Department of Histology, Medical University of Gdansk, Gdansk, Poland.
Vitam Horm. 2013;92:319-55. doi: 10.1016/B978-0-12-410473-0.00013-1.
Anorexia of aging is a physiologic decrease in food intake, which gradually leads to weight loss accompanied by age-related changes in body composition. Animal experiments have revealed that advanced age is associated with altered regulation of food intake and energy homeostasis: suppression of orexigenic mechanisms mediated by neuropeptide Y, orexins, and ghrelin, and by increased activity of the major anorexigenic neuropeptide, α-MSH. In the elderly, a reduced sense of smell and taste may contribute to the loss of appetite, and in old humans, increased serum cholecystokinin concentration may delay gastric emptying resulting in a prolonged feeling of satiety. Although leptin and insulin play a major role in the control of energy homeostasis, their role in the loss of body weight in healthy elderly persons remains to be established. In some of the elderly, loss of body mass may result in malnutrition or even cachexia. Anorexia of aging plays some role in sarcopenia, involuntary loss of muscle mass and strength; however, there are intrinsic age-related changes in skeletal muscle, which underlie this health-endangering condition. Currently, there is no efficient pharmacological treatment for the anorexia of aging; however, it may be partially prevented by improved processing and presenting of food, physical training, and an appropriate social environment.
衰老相关性厌食症是一种生理性的食欲减退，其逐渐导致体重下降，并伴有与年龄相关的身体成分变化。动物实验表明，衰老与食物摄入和能量平衡的调节改变有关：神经肽 Y、食欲素和胃饥饿素介导的食欲刺激机制受到抑制，而主要的食欲抑制神经肽 α-MSH 的活性增加。在老年人中，嗅觉和味觉的减退可能导致食欲下降，而在老年人中，血清胆囊收缩素浓度的增加可能会延迟胃排空，导致饱腹感延长。虽然瘦素和胰岛素在能量平衡的控制中起主要作用，但它们在健康老年人体重下降中的作用仍有待确定。在一些老年人中，体重减轻可能导致营养不良甚至恶病质。衰老相关性厌食症在肌肉减少症（非自愿性的肌肉质量和力量损失）中起一定作用；然而，骨骼肌存在内在的与年龄相关的变化，这是这种危及健康的状况的基础。目前，衰老相关性厌食症尚无有效的药物治疗方法；然而，通过改善食物的加工和呈现、身体锻炼和适当的社会环境，可能部分预防这种疾病。
