Poor and loss of appetite is a common issue faced by seniors living at home, retirement communities, care homes, as well as hospital inpatients. It can lead to weight loss and nutritional deficiencies, and with these, the associated poor healthcare outcomes. This can unfortunately include increased mortality. Understanding what can lead to reduced appetite and knowing how to address this can empower seniors, their loved ones, caregivers, nurses, and other clinical staff to identify an impaired appetite. This can help with strategies being implemented to promote better appetite and increase food intake to avoid serious health complications. This article will outline some of the major causes of appetite loss, the effects, and methods to combat this problem to avoid further health complications.
What can cause loss of appetite in the elderly?
The changes that occur within the body as we age contribute to an impaired or loss of appetite. Seniors experience changes both physiological and psychological which can all contribute to disruption and changes in appetite. Physiological changes that impact or impair appetite include digestive tract issues, poor dentition, hormone level shifts, disease, chronic pain, and decrease in sense acuity. Appetite is also strongly influenced by a person’s surrounding environment and mood. Therefore, many of the psychological and social changes that can occur with ageing will influence and negatively affect appetite.
Beginning with physiological changes, digestive tract and dentition issues can be a major cause of appetite loss in seniors. For the purpose of this article, the digestive tract includes the mouth and teeth. It’s estimated that one third of people over the age of 65 years old have reduced saliva production, causing difficulties and discomfort while eating that can impair appetite. Though it is important to note that decreased saliva production is not directly linked to ageing, it is most often caused by medications. Seniors are more likely to have poor dentition. Wearing dentures and chewing difficulties are both associated with loss of appetite as poor oral hygiene and health is more common in frail older people. A declining sense of taste may also contribute to poor appetite. Gastric emptying is slower in older people, so food remains in the stomach longer prolonging satiation and reducing appetite. Constipation can cause reduced appetite and is commonly reported by older people.
An acute or chronic illness or infection can impair one’s appetite. Many chronic diseases can also suppress appetite, and these include cardiac failure, chronic obstructive pulmonary disease, renal failure, chronic liver disease, Parkinson’s disease and cancer. These conditions are more prevalent in seniors. Chronic disease can also impair appetite through impaired dexterity and recurring pain. Impaired dexterity interferes with the eating process as food takes longer to eat and may go cold, reducing the palatability of the food and thus the appetite usually stimulated during eating. Chronic pain is a common ailment amongst seniors and is associated with poor appetite due to it causing overall discomfort. More serious conditions including thyroid disorders, hepatitis or chronic liver disease, kidney failure and cancer can all be reasons for appetite loss.
Taste, smell, dexterity, and vision are all involved with the enjoyment of food. Impairments of these senses that ultimately occur with ageing can cause a reduced or lost appetite. The smell of food stimulates appetite, taste promotes the enjoyment of food and further stimulates appetite during eating. Seniors can develop an impaired sense of smell and taste which then leads to a loss of appetite. Seniors with poor vision are more likely to report poor appetite as visual impairment is increasingly common with increasing age. Being unable to see your food, surroundings or company can have a negative impact on eating and appetite.
Lastly, overall body composition and deterioration from aging can have adverse effects on appetite. Older people have lower requirements for energy which may contribute to a reduction in appetite. This will vary between individuals reflecting differences in their body composition and levels of physical activity.
Moving onto psychological factors. Appetite is strongly influenced by an individual’s environment and mood. Therefore, many of the psychological and social changes that can occur with ageing will influence appetite. Depression is known to impair appetite and is common in older people, thus a contributing factor in elderly appetite loss. Patients with dementia and delirium can have reduced appetite, but this can be a byproduct of medications for these conditions. Living and eating alone can cause reduced appetite, possibly because those who have difficulties with shopping and cooking lack support to overcome these problems and become less motivated to cook and eat. Additionally, eating alone is less pleasurable and people living alone have fewer social cues to eat.
Nausea and loss of appetite in elderly
If you or a loved one are expressing a lack of appetite due to general nausea or stomach upset, this could be a symptom of an underlying condition. A reaction to medications, stomach ulcers, an undiagnosed food sensitivity, acid reflux or a more serious undiagnosed condition could be contributing to chronic nausea leading to loss of appetite.
Natural appetite stimulant for elderly
There are a variety of things you can do to help prevent appetite loss or help it return. Using a medical supplement is a possibility however this should only be done under medical supervision once a reason for the loss of appetite has been determined.
Stimulating your appetite or your loved one’s can be accomplished by implementing a few different methods if a chemical stimulant isn’t an option. Start by enjoying a meal together or encouraging your loved one to join others for a weekly lunch or dinner where possible. It’s been shown that seniors who eat with others tend to eat more and make healthier food choices.
Remember that yours or your loved one’s tastes are changing. By making nutritious meals that are bright, colorful, and packed with vitamins and minerals, the strong natural and healthy flavors of the food will stay prevalent. However, don’t overwhelm your loved ones with large portions, this could deter them from eating altogether.
Setting a schedule for meals makes it a routine and part of yours or your loved one’s day. Breakfast, lunch, dinner, and snacks should be served at the same time throughout the day, every day of the week. Consistency will help with both psychological and physiological reasons for appetite loss.
You can also consider the loss of dexterity and how easy it is to still use regular utensils. The frustration of not being able to use a spoon, fork, or knife could make some older adults not want to eat at all. Try foods that can be eaten without utensils or using adaptive utensils. Soups, milkshakes, and smoothies are good alternatives if mouth and teeth issues are a consideration. These can be nutritious and flavorful and can be adapted to make sure vitamin, mineral and caloric needs are being met.
It is evident that there are several reasons why seniors may be suffering from appetite loss and the potential ramifications. It is important to try and identify the root cause if the issue, and know what methods can be tried in order to help someone regain their appetite.