EATING DISORDERS IN LATER LIFE - A REVIEW

Eating disorders are considered to primarily afflict young people to the exclusion of the elderly. However, reports in the recent literature have challenged this view, with both anorexia nervosa and bulimia nervosa being described in later life. Although in some reports the diagnosis appears doubtful, the majority appear to demonstrate the classical features of these conditions. They have many similarities with younger sufferers, including clinical features, maladaptive psychological functioning, and a close relationship with other psychiatric conditions, such as depression and obsessive-compulsive disorder. The aetiology of eating disorders in the elderly appears to be multifactorial, involving both vulnerability factors and precipitating factors. The outcome is often poor, although behavioural modification leads to a significant benefit in most cases. It is probable that these disorders are poorly recognized in the elderly, possibly because of a lack of suspicion and because the symptoms are often assumed to be secondary to an alternative physical or psychiatric cause.