Lack Of Appetite Causes In The Elderly – Iron-folic acid supplementation during pregnancy reduces the risk of birth defects in children younger than 2 years: a new cohort study from Nepal.

Effects of Oral Exposure Duration and Dietary Energy Content on Desire and Energy Intake in Lean Men

Lack Of Appetite Causes In The Elderly

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Associations Of The Oral Microbiota And Candida With Taste, Smell, Appetite And Undernutrition In Older Adults

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Helping Seniors Suffering From Appetite Loss

By Francesco Landi Francesco Landi Scilit Preprints.org Google Scholar View Publications * , Riccardo Calvani Riccardo Calvani Scilit Preprints.org Google Scholar View Publications , Matteo Tosato Matteo Tosato Scilit Preprints.org Google Scholar View Publications , Anna Maria Martone Anna Maria Martone Scilit. org Google Scholar View Publications , Elena Ortolani Elena Ortolani Scilit Preprints.org Google Scholar View Publications , Giulia Savera Giulia Savera Scilit Preprints.org Google Scholar View Publications , Alex Sisto Alex Sisto Scilit Preprints.org Google Scholar View Publications and Emanuele Marzetti Emanuele Marzetti Preprints .org Google Scholar View Publications

Older adults often do not consume enough food to meet their energy and nutrient needs. Anorexia of aging, characterized by decreased appetite and food intake in old age, is a major cause of malnutrition and adverse health outcomes in the aging population. This disease is very strong and is known to be a specific indicator of disease and death in different clinical areas. Although anorexia is an inevitable consequence of aging, aging often promotes its development through various mechanisms. Age-related changes in lifestyle, disease patterns, as well as social and environmental factors affect eating behaviors and nutritional status. Despite their importance, eating disorders often receive little clinical attention. Although this is the result of an “old-fashioned” approach, it should be noted that simple interventions, such as oral supplementation or dietary modification, can improve the health status and quality of life of those adult.

Anorexia of old age, defined as loss of appetite and decreased appetite in late life, is a well-known example of geriatric cancer. This term was coined because the many clinical conditions seen among the frail elderly are not easily categorized into specific diseases or “inherited” disease categories. Many of these clinical conditions are severe and are associated with a number of complications and adverse outcomes, including disability and quality of life. Anorexia nervosa of old age is associated with many diseases and effects that occur when the accumulation of health deficiencies in multiple systems combine to make the elderly more vulnerable to internal stressors. , or external.

The regulation of appetite, especially when weak, is the key to understand the pathogenesis of anorexia of old age. The food intake is controlled through strict, non-safe procedures designed to ensure that the food drive remains intact. To make it easier, the central feeding channel is blocked by peripheral signals to control food intake. The central nervous system gathers additional feedback from peripheral fat cells, specific nutrients, and circulating hormones. Multi-factorial changes in this system during aging result in the “physiologic” anorexia of aging (Figure 1).

Common Causes Of Loss Of Appetite In Older Adults

Complex mechanisms include the age-related decline of specific functions in certain brain areas, such as the hypothalamus, in response to environmental stimuli (for example, metabolic hormones, adipokines, nutrients) [ 1, 2, 3]. Although an explanation of these mechanisms is beyond the scope of this review, there are several factors that contribute to the onset of anorexia in the elderly that deserve brief mention (Figure 1).

Aroma and taste play an important role in making food and drink enjoyable. Sense of smell and taste decline with age, although at different rates. This contributes to the reduction of food consumption during old age, which also negatively affects the type of food eaten, which means that the food is less varied and the food is monotonous. The number of taste buds also decreases during aging, and the remaining buds begin to atrophy. Diseases, medications, smoking, and certain environmental factors can cause noticeable changes in the number and function of taste buds. Older people lose their saltiness and taste first. Therefore, some foods do not have the taste to satisfy the craving, because older people choose the tastier, but unhealthy food. Finally, decreased salivary secretion reduces the ability to digest foods and limits their interaction with the taste receptor cells of the tongue [ 4 , 5 ].

Ghrelin, also known as the “hunger hormone”, is the only peripheral hormone identified to stimulate hunger. It is released in a burst form by ghrelin cells embedded in the gastrointestinal mucosa and placed in the stomach. Little evidence is available for changes in ghrelin dynamics during aging. However, it appears that the increased secretion of leptin and insulin is associated with a lower sensitivity to ghrelin in older people [5, 6, 7, 8].

Similar to ghrelin, changes in cholecystokinin (CCK) activity have been observed in older adults. CCK is an example of satiety hormones, released by the proximal small intestine in response to the delivery of nutrients, mainly protein and lipids, from the antrum [ 5 , 6 , 7 , 8 ]. Some findings suggest a possible role of altered CCK mutations in the cause of anorexia of aging. Other studies have also shown an increase in the serum concentration of peptide YY (PYY) at the end of the post-meal period in older people compared to younger controls. Elevated PYY levels after a meal inhibit the desire for a second meal and prolong the fasting period. Thus, the combined actions of CCK and PYY convey important anorexigenic signals to the hypothalamus [ 5 , 6 , 7 , 8 ].

Causes Of Weight Loss In The Elderly

Leptin is an accessory hormone that has been implicated in the pathogenesis of anorexia of aging. High circulating levels of leptin are expected to play an important role in the postprandial pathway of symptoms in anorexia of aging [5, 6, 7, 8]. Finally, aging is accompanied by an increase in fasting and a decrease in postprandial plasma insulin. Insulin, the main regulator of glucose metabolism, acts as a satiety hormone. Indeed, the reduction in glucose and the increase in insulin levels seen during aging can accelerate the development of anorexia. This action of insulin is carried out by enhancing the anorexigenic signal of leptin to the hypothalamus and inhibiting ghrelin stimulation [5, 6, 7, 8].

Abnormal bowel movements may lead to early satiety and decreased compliance. In older people, it has been explained that the concentration of nitric oxide decreases at the level of the bladder, which causes the loss of gastric emptying and the faster filling of anchors. In addition, delaying gastric emptying is responsible for prolonged satiety after eating. Slow gastric emptying in older adults may be related to decreased gastric emptying and abnormal gastric emptying. Chronic gastritis with certain drugs (for example, proton-pump inhibitors) may cause hypochlorhydria, which delays gastric emptying [5, 9]. Slow gastric emptying can reduce appetite and food intake by strengthening and delaying gastric emptying, and altering the signals that satiate the small intestines.

Low-grade inflammation, a hallmark of aging, may alter the response of target brain areas to peripheral stimuli. Circulating levels of interleukin (IL) 1, IL6 and tumor necrosis factor alpha (TNF-α) are higher in older adults independent of specific and multimorbidity. These cytokines reduce food intake and, therefore, increase body weight in a number of ways, contributing to delaying gastric emptying and inhibiting the motility of the small intestines. These cytokines directly stimulate leptin mRNA expression and enhance circulating leptin levels, too [10, 11]. In addition to their effects on leptin, pro-inflammatory cytokines also stimulate the production of hypothalamic corticotropin releasing factor (CRF), a mediator of the anorexigenic effect of leptin [10, 12].

There are several risk factors associated with this disease that need to be assessed [13]. In the

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