Abstract
Introduction
Poor appetite affects 15-20% of community dwelling older adults. Studies link poor appetite with frailty and sarcopenia; however, lack of longitudinal evidence exists to inform potential causality. We aimed to determine if poor appetite predicts frailty or sarcopenia-related factors in community dwelling older adults.
Methods
Secondary data analysis on adults aged >60 years recruited from, syncope, fragility fracture and comprehensive geriatric assessment clinics with 2.5 year follow up. Appetite was assessed by Simplified Nutritional Appetite Questionnaire (SNAQ); a score of <14/20 defining poor appetite. Hand grip strength (HGS) was measured using a dynamometer, low HGS was defined by European criteria (<27kg for males and <16kg for females). Frailty was measured using self-report of Fried phenotype.
Results
86 participants, mean age of 78 years, 62% female. Sixty-two (72%) were followed up, of those 9 had died.
Baseline mean SNAQ score was 15.2 (SD 8.1); 14 (16.3%) scored <14. Mean SNAQ score for the 53 participants at 2.5 year follow up was 14.9, 12 (22%) scored <14. Baseline and follow up SNAQ scores correlated moderately (Pearson’s r=0.5; P=<.001).
Fifteen (28%) individuals had low HGS at follow up, 12 had frailty (22%). Baseline SNAQ score <14 was associated with increased odds of frailty (OR 18.00; 95% CI 2.92-111.00) and low HGS (OR 7.76; 95% CI 1.62-37.30) after 2.5 years. The association of baseline SNAQ <14 with presence of frailty was robust to adjustment for age and comorbidities (OR 13.50; 95% CI 1.14-160.03), while association with low HGS was attenuated (OR 2.29; 95% CI 0.27-19.39).
Conclusion
Poor appetite is predictive of presence of frailty and low HGS after 2 years in community dwelling older adults. This suggests poor appetite as causative in the development of poor health outcomes in older people and so a key intervention target to optimise healthy ageing.