Poor appetite predicts worse health in community dwelling older adults

Abstract

Introduction: poor appetite affects 15–20% of community dwelling older adults. Studies link poor appetite with frailty and sarcopenia; however, lack of longitudinal evidence exists to inform potential causality. We aimed to determine if poor appetite predicts frailty or sarcopenia-related factors in community dwelling older adults.

Methods: secondary data analysis on adults aged >60 years recruited from, syncope, fragility fracture and comprehensive geriatric assessment clinics with 2.5 year follow up. Appetite was assessed by Simplified Nutritional Appetite Questionnaire (SNAQ); a score of <14/20 defining poor appetite. Hand grip strength (HGS) was measured using a dynamometer, low HGS was defined by European criteria (<27 kg for males and < 16 kg for females). Frailty was measured using self-report of Fried phenotype.

Results: 86 participants, mean age of 78 years, 62% female. Sixty-two (72%) were followed up, of those 9 had died. Baseline mean SNAQ score was 15.2 (SD 8.1); 14 (16.3%) scored <14. Mean SNAQ score for the 53 participants at 2.5 year follow up was 14.9, 12 (14%) scored <14. Baseline and follow up SNAQ scores correlated moderately (Pearson’s r = 0.5; P = <.001). Fifteen (28%) individuals had low HGS at follow up, 12 had frailty (22%). Baseline SNAQ score < 14 was associated with increased odds of frailty (OR 18.00; 95% CI 2.92–111.00) and low HGS (OR 7.76; 95% CI 1.62–37.30) after 2.5 years. The association of baseline SNAQ <14 with presence of frailty was robust to adjustment for age and comorbidities (OR 13.50; 95% CI 1.14–160.03), while association with low HGS was attenuated (OR 2.29; 95% CI 0.27–19.39).

Conclusion: poor appetite is predictive of presence of frailty and low HGS after 2.5 years in community dwelling older adults. This suggests poor appetite as causative in the development of poor health outcomes in older people and so a key intervention target to optimise healthy ageing.

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Identifiers

ORCID for Natalie Cox: orcid.org/0000-0002-4297-1206

ORCID for Stephen Lim: orcid.org/0000-0003-2496-2362

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