92. Anorexia in older people and its treatment: a systematic review
92. Anorexia in older people and its treatment: a systematic review
Introduction: appetite loss in older people, often termed ‘Anorexia of Ageing’ (AA), is common. Recognised consequences include undernutrition, sarcopenia, frailty, and in-hospital increased length of stay, morbidity and mortality. Identification and management of AA is important to optimise care of older people.This systematic review aimed to identify interventions for AA with reported effects on appetite.
Methods: the review followed PRISMA recommendations. Study inclusion criteria were participants aged >65, appetite measurement and an intervention for AA or undernutrition. Studies on specific health cohorts e.g. cancer were excluded. Searches were performed in MEDLINE, EMBASE, and CINAHL databases. Reference lists of included articles and relevant reviews were hand-searched. Two researchers independently screened for eligibility and assessed study quality.
Results: authors screened 8729 titles, 402 abstracts and 42 full texts. 16 studies were included. The quality of included studies was largely good with one study rated poor. Settings included own home (n = 7), care home (n = 5), rehabilitation (n = 2) and acute hospital (n = 5). Three studies had combinations of settings. Appetite was measured by multiple different methods, predominantly utilising Likert scales (n = 8), or visual analogue scales (n = 5).Interventions were categorised into education (n = 2), exercise programmes (n = 2), supplementation (fortified food, oral nutritional supplement (ONS), amino acid pre-cursor) (n = 9), drug therapy (megestrol acetate, nandrolone decanoate) (n = 3) and meal adjustments (n = 3). Three studies included combinations of categories.Education had no effect on appetite. Exercise showed no effect alone or combined with education or ONS. Supplementation gave mixed results with transient appetite depression (n = 2), no effect (n = 4) or increases (n = 3). Drug therapies were mixed: megestrol acetate increased appetite (n = 2), nandrolone decanoate had no effect (n = 1). Flavour enhancement increased appetite whilst other meal adjustments (mealtime assistance, increased variety) had no effect.
Discussion: few studies have measured appetite with an intervention for AA or undernutrition. The lack of consensus on how to measure appetite and the heterogeneity of interventions and methodologies makes pooling of results unachievable and it is difficult to draw meaningful conclusions about effects. AA warrants further research as an avenue to treating undernutrition, with its importance in the trajectory to sarcopenia, frailty and ultimately poor outcomes.
i26
Cox, Natalie
dfdfbc5f-41b8-4329-a4b5-87b6e93aa09e
Ibrahim, Kinda
54f027ad-0599-4dd4-bdbf-b9307841a294
Aihie Sayer, Avan
fb4c2053-6d51-4fc1-9489-c3cb431b0ffb
Roberts, Helen
5ea688b1-ef7a-4173-9da0-26290e18f253
7 February 2019
Cox, Natalie
dfdfbc5f-41b8-4329-a4b5-87b6e93aa09e
Ibrahim, Kinda
54f027ad-0599-4dd4-bdbf-b9307841a294
Aihie Sayer, Avan
fb4c2053-6d51-4fc1-9489-c3cb431b0ffb
Roberts, Helen
5ea688b1-ef7a-4173-9da0-26290e18f253
Cox, Natalie, Ibrahim, Kinda, Aihie Sayer, Avan and Roberts, Helen
(2019)
92. Anorexia in older people and its treatment: a systematic review.
British Geriatrics Society Communications to the Autumn Meeting, , London, United Kingdom.
14 - 16 Nov 2018.
.
(doi:10.1093/ageing/afy201.01).
Record type:
Conference or Workshop Item
(Poster)
Abstract
Introduction: appetite loss in older people, often termed ‘Anorexia of Ageing’ (AA), is common. Recognised consequences include undernutrition, sarcopenia, frailty, and in-hospital increased length of stay, morbidity and mortality. Identification and management of AA is important to optimise care of older people.This systematic review aimed to identify interventions for AA with reported effects on appetite.
Methods: the review followed PRISMA recommendations. Study inclusion criteria were participants aged >65, appetite measurement and an intervention for AA or undernutrition. Studies on specific health cohorts e.g. cancer were excluded. Searches were performed in MEDLINE, EMBASE, and CINAHL databases. Reference lists of included articles and relevant reviews were hand-searched. Two researchers independently screened for eligibility and assessed study quality.
Results: authors screened 8729 titles, 402 abstracts and 42 full texts. 16 studies were included. The quality of included studies was largely good with one study rated poor. Settings included own home (n = 7), care home (n = 5), rehabilitation (n = 2) and acute hospital (n = 5). Three studies had combinations of settings. Appetite was measured by multiple different methods, predominantly utilising Likert scales (n = 8), or visual analogue scales (n = 5).Interventions were categorised into education (n = 2), exercise programmes (n = 2), supplementation (fortified food, oral nutritional supplement (ONS), amino acid pre-cursor) (n = 9), drug therapy (megestrol acetate, nandrolone decanoate) (n = 3) and meal adjustments (n = 3). Three studies included combinations of categories.Education had no effect on appetite. Exercise showed no effect alone or combined with education or ONS. Supplementation gave mixed results with transient appetite depression (n = 2), no effect (n = 4) or increases (n = 3). Drug therapies were mixed: megestrol acetate increased appetite (n = 2), nandrolone decanoate had no effect (n = 1). Flavour enhancement increased appetite whilst other meal adjustments (mealtime assistance, increased variety) had no effect.
Discussion: few studies have measured appetite with an intervention for AA or undernutrition. The lack of consensus on how to measure appetite and the heterogeneity of interventions and methodologies makes pooling of results unachievable and it is difficult to draw meaningful conclusions about effects. AA warrants further research as an avenue to treating undernutrition, with its importance in the trajectory to sarcopenia, frailty and ultimately poor outcomes.
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Published date: 7 February 2019
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British Geriatrics Society Communications to the Autumn Meeting, , London, United Kingdom, 2018-11-14 - 2018-11-16
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Local EPrints ID: 432915
URI: http://eprints.soton.ac.uk/id/eprint/432915
PURE UUID: 4b60c870-3595-4b82-956e-60923b7f25ed
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Date deposited: 01 Aug 2019 16:30
Last modified: 10 Apr 2024 02:14
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Author:
Natalie Cox
Author:
Avan Aihie Sayer
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