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Social Isolation and Loneliness: Overlooked Therapeutic Targets of Anorexia of Aging?
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Edité par CCSD ; Springer Verlag (Germany) -
International audience. Anorexia of aging, need for therapeutic targets
A norexia of aging (AA) is defined as the reduction in appetite and food intake at older age (1). It affects over 20% of older adults, with higher figures among those living in nursing homes and hospitalized (2). Overt reductions in food intake may lead to derangements in the balance between quantity and quality of energy and nutrients ingested, and physiological demands, making AA a core prodrome of malnutrition (3). Consequently, AA results in the development of detrimental outcomes at older age such immune dysfunction, weight loss, frailty, cognitive decline, sarcopenia and increased morbidity and mortality (4-6). Given its impactful consequences, AA has been included among the "geriatrics giants" (7).Unfortunately, AA is underrecognized in clinical settings and is usually considered in the scope of malnutrition, which limits the identification of its contributors and the design of timely preventive interventions (8). At present, there is an increasing interest in unveiling therapeutic targets to promote appetite at old age as a mean to intervene on AA before overt malnutrition ensues.
So far, available research in this regard has been mostly focused on the biological substrates of AA. Hunger and satiation sensations are altered in late life due to changes in peripheral and central appetite signaling, altered gut dynamics, poor oral health, sensory function impairment secondary to biological aging, the presence of chronic diseases, depression, pain and medications (9). However, despite often overlooked, potentially modifiable social issues such as social isolation and loneliness are growingly being uncovered as further contributors to the reduction in appetite and food intake with aging (10) (Figure 1).
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