What causes loss of appetite in older adults?

Appetite may fall when eating becomes tiring, food tastes different, swallowing is difficult, teeth hurt or constipation is present. New medicines and side effects such as nausea, dry mouth or altered taste can also reduce interest in food. Infection, including Influenza, COVID-19, Gastroenteritis or Hepatitis A, may temporarily suppress appetite. Gastritis and Peptic Ulcer can cause nausea or upper abdominal discomfort. Depression may appear as withdrawal, low mood or loss of pleasure rather than sadness alone. Persistent appetite loss, pain, jaundice or unplanned weight change needs assessment, because less common but serious conditions can also affect eating.

Keep a brief record of meals, drinks, symptoms, medicines and weight changes. Offer small, nourishing meals at familiar times, with help opening packages or preparing food if fatigue or dexterity is a barrier. Encourage fluids and address dental pain, constipation or swallowing difficulty with a clinician. Do not stop prescribed medicines without advice. A healthcare professional can review the medication list, examine the mouth and abdomen, and arrange tests when the pattern calls for them.

Arrange medical review if reduced appetite persists, daily intake is falling, or there is weakness, repeated vomiting, swallowing difficulty, abdominal pain, fever, diarrhoea, jaundice or noticeable unplanned weight loss. Seek urgent help for confusion, fainting, severe dehydration, blood in vomit or stool, or inability to keep fluids down. A carer should seek advice sooner when the person has dementia, diabetes or another condition affected by poor intake.

Could a medicine, dental issue or mood change be affecting eating? Which symptoms or weight changes need urgent review? Would a dietitian, dentist or swallowing assessment help?