Psychologists at the University of British Columbia have uncovered
evidence that fatal cases of anorexia nervosa may strike more older
people, and men, than is commonly believed.
Their findings fly in the face of conventional wisdom that anorexia
nervosa is almost exclusively a condition affecting young females
and does not exist beyond the age of 35.
Associate Prof. Paul Hewitt and Prof. Stanley Coren examined 10.5
million death records in the U.S. spanning the years 1986-90, looking
for records of those whose death certificates listed anorexia nervosa
as a contributing factor.
The results showed that the median age of death from anorexia nervosa
for women is 69, and for men, 80. And while at younger ages anorexia
victims are 90 per cent female and 10 per cent male, for those over
45, the rate of men doubled to 21 per cent.
The eating disorder is more common among young people, but when
it strikes the elderly, it is more deadly, accounting for 78 per
cent of all anorexia nervosa deaths.
“We scoured the literature and found that other clinicians had
noted cases of anorexia nervosa among people in their 60s, 70s and
80s. This suggests that our results were not just artifacts of the
data,” Hewitt says.
Problems inherent in death record data were accounted for, and
they were careful to ensure the records did not confuse anorexia
nervosa with the related syndrome simply known as anorexia, in which
appetite loss is caused by cancer and other wasting illnesses.
Hewitt says there are a number of reasons why anorexia nervosa
is considered a young person’s ailment.
Fatalities drop off after the late 30s, which could lead to a belief
that the condition disappears with age.
Hewitt and Coren’s numbers show, however, that fatalities make
a dramatic increase at age 50 and continue to climb until peaking
at age 80 to 85.
Hewitt and Coren suggest that there may be two types of anorexia
nervosa, with the type that strikes older people responsible for
a greater number of deaths and more often affecting men.
As to why the elderly would fall victim to anorexia nervosa, Hewitt
notes that there could be many social, genetic, family and biological
reasons, but no definitive answers.
“We don’t know the cause in younger women, yet alone in seniors,”
Common across all age groups, however, is that the onset or reappearance
of anorexia nervosa may be triggered by major stressful events.
In older people, these could include the death of a spouse, retirement
or simply adjusting to different income levels.