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Editorial| Volume 11, ISSUE 4, P225-228, May 2010

Anorexia, Weight Loss, and Frailty

  • John E. Morley
    Correspondence
    Address correspondence to John E. Morley, MB, BCh, Division of Geriatric Medicine, Saint Louis University School of Medicine, 1402 S. Grand Boulevard, M238, St Louis, MO 63104.
    Affiliations
    Division of Geriatric Medicine, Saint Louis University School of Medicine, and GRECC, VA Medical Center, St. Louis, MO
    Search for articles by this author
      In this issue of the Journal, Landi et al
      • Landi F.
      • Russo A.
      • Liperoti
      • et al.
      Anorexia, physical function and incident disability among frail elderly population: Results from the ilSIRENTE study.
      have found that nearly 20% of old-old persons have anorexia. More importantly, they found that persons with anorexia were more likely to be frail and to go on to develop disability. This is in concert with a previous study that found that persons with anorexia have an increased rate of mortality.
      • Cornali C.
      • Franzoni S.
      • Frisoni G.B.
      • Trabucchi M.
      Anorexia is an independent predictor of mortality.
      A simple scale that identifies persons at risk for anorexia, the Simplified Nutrition Assessment Scale (SNAQ), is highly predictive of weight loss
      • Wilson M.M.
      • Thomas D.R.
      • Rubenstein L.Z.
      • et al.
      Appetite assessment: Simple appetite questionnaire predicts weight loss in community-dwelling adults and nursing home residents.
      (Table 1). Weight loss is a core component of frailty
      • Abellan van Kan G.
      • Rolland Y.M.
      • Morley J.E.
      • Vellas B.
      Frailty: Toward a clinical definition.
      • Abellan van Kan G.
      • Rolland Y.
      • Bergman H.
      • et al.
      The I.A.N.A. Task Force on frailty assessment of older people in clinical practice.
      • Morley J.E.
      Developing novel therapeutic approaches to frailty.
      • Rockwood K.
      • Abeysundera M.J.
      • Mitnitski A.
      How should we grade frailty in nursing home patients?.
      and is highly predictive of future mortality.
      • Morley J.E.
      Weight loss in older persons: New therapeutic approaches.
      • Bales C.W.
      • Buhr G.
      Is obesity bad for older persons? A systematic review of the pros and cons of weight reduction in later life.
      Table 1The Simplified Nutrition Assessment Questionnaire (SNAQ)
      • 1.
        My appetite is
        • A.
          very poor
        • B.
          poor
        • C.
          average
        • D.
          good
        • E.
          very good
      • 2.
        When I eat
        • A.
          I feel full after eating only a few mouthfuls
        • B.
          I feel full after eating about a third of a meal
        • C.
          I feel full after eating over half a meal
        • D.
          I feel full after eating most of the meal
        • E.
          I hardly ever feel full
      • 3.
        Food tastes
        • A.
          very bad
        • B.
          bad
        • C.
          average
        • D.
          good
        • E.
          very good
      • 4.
        Normally I eat
        • A.
          less than 1 meal a day
        • B.
          1 meal a day
        • C.
          3 meals a day
        • D.
          3 meals a day
        • E.
          more than 3 meals a day
      Instructions: Complete the questionnaire by circling the correct answers and then tally the results based on the following numerical scale: A = 1, B = 2, C = 3, D = 4, E = 5.
      Scoring: If the mini-SNAQ is less than 14, there is a significant risk of weight loss.
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