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ARS Home » Northeast Area » Boston, Massachusetts » Jean Mayer Human Nutrition Research Center On Aging » Research » Publications at this Location » Publication #402009
Research Project: Nutrition, Sarcopenia, Physical Function, and Skeletal Muscle Capacity During Aging

Location: Jean Mayer Human Nutrition Research Center On Aging

Title: Anorexia in medicare fee-for-service beneficiaries: A claims-based analysis of epidemiology and mortality

Author
item DAGENAIS, SIMON - Pfizer, Inc
item FIELDING, ROGER - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item CLARK, SUNDAY - Pfizer, Inc
item CANTU, CERA - Clarify Health
item PRASAD, SAPNA - Clarify Health
item GROARKE, JOHN - Pfizer, Inc

Submitted to: Journal of Nutrition Health and Aging
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 12/27/2022
Publication Date: 1/16/2023
Citation: Dagenais, S., Fielding, R.A., Clark, S., Cantu, C., Prasad, S., Groarke, J. 2023. Anorexia in medicare fee-for-service beneficiaries: A claims-based analysis of epidemiology and mortality. Journal of Nutrition Health and Aging. https://doi.org/10.1007/s12603-023-1882-4.
DOI: https://doi.org/10.1007/s12603-023-1882-4

Interpretive Summary: Loss of appetite can lead to nutritional deficiencies, malnutrition, weight loss, frailty, and increased morbidity and mortality. We examined the diagnosis of loss of appetite using the Medicare database between 2015 and 2021. We found that the prevalence of loss of appetite was approximately 1% among older adults in the United States. Individuals who were diagnosed with loss of appetite had a 5-fold higher risk of death compared to those without loss of appetite.

Technical Abstract: Background: Loss of appetite (LOA) can lead to nutritional deficiencies, malnutrition, weight loss, frailty, and increased morbidity and mortality, but little is known about its epidemiology among Medicare fee-for-service (FFS) beneficiaries in the United States (US). Methods: This was a retrospective analysis of administrative claims data representing individuals in the US with Medicare FFS coverage. LOA was identified using the ICD-10 diagnosis code R63.0. Annual prevalence and incidence of LOA were estimated among individuals ages 65-115 years old with continuous medical (Parts A and/or B) coverage for 12-month periods from 10/1/2015-9/30/2021. Individuals with and without LOA were compared with respect to demographics, comorbidities using the Charlson comorbidity index (CCI), claims-based frailty index (CFI), and annual mortality. Results: In 12-month periods from 10/1/2015-9/30/2021, the number of individuals with a LOA diagnosis code ranged from 317,964-328,977, a mean annual prevalence rate of 1.1%. In 12-month periods from 10/1/2016-9/30/2021, the number of individuals with a new claim for LOA ranged from 243,391-281,071, a mean annual incidence rate of 0.9%. Individuals with LOA had a mean (+/-standard deviation) age of 80.5+/-8.7 years (vs. 74.9+/-7.5 years without LOA; p<0.001), 64.4% were female (vs. 53.8%; p<0.001), and 78.4% were White (vs. 83.2%; p<0.001). The most common CCI comorbidities for those with LOA were chronic pulmonary disease (39.4%), dementia (38.3%), and peripheral vascular disease (38.0%). Median (interquartile range [IQR]) CCI was 4 [5] (vs 1 [3] without LOA; p<0.001). The annual mortality rate among those with LOA was 22.3% (vs. 4.0% without LOA; relative risk 5.49 [95% confidence interval, 5.45-5.53]). Conclusion: At least one claim for LOA was observed among a large number of Medicare FFS beneficiaries each year and these individuals appeared to have a high burden of illness and greater risk of mortality compared to those without LOA.