Global prevalence of anorexia and appetite loss among older adults: a systematic review and meta-analysis.

Background: Anorexia/appetite loss is common among older adults and may arise from underlying diseases, adverse drug effects or the physiological ageing process. This study aims to estimate the prevalence of anorexia/appetite loss in older adults with associated factors.

Design: Systematic review and meta-analysis.

Methods: A comprehensive literature search of five electronic databases was conducted on 10 November 2024. Studies were eligible if they reported the prevalence of anorexia/appetite loss in older adults using the Simplified Nutritional Appetite Questionnaire. A random-effects model was applied to calculate the overall prevalence of anorexia/appetite loss. Predefined subgroup analyses were conducted to estimate the prevalence of anorexia/appetite loss among older adults with varying characteristics.

Results: Sixty-two studies from 24 countries (n = 80 176 participants) were included. The pooled prevalence of anorexia/appetite loss was 29% (95% CI: 26%-34%). The pooled prevalence of anorexia/appetite loss varied geographically, ranging from 22% (95% CI: 17%-27%) in South America to 55% (95% CI: 51%-59%) in Africa. By setting, anorexia/appetite loss prevalence was 25% (95% CI: 21%-30%; n = 56 172) in communities, 38% (95% CI: 28%-50%; n = 471) in nursing homes and 42% (95% CI: 32%-52%; n = 2498) in hospitals. Subgroup analyses showed that female sex, lower educational level, eating alone, oral problems and depression were associated with higher rates of anorexia/appetite loss.

Conclusions: The high prevalence of anorexia/appetite loss warrants attention. Further studies should explore a broader array of sociodemographic and biopsychosocial factors to enhance understanding of anorexia/appetite loss and guide targeted interventions.