Anorexia and aging: Pathophysiology

Aging results in a dysregulation of the ability to regulate food intake. In general, this presents as a decrease in food intake accompanied by early satiation. The early satiation appears to be predominantly due to a decrease in adaptive relaxation of the fundus of the stomach resulting in early antral filling. Increased levels and effectiveness of cholecystokinin also play a role in the anorexia of aging. Leptin levels increase with aging in males but not in females. With regard to the central feeding drive, both the opioid and neuropeptide Y effects appear to decline with age. This physiologic anorexia of aging increases the risk for older persons to develop severe anorexia and weight loss when disease occurs. (C) Elsevier Science Inc. 1999.