It is not uncommon that as people age, especially older adults, they experience a decrease in their appetite. The term “anorexia of ageing” was coined in 1988 by John Morley and is used to describe this decline and it is estimated that between 15% and 30% of older people have decreased appetite. Higher rates of anorexia of aging occur in women, nursing home residents, older adults who are hospitalized and increasing age.
The reduction of food intake negatively affects nutrition intake which increase the risk of further weight loss and nutritional deficiencies. “Nutritional deficiencies and weight loss have serious consequences for older people including: Frailty; falls; decreased wound healing; Osteoporosis; hip fracture and immune issues.” In addition, once an older person experiences weight loss due to decreased appetite, they can often find it difficult to regain the weight that has been lost.
The Simplified Nutritional Appetite Questionnaire (SNAQ) was developed to predict >5% weight loss over six months in community dwelling older people and has four simple questions. Patients identified as having poor appetite using this screening tool will need further investigation to identify the cause.
The Simplified Nutritional Appetite Questionnaire
My appetite is
- very poor
- very good
When I eat
- I feel full after only a few mouthfuls
- I feel full after eating a third of a meal
- I feel full after eating half a meal
- I feel full after eating most of a meal
- I hardly ever feel full
- very bad
- very good
Normally I eat
- less than one meal a day
- one meal a day
- two meals a day
- three meals a day
- four or more meals a day
Ask the subject to complete the questionnaire by circling the correct answers and then tally the results based upon the following numerical scale: a = 1, b = 2, c = 3, d = 4, e = 5. The sum of the scores for the individual items constitutes the SNAQ score.
SNAQ score < 14 indicates significant risk of at least 5% weight loss within six months in community dwelling people aged > 60 years.