Recognizing and Treating Anorexia of AgingPosted: Sat, Jun 27, 2015By: Danielle Heard, MS, HHC Artemis in the City Blog Home
Anorexia of aging is a geriatric wasting disorder which involves the ability to compensate energy needs and satiation. A person with this disorder experiences a decrease in energy expenditure, metabolism and also muscle mass.1 Other aging issues play a role in this disorder such as declines in vision caused by cataracts, macular degeneration or other vision issues, as well as a decline in their sense of smell and also taste that can cause a decrease in the desire to eat food. Medications can also alter the taste of food and make eating less enjoyable. Some elderly people experience a decline in mucus secretions which can affect swallowing. Over a long period of time, the lowered food intake can lead to weight-loss and malnourishment. Around adult middle-age or in the 40’s, people can acquire body fat but beginning in the older adult years or 70’s, a decline in both lean body mass and also fat can occur.2 The primary physiological and pathological factors include a delay in gastric emptying which involves the gastrointestinal hormones cholecystokinin (CCK), glucagon-like peptide 1 (GLP-1) and ghrelin. CCK is associated with satiation and GLP-1 is an anorexic hormone that causes slow gastric emptying. Both hormones have been found to be increased in elderly people. Ghrelin on the other hand, which activates nitric oxide synthase, a stimulator of eating enzyme, has been found by research to be lower in malnourished elderly people. So with aging comes not only a decline in the senses which make food more enjoyable, but also changes in gastrointestinal hormones which can cause satiation and suppress hunger. This disorder is more prevalent in men and is associated with the development of sarcopenia, frailty, poor outcomes with hip fracture, institutionalization and mortality.1 Elderly people are already at an increased risk for malabsorption issues due to a decline in hydrochloric acid which affects their ability to breakdown foods for absorption. This can cause deficiencies in essential nutrients such as B12. Medications can also prevent absorption of nutrients. Various health conditions and infections can affect the body’s ability to maintain homeostasis and therefore disrupt nutrient absorption or cause loss of nutrients due to chronic diarrhea etc. Additionally, a change in eating ability can prohibit a person from consuming enough foods to maintain energy balance, or a healthy diet that is necessary to promote the growth of healthy microorganisms which are important for digestion, absorption of food as well as the formation of nutrients and prevention against disease.
FACTORS WHICH CONTRIBUTE TO ANOREXIA OF AGING:1
CRITICAL ROLE OF A CLINICAL NUTRITIONIST FOR THESE PATIENTS: These patients could benefit greatly from customized free form amino acid mixes that are based on their own individual diagnostic report of amino acid status. Because there is a decrease in appetite, it is very important that the quality of food these patients consume is both high calorie and nutrient dense. All calories are not created equal as some forms of calories cause increased inflammation and progress disease. A clinical nutritionist can help patients incorporate beneficial foods for their specific condition. As people age and chewing, swallowing and digestion becomes more difficult, there is a greater need for more cooked building foods. Because of lower hydrochloric acid, cooked foods can also reduce the risk of food borne illness which can be fatal for an elderly person.
Sources:
1) Morley J. Pathophysiology of the anorexia of aging. Clinical Nutrition and Metabolic Care. 2013 Jan;16(1):27-32. doi: 10.1097/MCO.0b013e328359efd7. http://journals.lww.com/co-clinicalnutrition/Fulltext/2013/01000/Pathoph.... Accessed May 26, 2015. Thank you very much for reading my blog and please continue to visit often. I wish you good health, happiness and love! Danielle Follow Artemis in the City!
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Email: info@artemisinthecity.com | Phone: 903-759-0172 | United States
Artemis in the City and logo and Food for the Untamed Soul are trademarks of Artemis in the City, LLC.