Anorexia in Medicare Fee-for-Service Beneficiaries: A Claims-Based Analysis of Epidemiology and Mortality

• Published in: The Journal of nutrition, health & aging health & aging, 2023-03, Vol.27 (3), p.184-191
• Main Authors: Dagenais, Simon, Fielding, R. A., Clark, S., Cantu, C., Prasad, S., Groarke, J. D.
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Aging; Anorexia; Anorexia - epidemiology; Comorbidity; Dementia; Epidemiology; Fee-for-Service Plans; Female; Frailty; Frailty - epidemiology; Geriatrics/Gerontology; Humans; Male; Medicare; Medicine; Medicine & Public Health; Mortality; Neurosciences; Nutrition; Older people; Original Research; Primary Care Medicine; Quality of Life Research; Retrospective Studies; United States - epidemiology
• ISSN: 1279-7707; 1760-4788
• DOI: 10.1007/s12603-023-1882-4

Objectives Loss of appetite in older adults can lead to malnutrition, weight loss, frailty, and death, but little is known about its epidemiology in the United States (US). The objective of this study was to estimate the annual prevalence and incidence of anorexia in older adults with Medicare fee-for-service (FFS) health insurance. Design Retrospective and observational analysis of administrative health insurance claims data. Setting This study included Medicare FFS claims from all settings (eg, hospital inpatient/outpatient, office, assisted living facility, skilled nursing facility, hospice, rehabilitation facility, home). Participants This study included all individuals aged 65 to 115 years old with continuous Medicare FFS medical coverage (Parts A and/or B) for at least one 12-month period from October 1, 2015, to September 30, 2021 (ie, approximately 30 million individuals each year). Intervention Not applicable. Measurements Anorexia was identified using medical claims with the ICD-10 diagnosis code “R63.0: Anorexia”. This study compared individuals with anorexia to a control group without anorexia with respect to demographics, comorbidities using the Charlson Comorbidity Index (CCI), Claims-based Frailty Index (CFI), and annual mortality. The annual prevalence and incidence of anorexia were estimated for each 12-month period from October 1, 2015, to September 30, 2021. Results The number of individuals with anorexia ranged from 317,964 to 328,977 per year, a mean annual prevalence rate of 1.1%. The number of individuals newly diagnosed with anorexia ranged from 243,391 to 281,071 per year, a mean annual incidence rate of 0.9%. Individuals with anorexia had a mean (±standard deviation) age of 80.5±8.7 years (vs 74.9±7.5 years without anorexia; p