Poor appetite predicts incident muscle weakness and disability: a multi-country longitudinal study of European older adults

Background Poor appetite, often termed anorexia of ageing, may serve as an early marker of adverse health outcomes in old age. This study aimed to evaluate whether poor appetite predicts incident low handgrip strength (HGS), physical disabilities, and reduced quality of life (QoL) in older adults across Europe. Methods Data were drawn from waves 5–9 of the Survey of Health, Ageing and Retirement in Europe (SHARE), including individuals aged 50+. Appetite status was assessed at baseline (2013), and outcomes were tracked longitudinally. Incident low HGS, physical disabilities, and low quality of life were analyzed using logistic regression models adjusting for age, sex, country, comorbidity burden, depressive symptoms (Euro‑D scale), and reduced body mass index. Results Poor appetite at baseline was a strong predictor of adverse outcomes. In adjusted models, poor appetite was independently associated with higher odds of incident low HGS, physical disabilities, and low QoL, with the strongest effects observed in adults aged 66+; sex‑specific patterns were evident, with women showing greater susceptibility to mobility limitations and men to muscle weakness. The compounded effect of poor appetite, older age, and female gender was particularly pronounced. Incidence rates of all outcomes were nearly doubled in those with poor appetite compared to those with good appetite. Conclusion Poor appetite is a robust, independent predictor of future muscle weakness, physical disability, and reduced QoL. Routine appetite assessment may help identify at-risk individuals and guide early interventions in ageing populations.