The Anorexia of Aging: Is It a Geriatric Syndrome?

Recognizing that anorexia of aging is a frequent problem found after a comprehensive assessment of frail older subjects, this issue of the Journal of the American Medical Directors Association includes a report from Di Francesco and colleagues¹ who have documented how different compositions of macronutrients affect satiety and hunger signals as well as subjective sensations after meals in healthy elderly subjects. They demonstrated that relatively large amounts of fat increase the satiety signal from Glucagon-Like Peptide 1 (GLP-1) and lower the acylated to desacylated ratio of ghrelin, consequently, decreasing hunger. This condition may lead to a reduction in calorie intake and unintended weight loss. This study, in conjunction with others, contributes significantly to our pool of knowledge about anorexia of aging, an area that remains substantially poorly studied. Nonetheless, a number of issues related to definition of secondary anorexia and possible interventions for elderly subjects with anorexia need to be addressed.