Fatigue and loss of appetite in older adults

COVID-19, influenza, gastroenteritis, gastritis, or a peptic ulcer may reduce appetite while causing tiredness. Depression can present through withdrawal, low motivation, sleep changes, and altered eating rather than sadness alone. Hepatitis A may cause loss of appetite with nausea or jaundice. Persistent or unexplained symptoms need a clinician’s assessment, including review of prescribed medicines, swallowing, dentures, pain, constipation, vision, memory, and ability to shop or prepare food.

Reduced intake can make weakness worse, creating a cycle in which cooking and eating become harder. A carer can look for changes in fluids, urine, clothing fit, alertness, mobility, and usual routines without assuming that ageing alone explains them.

Offer preferred foods in small portions at regular times, with snacks available between meals. Include energy- and protein-rich choices that are easy to chew, and keep drinks within reach unless a clinician has restricted fluids. Check whether pain, nausea, mouth soreness, constipation, or a new medicine is making eating difficult. Involve the older person in choices and avoid pressure at mealtimes.

Contact a clinician promptly for a clear decline in eating or drinking, new confusion, repeated falls, increasing sleepiness, vomiting, diarrhoea, fever, jaundice, or reduced urine. Emergency care is needed for collapse, severe breathing difficulty, chest pain, or inability to stay awake.

Could a medicine, infection, depression, dental issue, swallowing difficulty, or constipation be involved? Should nutrition, hydration, mobility, or memory be assessed? What changes should prompt same-day advice?