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Underrepresentation

Eating disorders are less reported in preindustrial, non-westernized countries than in Western countries. In Africa, not including South Africa, the only data presenting information about eating disorders occurs in case reports and isolated studies, not studies investigating prevalence. Western countries experience slightly higher rates of eating disorders than non-western countries. Theories to explain these lower rates of eating disorders, lower reporting and lower research rates in include the effects of westernisation, and culture change.

Men (and women) who might otherwise be diagnosed with anorexia may not meet the DSM-IV criteria for BMI since they have muscle weight, but have very little fat. In many cases a subclinical "not otherwise specified" diagnosis is made instead; ED-NOS in the DSM-IV, and other specified feeding or eating disorder or unspecified feeding or eating disorder in the DSM-5. ED-NOS was the most diagnosed eating disorder in 2009, and it was also shown that AN did not differ significantly in eating pathology or general psychopathology from EDNOS involving restrictive eating.

Article Draft: Anorexia of Aging

The elderly population is increasingly experiencing anorexia nervosa, which has been termed the "Anorexia of Aging".[1] The eating disorder is similar to that of typical anorexia nervosa but is more often accompanied by the overuse of laxatives in order to purge the individual of ingested food.[1] Most geriatric anorexia patients limit their food intake to dairy or grains, whereas an adolescent anorexic has a more general limitation.[1]

This eating disorder that affects older adults has two types - early onset and late onset. [1] Early onset refers to a recurrence of anorexia in late life in an individual who experienced the disease during their youth.[1] Late onset describes instances where the eating disorder begins for the first time late in life. [1]

Elderly man starving

The stimulus for anorexia in elderly patients is typically a loss of control over their lives, which can be brought on by many events, including moving into an assisted living facility.[2] This is also a time when most older individuals experience a rise in conflict with family members, such as limitations on driving or limitations on personal freedom, which increases the likelihood of an issue with anorexia.[2] There can be physical issues in the elderly that leads to anorexia of aging, including a decline in chewing ability, a decline in taste and smell, and a decrease in appetite.[3] Psychological reasons for the elderly to develop anorexia can include depression and bereavement, and even an indirect attempt at suicide.[3] There are also common comorbid psychiatric conditions with aging anorexics, including major depression, anxiety disorder, obsessive compulsive disorder, bipolar disorder, schizophrenia, and dementia.[4]

The signs and symptoms that go along with anorexia of aging are similar to what is observed in adolescent anorexia, including sudden weight loss, unexplained hair loss or dental problems, and a desire to eat alone.[2]

There are also several medical conditions that can result from anorexia in the elderly. An increased risk of illness and death can be a result of anorexia[3]. There is also a decline in muscle and bone mass as a result of a reduction in protein intake during anorexia[3]. Another result of anorexia in the aging population is irreparable damage to kidneys, heart or colon and an imbalance of electrolytes[5].

Many assessments are available to diagnose anorexia in the aging community. These assessments include the Simplified Nutritional Assessment Questionnaire (SNAQ) and Functional Assessment of Anorexia/Cachexia Therapy (FAACT)[1]. Specific to the geriatric populace, the interRAI system identifies detrimental conditions in assisted living facilities and nursing homes[1]. Even a simple screening for nutritional insufficiencies such as low levels of important vitamins, can help to identify someone who has anorexia of aging[1].

Anorexia in the elderly should be identified by the retirement communities but is often overlooked[2], especially in patients with dementia[6]. Some studies report that malnutrition is prevalent in nursing homes, with up to 58% of residents suffering from it, which can lead to the difficulty of identifying anorexia[6]. One of the challenges with assisted living facilities is that they often serve bland, monotonous food, which lessens residents desire to eat[6].

The treatment for anorexia of aging is undifferentiated as anorexia for any other age group. Some of the treatment options include outpatient and inpatient facilities, antidepressant medication and behavioral therapy such as meal observation and discussing eating habits[4].

