International Psychogeriatrics

Review Article

Eating disorders in the elderly

Maria I. Lapida1 c1, Maria C. Proma1, M. Caroline Burtona2, Donald E. McAlpinea1, Bruce Sutora1 and Teresa A. Rummansa1

a1 Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, U.S.A.

a2 Department of Medicine, Mayo Clinic, Rochester, Minnesota, U.S.A.

ABSTRACT

Background: Eating disorders in the elderly are often overlooked. When they occur, significant morbidity and mortality result. In this study we review all existing literature on eating disorders in the elderly and provide practical guidelines for clinicians in recognizing and managing eating disorders in the elderly.

Methods: A literature search using Medline(R), PubMed(R), Web of Knowledge(R), and PsychINFO(R) revealed 48 published cases of eating disorders in people over the age of 50 years.

Results: The mean age was 68.6 years (range 50–94), and the majority (88%) of cases were females. The majority (81%) of cases had anorexia nervosa, and 10% had bulimia nervosa. Late onset eating disorders were more common (69%) than early onset. Comorbid psychiatric conditions existed in 60%, most commonly major depression. Management with a combination of behavioral and pharmacologic interventions was most successful, although only 42% were treated successfully. Mortality was high (21%) secondary to the eating disorder and its complications.

Conclusion: Eating disorders do occur in the elderly and should be included in the differential diagnosis of unexplained weight loss in the elderly.

(Received October 12 2009)

(Revised November 13 2009)

(Revised January 04 2010)

(Accepted January 11 2010)

(Online publication February 22 2010)

Correspondence:

c1 Correspondence should be addressed to: Maria I. Lapid, MD, Mayo Clinic Department of Psychiatry and Psychology, 200 First Street SW, Rochester, MN 55905, U.S.A. Phone: +1 507-255-7184; Fax: +1 507-255-7365. Email: lapid.maria@mayo.edu.