Appetite Loss and Malnutrition in Older Adults: An Updated Narrative Review of Prevalence, Mechanisms, and Clinical Implications

Vollständiger Abstract

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Introduction: Older adults face multiple challenges in meeting their daily energy, protein, and fluid requirements. These challenges adversely affect metabolic function, gastrointestinal health, muscle mass, and sensory perception. Malnutrition and appetite loss remain highly prevalent despite increasing clinical recognition and are often underdiagnosed in clinical practice. This narrative review aims to understand the prevalence of appetite loss and malnutrition in older adults and their combined effects on dietary intake, nutritional status, and body composition. It also addresses methodological considerations and highlights evidence-based strategies for diagnosis, management, and prevention. Methodology: A structured literature search was conducted across major scholarly databases to identify related studies published between 2015 and 2025. Results: Malnutrition prevalence ranged from 3% to 36%, while poor appetite affected 8% to 30% of older adults across different settings. A bidirectional cycle was observed. Appetite loss contributes to inadequate calorie and protein intake, micronutrient deficiencies, and weight loss. Malnutrition further exacerbates appetite reduction by inducing inflammation, sensory impairment, muscle wasting, adverse medical outcomes, and social factors. Both disorders were associated with reduced mobility, sarcopenia, cognitive decline, extended hospital stays, increased rehabilitation needs, and higher mortality. Multiple studies also identified “hidden malnutrition” in older adults with normal or high BMI without considering the malnutrition level. Discussion: The findings highlight the bidirectional relationship between appetite loss and malnutrition. They also reveal the limited incorporation of appetite assessment into routine clinical practice and significant gaps in current screening approaches. Conclusion: Identifying health problems and tailoring appropriate nutritional interventions in older adults, such as protein modification and a tailored diet plan, will provide effective appetite screening and nutrition support. Evidence indicated a close interconnected relationship between malnutrition and appetite loss. Addressing these concerns will support healthier aging.