References

  1. ^ a b c d e f g h i Landi, Francesco; Calvani, Riccardo; Tosato, Matteo; Martone, Anna; Ortolani, Elena; Savera, Giulia; Sisto, Alex; Marzetti, Emanuele (2016-01-27). "Anorexia of Aging: Risk Factors, Consequences, and Potential Treatments". Nutrients. 8 (2): 69. doi:10.3390/nu8020069. ISSN 2072-6643. PMC 4772033. PMID 26828516.{{cite journal}}: CS1 maint: PMC format (link) CS1 maint: unflagged free DOI (link)
  2. ^ a b c d Ekern, Baxter (2016-02-25). "Common Types of Eating Disorders Observed in the Elderly Population". Eating Disorder Hope. Retrieved 2022-06-12.
  3. ^ a b c d Donini, Lorenzo Maria; Poggiogalle, Eleonora; Piredda, Maria; Pinto, Alessandro; Barbagallo, Mario; Cucinotta, Domenico; Sergi, Giuseppe (2013-05-02). "Anorexia and Eating Patterns in the Elderly". PLOS ONE. 8 (5): e63539. doi:10.1371/journal.pone.0063539. ISSN 1932-6203. PMC 3642105. PMID 23658838.{{cite journal}}: CS1 maint: PMC format (link) CS1 maint: unflagged free DOI (link)
  4. ^ a b Lapid, Maria I.; Prom, Maria C.; Burton, M. Caroline; McAlpine, Donald E.; Sutor, Bruce; Rummans, Teresa A. (2010-06-01). "Eating disorders in the elderly". International Psychogeriatrics. 22 (4): 523–536. doi:10.1017/S1041610210000104. ISSN 1741-203X.
  5. ^ Hunnicutt, Carrie (2019-06-14). "How Eating Disorders Affect the Elderly". Monte Nido. Retrieved 2022-07-06.
  6. ^ a b c Morley, John E.; Silver, Andrew J. (1988-01-01). "Anorexia in the elderly". Neurobiology of Aging. 9: 9–16. doi:10.1016/S0197-4580(88)80004-6. ISSN 0197-4580.

Instructor Feedback: Great work on your edits thus far! I have placed suggested edits above (underlined and strikethrough). Please review and determine what you want to accept/reject. I would encourage you to bring over some more of the existing article so reviewers can see how your proposed edits fit within the existing article. For instance, what is the top paragraph and how does that relate to the existing article and/or your proposed edits. What do you mean where you state, "whereas an adolescent anorexic has a more general limitation"? I do not believe the terms "early onset and late onset" should be capitalized in the statement above. The same is true of the terms: "major depression, anxiety disorder, obsessive compulsive disorder, bipolar disorder, schizophrenia, and dementia" as used above. You included two examples of peer-reviewed secondary literature, one example of peer-reviewed primary literature, and one website. It appears your final citation needs technical work (errors in red) and I would encourage you to include at least one additional peer-reviewed secondary article. I look forward to watching your edits evolve and really great work thus far!


Author Feedback: After receiving 14 peer reviews and taking their comments into consideration, I made several updates to my article. Haleymck suggested adding specific examples as to what the conflicts with family can lead to but since the sentence mentions that the conflicts lead to anorexia in aging, I instead gave examples of the conflicts themselves such as driving limitations or limitations on freedom. Shivamp1999 suggested that the term “Anorexia of Aging” be changed to “Aging with Anorexia”, but I did not make the change because the term was coined outside of this article and is how the disease is identified in the medical community, it is not a name that I created. Joyb3 gave many helpful grammatical edits including placement of commas and rewording “an elderly patient” to “in elderly patients”. I made all the grammatical edits suggested by Joyb3 to the article. Several of my peers made mention that the lead paragraph was probably not the best choice to precede this section on “Anorexia of Aging”, so I will be re-reading the original article on Anorexia to see if there is a better place to place the new information. There were also several peers that recommended adding pictures to the article and I will take that under consideration. I will need to determine how to portray anorexia in the elderly in pictures while still maintaining a respectful tone to the article. I will continue to work on the content of the article and expand on the behavioral symptoms, as suggested by Arleenicolee. Most of my peers felt the article did a good job of coming across as neutral although Eyannaib mentioned that they felt the 3rd paragraph was somewhat biased, so I will take an additional look at that specifically. The instructor also made several suggestions as to the capitalization of certain words in the article, which was echoed by several peers, so I made changes to “early onset and late onset” as well as the terms for the co-morbid psychological disorders. There was also an issue with the date on one of my references but I was able to look through the help articles in Wiki and find the way to correct the issue.

Author Feedback: I have updated the lead paragraph to be something more in line with placement of "Anorexia of Aging".

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