationship with food and their desire to eat.

Medical treatments and medications

Often, medical treatments or medications associated with these conditions can cause chemical changes in the body that impact taste, smell, and appetite.

Tips to Improve Appetite in the Elderly

So, now that we have covered some of the various causes contributing to the loss of appetite in the elderly, let’s talk about some solutions!

Frequent Meals

Having frequent meals throughout the day is a great way to cope with the loss of appetite. Eating small meals and snacks will help to stimulate hunger throughout the day and increase appetite!

Not eating enough can put you at risk for vitamin and mineral deficiency. So, having about 6 small meals per day is a great place to start increasing your frequency of food!

Water in-between meals

Now, have you ever noticed that when you drink water in between bites of your food, you start to feel full? This can end up making you eat less and feel full faster because of the water content.

This might not be such a good thing if you are experiencing a loss of appetite because water has no calories.

This means you are getting full from no calorie intake and it can cause you to eat less of your nutritious meal-which is full of calories.

Drinking after your meals or in-between them can be more effective in helping you to eat more of your food. Try this method and it will help you to consume more of your nutritious food when you have an appetite!

Enhancing Flavor and Appearance

Enhancing the flavor and appearance of your food can be a great way to stimulate your appetite. As I said before, your senses like taste, smell, and vision all have an impact on your satisfaction with food and desire to eat!

So how do you make your favorite foods taste even better?! Herbs and spices can add tremendous flavor.

Changing up your cooking routine and adding different herbs and spices can really take it to the next level. Take one of your favorite meals, change up the flavor profiles, and it could taste like a brand-new meal!

Following recipes closely can also help to intensify your food. They tell you the exact amount of measurements for your flavor contents of spices and herbs and following these will result in a more rewarding experience!

Enhancing the look of your food can also be an encouraging way for you to want to eat your food. Using new plates or different ones, a neat food presentation, or adding garnishes can help your food look even more appealing!

Cooking

Pre-made meals are great for saving time and add to convenience! However, cooking your foods at home can really help to increase your appetite.

The flavorsome aromas you get as you make each part of your meal will help to stimulate your hunger and make you look forward to eating it! It’s also important to provide food in a variety of textures so it can be easier for elderly people to chew.

High Calorie Foods

Food remains in the stomach longer, which makes you feel full for a longer duration and this reduces appetite (1).

One way to combat this is finding nutrient dense foods that are also high calorie. High calorie powders can also be mixed into foods. This will help you stay full, satisfied and is full of nutrients!

Eating with Others

Food is all about connection, tradition, and bonding. Therefore, eating with others can help you have more of an enjoyable time. As you are surrounded by people who are doing the same thing, this is a great technique to deal with the loss of appetite and weight loss.

Receiving encouragement from the people around you or simply seeing them enjoy the same meal as you can help make your experience more rewarding.

Next Steps

Now that you have gotten some background about why a loss of appetite can happen in the elderly, and some solutions to cope with it, what are the next steps?

See a Medical Provider

Losing weight at an older age comes with risks as we talked about. Therefore, contacting a medical provider or a geriatric dietitian can be important in your journey.

They can help to evaluate your specific problems, create meal plans for you, monitor your loss of appetite and weight, and help you with any other related problems.

Make mealtimes awesome   

Remember, you can always jazz up your meals with the flavor profile and appearance but you can also work on little tricks to make your mealtimes awesome.

Eating with your family or friends, lighting candles on your dinner table, playing music in the background, or other tricks can help to make the environment you eat in even more enjoyable.

Involve older adults in planning

If you are a caregiver for an older adult, make sure you involve them in your process of buying and preparing their foods.

It’s important to ask them what they like, what they want, and if they would be open to trying new foods.

Involving them in the process of creating a menu can help them get excited about eating!

Loss of Appetite in the Elderly Conclusion

Losing your desire to eat can take a toll and impact your quality of life. The risks that come with losing your appetite can also add further complications. But remember, there are so many ways and tips to help you get your desire back! Here are some links that may help:

References

  1. Pilgrim, Anna L, et al. “An Overview of Appetite Decline in Older People.” Nursing Older People, vol. 27, no. 5, 2015, pp. 29–35., doi:10.7748/nop.27.5.29.e697
  2. Giezenaar, Caroline, et al. “Ageing Is Associated with Decreases in Appetite and Energy Intake—A Meta-Analysis in Healthy Adults.” Nutrients, vol. 8, no. 1, 2016, p. 28., doi:10.3390/nu8010028.
  3. Alibhai, S. M. (2005). An approach to the management of unintentional weight loss in elderly people. Canadian Medical Association Journal, 172(6), 773-780. doi:10.1503/cmaj.1031527

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