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a Geriatric Research, Education and Clinical Center, Saint Louis VA Medical Center and Division of Geriatric Medicine, Saint Louis University Health Sciences Center, Saint Louis, Missouri
John E. Morley, Division of Geriatric Medicine, Saint Louis University Health Sciences Center, 1402 S. Grand Blvd., Room M238, Saint Louis, MO 63104 E-mail: morley{at}slu.edu.
There is a physiological decline in food intake with aging. The reasons for the decline in food intake are multifactorial and involve both peripheral and central mechanisms. Altered hedonic qualities of food occur due to alterations in taste and, more particularly, smell with aging. A decline in adaptive relaxation of the fundus of the stomach and an increased rate of antral filling appear to play a role in the early satiation seen in many older persons. Cholecystokinin levels are increased with aging and older persons are more sensitive to the satiating effects of this gut hormone. The decline in testosterone levels in older males leads to increased leptin levels and this may explain the greater decline in food intake with aging in the male. Within the hypothalamus, decreased activity of both the dynorphin (kappa opioid) and neuropeptide Y systems occurs in aging rodents. Cytokines are potent anorectic agents. Many older persons have mild inflammatory disorders that lead to anorexia. Exercise may increase food intake in older persons.
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