Older Adults’ Chronic Pain May Dull Appetite

Chronic pain may dampen elderly adults’ desire to eat, potentially leading to weight loss and malnutrition, a small study suggests.

Among 65 older men and women with chronic pain due to arthritis and other conditions (but not cancer), researchers found that appetite loss was directly related to the intensity of patients’ pain. Overall, 45 percent of patients described their appetite as “fair or worse,” and nearly as many complained that pain dulled their desire to eat. The concern is that such appetite impairment could lead to weight loss and malnutrition, a common problem among the elderly, study author Dr. Debra K. Weiner told Reuters Health. According to Weiner and her colleagues at the University of Pittsburgh Medical Center in Pennsylvania, experience tells doctors and patients alike that chronic pain can quash the desire for food, but few studies have specifically looked at the problem. One reason is that both pain and appetite are complex, with physical, emotional and mental components at work. Depression, for example, is related to pain and appetite individually, and higher rates of depression could explain the appetite loss seen in older adults’ plagued by constant pain. For their study, in the Journal of the American Geriatric Society, Weiner and her colleagues gave patients standard surveys on pain and appetite, and on related factors such as depression, medication use and mental functioning. Many of the patients, who were 75 years old on average, had arthritis; others had fibromyalgia, nerve damage, spinal degeneration or osteoporosis-related bone fractures. Weiner’s team found that patients who said pain interfered with their appetites tended to have more severe pain, and the relationship was not explained away by depression, the side effects of pain medication or other factors. Still, patients with appetite problems were more likely than others to be on opioid pain drugs; more than half were on these medications, compared with less than one-quarter of those without appetite loss. This implies that when pain treatment is inadequate, appetite problems may follow, according to Weiner. Whether better pain control might prevent or improve appetite loss is unclear. Weiner said she and her colleagues are now looking at that issue in pain intervention studies. (Source: Journal of the American Geriatric Society: Reuters Health: Amy Norton: MedLinePlus: April 2004.)