title: Prevalence and associated factors for decreased appetite among patients with stable heart failure.
abstract: OBJECTIVE
  To explore the prevalence of decreased appetite and factors associated with appetite among patients with stable heart failure.
  
  
  BACKGROUND
  Decreased appetite is an important factor for the development of undernutrition among patients with heart failure, but there are knowledge gaps about prevalence and the factors related to appetite in this patient group.
  
  
  METHODS
  Observational, cross-sectional study.
  
  
  METHODS
  A total of 186 patients with mild to severe heart failure were consecutively recruited from three heart failure outpatient clinics. Data were obtained from medical records (heart failure diagnosis, comorbidity and medical treatment) and self-rated questionnaires (demographics, appetite, self-perceived health, symptoms of depression and sleep). Blood samples were taken to determine myocardial stress and nutrition status. Heart failure symptoms and cognitive function were assessed by clinical examinations. The Council on Nutrition Appetite Questionnaire was used to assess self-reported appetite. Bivariate correlations and multivariate linear regression analyses were conducted to explore factors associated with appetite.
  
  
  RESULTS
  Seventy-one patients (38%) experienced a loss of appetite with a significant risk of developing weight loss. The final multiple regression model showed that age, symptoms of depression, insomnia, cognitive function and pharmacological treatment were associated with appetite, explaining 27% of the total variance.
  
  
  CONCLUSIONS
  In this cross-sectional study, a large share of patients with heart failure was affected by decreased appetite, associated with demographic, psychosocial and medical factors.
  
  
  CONCLUSIONS
  Loss of appetite is a prevalent problem among patients with heart failure that may lead to undernutrition. Health care professionals should routinely assess appetite and discuss patients' experiences of appetite, nutrition intake and body weight and give appropriate nutritional advice with respect to individual needs.
authors.affiliation: Department of Medical and Health Sciences, Division of Nursing Science, Linköping University, Linköping, Sweden.|Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden.
authors.forename: Christina
authors.initials: C
authors.lastname: Andreae
authors.affiliation: Department of Medical and Health Sciences, Division of Nursing Science, Linköping University, Linköping, Sweden.|Department of Cardiology, Linköping University Hospital, Linköping, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Strömberg
authors.affiliation: Department of Medical and Health Sciences, Division of Nursing Science, Linköping University, Linköping, Sweden.|Center for Collaborative Palliative Care, Linnaeus University, Kalmar, Sweden.
authors.forename: Kristofer
authors.initials: K
authors.lastname: Årestedt
mesh_terms: D000368:Aged; D001066:Appetite; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology; D001068:Feeding and Eating Disorders / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006333:Heart Failure / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D015995:Prevalence; D011788:Quality of Life; D011795:Surveys and Questionnaires
keywords: age; appetite; cognitive function; depression; heart failure; insomnia; outpatient; pharmacological treatment