Anorexia of ageing and routinely collected ‘big data’: helpful insights and new challenges

The research interest in anorexia of ageing, broadly defined as appetite loss attributable to the ageing process, has been building momentum over the last decade. An increasing number of observational studies have demonstrated its importance in trajectories of healthy ageing and association with increased morbidity and mortality (1-5). The recent article “Anorexia in Medicare fee-for-service beneficiaries: A claims-based analysis of epidemiology and mortality” by Dagenais et al (6), now holds these observations true in a ‘real-world’ big data setting in the United States. The authors looked at health insurance claims over a 6-year period for people aged 65–115 years, equating to nearly 30 million people each year from a range of care and community settings and used the ICD-10 code R63.0 to identify anorexia. When compared to controls without anorexia the authors observed advanced age, female sex and higher comorbidity burden as covariates to anorexia diagnosis, alongside a substantially higher (up to ten-fold) 12-month mortality rate for anorexic individuals