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Poor appetite is associated with six month mortality in hospitalised older men and women

Poor appetite is associated with six month mortality in hospitalised older men and women
Poor appetite is associated with six month mortality in hospitalised older men and women

Objectives: Appetite loss is common in hospitalised older individuals but not routinely assessed. Poor appetite in hospital has previously been identified as predictive of greater mortality in the six months following discharge in a single study of female patients. The present study aimed to assess this association in a larger sample including both hospitalised men and women. Design: Longitudinal observational study with six month follow up. Setting: Acute hospital wards in a single large hospital in England. Participants: Older inpatients aged over 70 years. Measurements: Appetite was assessed using the Simplified Nutritional Appetite Questionnaire (SNAQ) during hospital stay. Deaths during six month follow-up period were recorded. Association between SNAQ score during hospital admission and death 6 months post-discharge was assessed using binary logistic regression in unadjusted and adjusted analysis. Results: 296 participants (43% female, mean age 83 years (SD 6.9)) were included in this study. Prevalence of poor appetite (SNAQ score <14) was 41%. In unadjusted analysis a SNAQ score of <14 was associated with a 2.47 increase in odds of mortality at six months (OR 2.47 (95% CI 1.27,4.82)). This association remained after adjusting for number of comorbidities (Charlson index), length of stay and gender (OR 2.62 (95% CI 1.30, 5.27)). In unadjusted continuous analysis, every one point decrease in SNAQ score led to a 1.20 fold increase in odds of mortality at six months (OR 1.20 (95% CI 1.06–1.36)). This association remained in adjusted analysis (OR 1.22 (95% CI 1.07–1.39)). Conclusion: Poor appetite is common in hospitalised older people. We have confirmed the association, previously reported in older women, between poor appetite during hospital stay and greater mortality at six months post-discharge but in a larger study including older men and women. Further research is needed to understand the mechanisms of poor appetite, which lead to increased mortality.

Appetite, hospitalised, mortality, nutrition, older people
1279-7707
1107-1110
Cox, Natalie Jayne
b59c2eb7-cfb2-4b2d-88cf-314240ddc557
Lim, Stephen
dd2bfbd7-7f74-4365-b77e-9989f6408ddc
Howson, Fiona FA
2578d848-4a23-4572-9770-584982a71e08
Moyses, Helen
56434d9c-870f-4539-a66a-c791add44f67
Ibrahim, Kinda
54f027ad-0599-4dd4-bdbf-b9307841a294
Sayer, A.A.
f4c60d4a-ae9c-4633-890f-598a717a61d4
Roberts, Helen
5ea688b1-ef7a-4173-9da0-26290e18f253
Robinson, S.M.
d2990871-44a1-48ab-b114-599753849c2b
Cox, Natalie Jayne
b59c2eb7-cfb2-4b2d-88cf-314240ddc557
Lim, Stephen
dd2bfbd7-7f74-4365-b77e-9989f6408ddc
Howson, Fiona FA
2578d848-4a23-4572-9770-584982a71e08
Moyses, Helen
56434d9c-870f-4539-a66a-c791add44f67
Ibrahim, Kinda
54f027ad-0599-4dd4-bdbf-b9307841a294
Sayer, A.A.
f4c60d4a-ae9c-4633-890f-598a717a61d4
Roberts, Helen
5ea688b1-ef7a-4173-9da0-26290e18f253
Robinson, S.M.
d2990871-44a1-48ab-b114-599753849c2b

Cox, Natalie Jayne, Lim, Stephen, Howson, Fiona FA, Moyses, Helen, Ibrahim, Kinda, Sayer, A.A., Roberts, Helen and Robinson, S.M. (2020) Poor appetite is associated with six month mortality in hospitalised older men and women. The Journal of Nutrition, Health & Aging, 24 (10), 1107-1110. (doi:10.1007/s12603-020-1442-0).

Record type: Article

Abstract

Objectives: Appetite loss is common in hospitalised older individuals but not routinely assessed. Poor appetite in hospital has previously been identified as predictive of greater mortality in the six months following discharge in a single study of female patients. The present study aimed to assess this association in a larger sample including both hospitalised men and women. Design: Longitudinal observational study with six month follow up. Setting: Acute hospital wards in a single large hospital in England. Participants: Older inpatients aged over 70 years. Measurements: Appetite was assessed using the Simplified Nutritional Appetite Questionnaire (SNAQ) during hospital stay. Deaths during six month follow-up period were recorded. Association between SNAQ score during hospital admission and death 6 months post-discharge was assessed using binary logistic regression in unadjusted and adjusted analysis. Results: 296 participants (43% female, mean age 83 years (SD 6.9)) were included in this study. Prevalence of poor appetite (SNAQ score <14) was 41%. In unadjusted analysis a SNAQ score of <14 was associated with a 2.47 increase in odds of mortality at six months (OR 2.47 (95% CI 1.27,4.82)). This association remained after adjusting for number of comorbidities (Charlson index), length of stay and gender (OR 2.62 (95% CI 1.30, 5.27)). In unadjusted continuous analysis, every one point decrease in SNAQ score led to a 1.20 fold increase in odds of mortality at six months (OR 1.20 (95% CI 1.06–1.36)). This association remained in adjusted analysis (OR 1.22 (95% CI 1.07–1.39)). Conclusion: Poor appetite is common in hospitalised older people. We have confirmed the association, previously reported in older women, between poor appetite during hospital stay and greater mortality at six months post-discharge but in a larger study including older men and women. Further research is needed to understand the mechanisms of poor appetite, which lead to increased mortality.

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Accepted/In Press date: 1 June 2020
e-pub ahead of print date: 13 July 2020
Published date: December 2020
Keywords: Appetite, hospitalised, mortality, nutrition, older people

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Local EPrints ID: 441270
URI: http://eprints.soton.ac.uk/id/eprint/441270
ISSN: 1279-7707
PURE UUID: c3525ebf-a3b4-4919-99bc-a2ea0369d37f
ORCID for Natalie Jayne Cox: ORCID iD orcid.org/0000-0002-4297-1206
ORCID for Stephen Lim: ORCID iD orcid.org/0000-0003-2496-2362
ORCID for Kinda Ibrahim: ORCID iD orcid.org/0000-0001-5709-3867
ORCID for Helen Roberts: ORCID iD orcid.org/0000-0002-5291-1880

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Date deposited: 15 Jul 2020 16:30
Last modified: 28 Apr 2022 05:33

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Contributors

Author: Natalie Jayne Cox ORCID iD
Author: Stephen Lim ORCID iD
Author: Fiona FA Howson
Author: Helen Moyses
Author: Kinda Ibrahim ORCID iD
Author: A.A. Sayer
Author: Helen Roberts ORCID iD
Author: S.M. Robinson

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