Division of Geriatric Medicine, Saint Louis, Missouri 63104, USA.
Drugs Aging. 2009;26(7):557-70. doi: 10.2165/11316360-000000000-00000.
The loss of appetite is termed 'anorexia'. Dramatic and poorly understood alterations occur in the physiological regulation of appetite in older adults, who frequently exhibit less hunger and earlier satiety. Appetite regulation (and, therefore, food intake) is affected by a number of social, cultural and psychological factors, as well as by acute and chronic disease states, drugs, dementia or mood disorders. Self-reported anorexia has been reported by approximately one-third of older men and women. Recent development of validated measures of appetite aid in the approach to the problem. The differential diagnostic approach for appetite disturbances should follow from an understanding of the physiological, social, psychological and pathophysiological causes of anorexia. Emerging understanding of the association between proinflammatory cytokines and the anorexia/cachexia syndrome indicates that this process is the most commonly encountered underlying reason for anorexia in acute and chronically ill older persons. Despite the changes in appetite regulation in older persons, the response to social and psychological stimulants in this age group is similar to that in younger adults. Pharmacological stimulants of appetite appear to be a promising intervention for anorexia.
食欲不振被称为“厌食症”。老年人的食欲生理调节会出现戏剧性且难以理解的改变，他们通常表现出饥饿感减少和饱腹感出现更早。食欲调节（因此，食物摄入）受到许多社会、文化和心理因素以及急性和慢性疾病状态、药物、痴呆或情绪障碍的影响。大约三分之一的老年男性和女性都报告了自我报告的厌食症。最近开发的食欲评估工具有助于解决这个问题。食欲障碍的鉴别诊断方法应基于对厌食症的生理、社会、心理和病理生理学原因的理解。人们对促炎细胞因子与厌食/恶病质综合征之间关联的认识不断加深，表明在急性和慢性疾病的老年患者中，这种情况是最常见的厌食症潜在原因。尽管老年人的食欲调节发生了变化，但他们对社会和心理刺激的反应与年轻人相似。食欲的药理学刺激剂似乎是治疗厌食症的一种很有前途的干预手段。
