Poor appetite predicted faster mobility loss in people in their seventies

Design

Prospective cohort (Health ABC), up to 6 years' follow-up

Population

3,073 community-dwelling US adults aged 70–79

Primary outcome

Persistent lower-extremity mobility limitation

Effect

Poor appetite: adjusted HR 1.44 (95% CI 1.2 to 1.7); 40% vs 20% by 18 months

An analysis of the Health, Aging and Body Composition study, published in the Journal of the American Geriatrics Society on 12 October, followed 3,073 community-dwelling adults aged 70 to 79 for up to six years. At baseline, 12.6% reported poor appetite.

People with poor appetite were more likely to develop persistent difficulty walking a quarter mile or climbing ten steps (64% vs 47%), and faster: 40% vs 20% by 18 months. After adjustment for chronic disease, mood, medications and sensory factors, poor appetite carried a 44% higher hazard (HR 1.44, 95% CI 1.2 to 1.7). Raised IL-6, TNF-alpha and CRP were independently associated with mobility loss, and those with both poor appetite and high inflammation declined fastest, half within a year.

This is observational, and poor appetite may be a marker of illness rather than a cause. But it is a single question that costs nothing to ask, and it identified a group in whom decline was rapid.

• Ask older patients directly whether their appetite has changed.
• Treat a report of poor appetite as a prompt to weigh the patient and review nutrition, mood, medications and oral health.
• Consider a structured nutrition and strength programme when appetite is poor, before mobility is lost.
• Look for treatable causes: depression, drug side effects, poor dentition, constipation, swallowing problems.

Why it matters

A one-line question may identify decline months before a walking test does.

Don't overread it

Observational; it does not show that improving appetite or lowering inflammation prevents mobility loss.

The statistics, in plain English

A hazard ratio of 1.44 means poor appetite was linked to about 44% faster onset of mobility limitation, after adjustment. The model accounted for death as a competing event.

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