MAnnER
Research type
Research Study
Full title
A feasibility study to Explore the Relationships between Modifiable influences and Anorexia of ageing.
IRAS ID
349347
Contact name
N J Cox
Contact email
Sponsor organisation
University of Southampton
Duration of Study in the UK
1 years, 10 months, 1 days
Research summary
Research Summary
Undernourished older adults are more likely to fall ill and develop disability. Loss of appetite with ageing affects many older people and can result in some becoming undernourished. However, we understand very little about why this occurs. A better understanding of poor appetite with ageing is needed to develop treatments.
Appetite is influenced by many things, including physical and mental health, the body’s signalling pathways, and social connections. Appetite loss can also be experienced differently and does not always lead to weight loss. This makes studying it complicated. So, the first step is to decide the best way to measure everything together. However, older people are often excluded from research, as traditional ways to collect information can be burdensome, so different approaches are needed.
The study's main aim is to assess the practicality and tolerability of researching appetite in an older person’s own home. We also aim to explore factors related to poor appetite in ageing and assess the usefulness of a new questionnaire on experiences of appetite loss.
The study includes two home visits, six months apart, in people aged 70 or older. Prior to visits, participants will collect their stool and urine. During visits, a researcher will take blood, and complete questionnaires and physical assessments. We will measure recruitment, follow up and completion rates and ask about participant’s experience of taking part. The blood, urine and stool will be examined to look at the body’s signalling pathways and interaction with the gut microbes. We will investigate changes over six months and compare them to existing records on healthy older people in the Twins UK research cohort.
The findings will ensure future research on appetite is appropriate for older people to participate in. The results will also describe what happens over time to people with poor appetite and factors important to study further.
Summary of Results
Older adults who lose weight and become undernourished are more likely to be unwell. Many older people experience a reduced appetite as they age. This can sometimes lead to weight loss and becoming undernourished. We don't fully understand why this happens, as it is not always linked to a medical problem.
Many things can affect your appetite. This includes your physical health and mental wellbeing, and your wider social connections. We have also learnt that the way your body signals you are hungry can change with age. The way people experience this appetite change also varies. This makes appetite in older age a complex area to study.
The MAnnER study was sponsored by the University of Southampton and funded by The Academy of Medical Sciences. It tested a new research approach to studying appetite in people aged 70 years. This approach had been designed with older people and clinicians.
We planned to find older adults with a poor appetite through their contact with parts of the NHS. Researchers would then visit their home. The researcher complete assessments while there and collect blood, urine and stool samples.
The study was open for 1 year to recruitment, which proved difficult. This meant we were unable to recruit enough people to answer all our research questions. One challenge was finding and approaching potential participants within busy NHS services. Many people, understandably, wanted to focus on their health issue, rather than the study. Clinicians were supportive but had limited time to recruit alongside busy clinical duties. Most people who had expressed an interest, later decided not to take part. Some felt too unwell to complete the study activities. Some felt their appetite had improved following illness. Others decided the assessments involved were more than they wished to undertake.
While we did not recruit enough participants to answer all our questions, the study did achieve our aim of testing this research approach. Importantly, it identified key challenges to recruitment and participation. This will help improve future studies.
We will now work with older people and clinicians to use these findings for future research. This will make sure that future designs are practical and acceptable to participants. But that also fit within busy NHS services. This will help understand poor appetite in later life and develop ways to prevent harmful weight loss and poor health.
REC name
London - Central Research Ethics Committee
REC reference
25/PR/0021
Date of REC Opinion
21 Jan 2025
REC opinion
Favourable Opinion