Work Package 1

Led by Newcastle University (NU)

Poor appetite is common in older age, affecting an estimated 15-30% of older adults. Understanding the causes of poor appetite is important because it may lead to lower food consumption and changes in diet, and result in weight loss and muscle loss. However, appetite is not routinely assessed. Research suggests a range of influences may be important, such as illness and the effects of medication, but understanding is limited. Importantly, there are few treatment options at present. 

The AGE research group at Newcastle University is part of the European consortium: APPETITE. The aim of the research was to gain detailed insights into the characteristics and preferences of older adults who have poor appetite and to develop new approaches to support older adults whose appetite is poor. The research was carried out in Newcastle is the first phase of the project - to interview older adults who have poor appetite to improve understanding of influences on appetite and to gain insights into strategies they may use to make sure they eat enough.

The AGE research group worked with VOICE to recruit members to join an advisory panel to oversee the research in Newcastle, who met every 6 months for its duration. These meetings were an opportunity to discuss how the research was carried out, how older adults were recruited to take part in interviews, and how to interpret the project findings. The first meeting of the panel included a focus group discussion of the factors that are associated with poor/declining appetite in older adults.

The second stage included carrying out one-to-one interviews with older adults who have poor appetite. To recruit participants, an ‘opportunity to take part in our research’ is circulated via the VOICE network. Older adults who were interested in taking part completed the SNAQ (Simplified Nutritional Appetite Questionnaire) on-line, to assess their level of appetite. A researcher contacted individuals who have low SNAQ scores to invite them to attend an interview and to obtain their written consent. The interviews were semi-structured, based on a guide that was informed by the focus group discussion in the first stage of the research.

All interviews were recorded and transcribed. The transcripts were analysed thematically, with development of a coding frame to identify emerging themes. Interviews continued until no new themes are emerged.

This work with older adults with poor appetite or at risk of undernutrition was supported by analysing a large dataset of Dutch older people with poor appetite [taken from the Longitudinal Aging Study Amsterdam] and comparing those to older adults with a normal appetite with respect to physical, emotional, cognitive and social factors as well as their nutrient and food group intakes. Information on appetite in two waves of the Dutch study were used to distinguish short-term from long-term poor appetite, and to clarify whether older adults with short-term and those with long-term poor appetite differ in their characteristics.

The findings from WP1 will inform the development of food products high in protein and fibre that can be used by older people to support them to remain healthy.