Appetite Control With Ageing: A Narrative Review Focused on the POMC and AgRP Neurons

Abstract

The anorexia of ageing, a reduction in food intake with increased age, is associated with negative health outcomes such as sarcopenia frailty, cachexia morbidity and mortality. Pharmacological agents such as appetite stimulants have been a major focus to combat the anorexia of ageing; however, these medications are linked to various adverse side effects. Therefore, understanding the physiological causes of reduced appetite may lead to the creation of innovative intervention strategies in the ageing population. Current research has identified the pro-opiomelanocortin (POMC) and Agouti-related peptide (AgRP) neuronal subsets of the arcuate nucleus (ARC) as the centre of appetite regulation. This review investigates the current understanding of appetite regulation and subsequent dysregulation with age, and the age-associated changes in the anorectic (appetite-suppression) and orexigenic (appetite-stimulating) pathways, thereby implicating the POMC and AgRP neurons. It primarily investigates the physiological changes underlying appetite reduction with ageing to orient future interventions to combat the anorexia of ageing.