Some medical professionals call the loss of appetite in old people the “anorexia of ageing.”
Up until a year ago, if anyone had told me I would one day need to work at maintaining or gaining weight, I would have collapsed laughing. The opposite had always been my problem and I've always loved to eat - just about anything.
Then, even after recovering from the extensive Whipple surgery 13 months ago, I wasn't hungry much of the time.
As happened to with me, serious diseases and conditions can reduce appetite in elders but it is not uncommon for a remarkably long list of other reasons too. Here are some of both kinds:
Any acute illness such as:
• Cardiac disease
• Renal failure
• Liver disease
• Parkinson's disease
• Alzheimer's disease
Other difficulties such as:
• Dental conditions or denture problems
• Reduced saliva production
• Swallowing problems
• Impaired senses of smell and taste
• Medication side effects
• Lack of energy to cook
And that's just a partial list from which, I suppose, it can be extrapolated that pretty much every old person has an appetite problem at one time or another.
The BBC website tell us that changes to appetite happen throughout our lives but become more common in old age:
“After the age of 50, we begin to suffer a gradual loss of muscle mass, at between 0.5-1% per year. This is called sarcopenia, and lessened physical activity, consuming too little protein, and menopause in women will accelerate the decline in muscle mass.”At age 60 and beyond, the BBC continues, old age and lack of hunger can lead “to unintentional weight loss and greater frailty,” and frailty is nothing to fool around with. The opening paragraph of Wikipedia's entry about it is worth quoting if just for the literary reference that amuses me:
”Frailty is a condition associated with ageing, and it has been recognized for centuries. As described by Shakespeare in As You Like It, 'the sixth age shifts into the lean and slipper’d pantaloon, with spectacles on nose and pouch on side, his youthful hose well sav’d, a world too wide, for his shrunk shank…'
“The shrunk shank is a result of loss of muscle with aging. It is also a marker of a more widespread syndrome of frailty, with associated weakness, slowing, decreased energy, lower activity, and, when severe, unintended weight loss.”
Unintended weight loss is serious business that is difficult to reverse in elders. A good-sized 2017 study about appetite in elders discovered that
”...older adults with poor appetites ate much less protein and dietary fiber. They also ate fewer solid foods, protein-rich foods, whole grains, fruits, and vegetables.
“However, people with poor appetite did eat/drink more dairy foods, fats, oils, sweets, and sodas compared to older adults who reported having very good appetites...
“The team concluded that identifying the specific food preferences of older adults with poor appetites could be helpful for learning how to help improve their appetite and the quality of their diets.”
Directly following my surgery, I was told to eat six small meals a day. I was lucky to be able to get down four before anything more that day threatened to cause me to vomit. But the nurses were terrific in helping me figure out how to increase the high daily calorie count I needed to prevent more weight loss.
Little things, they said, like adding grated cheese to scrambled eggs, switching to whole milk for cereal, eating as much of my two favorite foods – ice cream and cheese – as I wanted, also peanut butter, lots of high protein foods including red meat.
They also recommended that old folks' staple, protein drinks. I won't mention brand names because I dislike all the supermarket brands – it's like trying to drink glue to get them down.
(I go out of my way to not mention product names here and I tell you this one for information purposes: I finally discovered a brand of protein drink that actually tastes good: Odwalla. They make other kinds of drinks so if more protein is your goal, be sure to use the bottles labeled “Protein.” on the front. Of course, everyone's tastes differ.)
For the first three or four months, I wasn't allowed most vegetables and no fresh fruit with small seeds. When I said I was concerned about my health with such a high fat, high protein diet, one nurse said, “Ronni, cancer will kill you long before this diet will,” so I stopped complaining and followed instructions.
As much as the point was to keep up my weight, it was also to accommodate the radical surgery that removed quite a few pieces of my digestive system – something that would not apply to the diet of those who haven't had this kind of surgery.
Nowadays, just over a year since the surgery, I eat a normal three meals a day, am back on lots of salads, fish and fruit but I've hung on to red meat once or twice a week and I drink Odwalla (average 300 calories per 15 ounce container) several times a week.
Plus, I weigh myself every morning and keep a chart. Mostly my weight is stable but if it drops more two pounds within a week, I up the calorie intake for awhile.
And now, after nearly a year off, I am back to my workout four times a week. I've lost a lot of muscle mass and doubt I'll get much of it back, but I can work at strengthning the muscles I've got.
The point is to fight back against loss of appetite – it will go a long way to keeping us healthy and active. WebMD has a good list of strategies to help overcome lack of hunger.
What's your experience with anexoria of ageing?