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Nutrients 2019, 11(1), 144; https://doi.org/10.3390/nu11010144

Assessment and Treatment of the Anorexia of Aging: A Systematic Review

1
Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
2
NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
3
NIHR Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) Wessex, University of Southampton, Southampton SO16 7NP, UK
4
AGE Research Group, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne NE4 5PL, UK
5
NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University, Newcastle upon Tyne NE4 5PL, UK
6
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton SO16 6YD, UK
*
Author to whom correspondence should be addressed.
Received: 7 December 2018 / Revised: 4 January 2019 / Accepted: 7 January 2019 / Published: 11 January 2019
(This article belongs to the Special Issue Older Individuals' Nutrition)
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PDF [1210 KB, uploaded 16 January 2019]
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Abstract

(1) Background: Appetite loss in older people, the ‘Anorexia of Aging’ (AA), is common, associated with under-nutrition, sarcopenia, and frailty and yet receives little attention. This review had two aims: describe interventions for AA and their effectiveness, and identify the methods of appetite assessment. (2) Methods: Study inclusion: participants aged ≥65, intervention for AA, and appetite assessment, any design, and comparator. Exclusion: studies on specific health cohorts. Searches in four databases with hand searching of references and citing works. Two researchers independently assessed eligibility and quality. (3) Results: Authors screened 8729 titles, 46 full texts. Eighteen articles were included describing nine intervention types: education (n = 1), exercise (n = 1), flavor enhancement (n = 2), increased meal variety (n = 1), mealtime assistance (n = 1), fortified food (n = 1), oral nutritional supplement (ONS) (n = 8), amino acids (n = 1), and medication (n = 2). Three studies evaluated combinations: education + exercise, ONS + exercise, and ONS + medication. Five intervention types exhibited favorable effects on appetite but in single datasets or not replicated. Appetite was assessed predominantly by Likert (n = 9), or visual analogue scales (n = 7). (4) Conclusions: A variety of interventions and methods of appetite assessments were used. There was a lack of clarity about whether AA or undernutrition was the intervention target. AA is important for future research but needs standardized assessment so that effectiveness of a range of interventions can be fully explored. View Full-Text
Keywords: appetite; anorexia; treatment; assessment; older people; frailty; nutrition; systematic review appetite; anorexia; treatment; assessment; older people; frailty; nutrition; systematic review
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Cox, N.J.; Ibrahim, K.; Sayer, A.A.; Robinson, S.M.; Roberts, H.C. Assessment and Treatment of the Anorexia of Aging: A Systematic Review. Nutrients 2019, 11, 144.

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