Declined appetite is a common problem for older adults, putting them at risk for weight loss and malnutrition. This article will explain tricks to stimulate appetite in the elderly.
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Reasons for Decreased Intake
Appetite can decline as a part of aging, which has been coined “anorexia of aging.” This impacts 15%-30% of older adults (1). Multiple factors contribute to this decline:
- Medication affects
- Impaired dentition
- Poor oral health
- Dysphagia: swallowing difficulty
- Decreased sense of taste
- Slow stomach emptying
- Constipation
- Hormonal changes
- Chronic diseases
- Acute illness
- Pain
- Difficulty self feeding
- Poor vision
- Decreased physical activity
- Depression
- Social isolation
- Cognitive impairment
Consequences of Poor Appetite
Poor appetite can lead to unintentional weight loss and nutritional inadequacy. This can lead to other health declines (2, 3).
- Frailty
- Increased risk for falls
- Impaired skin integrity
- Increased hospital stays
- Osteomalacia: softening of the bone
- Osteoporosis: weak/brittle bones
- Fractures
- Weakness
- Increased mortality
- Delayed wound healing
- Declined immunity
- Poor quality of life
- Nutrient deficiencies
- Malnutrition
- Sarcopenia: age related involuntary muscle loss
- Anemia
Tricks to Stimulate Appetite in the Elderly
When possible, the root cause of declined appetite should be treated to improve appetite. This is not always achievable so appetite stimulating strategies may be helpful to improve appetite or at least increase nutritional intake.
Medication Review
Many medications have nutrition related side effects, such as altering taste, contributing to constipation, decreasing appetite, etc.
While medications are frequently necessary, it is important to have these reviewed by your medical team routeinly to ensure necessity.
There may come a point where risks outweigh potential medication benefits. However, never attempt to discontinue or adjust medications without the guidance of your health professionals.
Treat Acute & Chronic Conditions
Decreased appetite may be a symptom of acute illness and chronic disease. Proper management of disease can decrease nutritional impact.
Treating constipation, controlling pain, managing blood sugars, addressing mood issues, etc can reduce the likelihood of poor appetite.
Maintain Oral Health
Poor dentition can impact chewing ability and therefore may limit food choices. Dentures also may diminish ability to taste foods as well. Poor oral health can impact quality of life (4).
Having access and necessary assistance for routine oral care and dental visits can decrease barriers of poor oral intake. Food can be more appealing when able to chew with ease.
Mechanically Altered Diets
Dysphagia (swallowing difficulties) may be responsible for declined appetite and intake.
If symptoms are present (i.e. coughing, choking, runny nose, watery eyes, spitting out foods, holding foods) an altered diet may be appropriate.
Speech Language Pathologists (SLP) can diagnose and treat dysphagia with speech therapy. Pureed or ground foods, or even thicken liquids may be necessary.
It doesn’t have to be difficult to alter the texture of foods. Get my favorite blender/processor bundle right from Amazon. This will work for all your grinding and pureeing needs.
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Providing easy to chew and swallow foods during dysphagia can promote appetite and intake in the elderly. Avoiding especially hard to swallow foods may be necessary as well.
Focus on Flavor
Taste diminishes with age and medications can contribute to altered taste. Enhancing the flavor of meals can stimulate appetite.
Add extra herbs, salt, pepper, sugar, butter, cheese, gravy, and sauces for additional flavoring. When foods actually have taste the elderly will be more likely to eat them.
Stimulate Sense of Smell
The sense of smell can be declined in the elderly, however can still be used to stimulate appetite. Having the smell of food around prior to meal times may stimulate hunger.
Social Meal Environment
Isolated older adults tend to eat less and may eat up to 50% more with company (5). Encouraging meals in a dining room with others can help promote intake.
Increased socialization at meal times and seeing others eating can help stimulate eating. Company can also provide encouragement with meals as well.
Meal Ambiance
Visual impairments are common in the elderly. Dementia can also cause visual deficits. Ensuring adequate lighting for meals can promote improved appetite and intake.
Try providing foods on contrasting colored plates. Serving meals family style can also boost appetite.
Portion Sizes
Some older adults may be overwhelmed by large portion sizes. Providing smaller portions may decrease overwhelm and improve appetite.
Providing nutrient dense foods at meals and snacks throughout the day can incorporate more nutrients as well.
Accessibility
For community dwelling older adults, having access to food may be an issue. The ability to cook may be limited or nonexistent.
Utilizing mobile meals and having easy to prepare foods available, such as freezer meals, can decrease this barrier.
Keep snacks and fluids visible to avoid food being out of sight, out of mind. Shop Amazon for all your snack storage needs. Keeping foods out on display can increase intake.
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Self feeding may also be impaired. Ensuring foods are within reach, appropriate condiments applied, and necessary assistance are provided can help appetite and intake.
Encourage Activity
Energy consumption decreases with age with a decline in activity level. Physical barriers may factor into decreased physical activity.
Encourage medically appropriate activities, physically and otherwise, to stimulate appetite.
Appetite Stimulating Medications
There are medications available that promote increased appetite, however are contraindicated in the elderly due to significant side effects.
Marinol
Marinol (Dronabinol) is prescribed to treat nausea, vomiting, and poor appetite, but is not without side effects.
Megace
Megace (Megestrol) is used to treat poor appetite, malnutrition, and weight loss. It can have serious side effects especially in the elderly.
Remeron
Remeron (Mirtazapine) is an antidepressant that is used at times to increase appetite in the elderly.
Final Thoughts
Poor appetite is a common occurrence in seniors for a variety of reasons. Treating medical conditions, keeping food accessible, and stimulating senses are all tricks to stimulate appetite in the elderly.
Sometimes this declined appetite does progress to a point where these strategies are no longer effective. Nutritional support via tube and advanced directives may come into play at that point.
