Determining whether or not end-of-life care is necessary for frail older adults with anorexia without underlying disease is often difficult. A study was conducted to ascertain the cause of anorexia, and the determinant of the cause and recovery from anorexia.

Patients with anorexia without an underlying disease, aged ≥65 years, and visiting the emergency department of a tertiary care center between 2016 and 2017 were included in the analysis. Retrospective chart reviews were conducted. Investigators outlined patient characteristics at hospital visit, the cause of anorexia, and diagnostic modalities. The diagnosis-providing rate, recovery rate, and the association between them were assessed.

In all, 83 patients (mean age 82.3 years; 50.6% male) were evaluated. In 81% of the patients, the causes of anorexia were identified, including 22% with infection, 16% with benign gastrointestinal diseases, and 8% with cardiovascular diseases. In about 19% of the patients, the causes of anorexia could not be identified. Plain computed tomography contributed most to diagnosis, followed by blood tests. About 78% patients recovered. Only 73% of patients with a definite cause recovered and all patients with an unknown cause recovered.

It was concluded that older adults with anorexia are not always at the end of life. Efforts should be made to identify the cause.

Source: Maki N, Nakatani E, Ojima T, et al. The cause of anorexia and proportion of its recovery in older adults without underlying disease: Results of a retrospective study. PLoS One. 2019 Oct 24;14(10):e0224354.