Restrictive eating patterns in older adulthood: avoidant/restrictive food intake disorder symptoms and related factors

This study aimed to examine the frequency of probable Avoidant/Restrictive Food Intake Disorder (ARFID), restrictive eating patterns, and their associations with mood and anxiety symptoms, chemosensory pleasure, and demographic factors among community-dwelling Turkish older adults. A cross-sectional survey was conducted with 118 adults aged ≥ 65 years. Participants completed the Nine-Item ARFID Screen (NIAS), the Chemosensory Pleasure Scale (CPS), the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7), and the Eating Attitudes Test-26 (EAT-26). Probable ARFID was identified using established NIAS subscale cutoffs (picky eating ≥ 10, low interest/appetite ≥ 9, or fear of aversive consequences ≥ 10) after excluding participants with probable weight/shape-related eating disorders based on EAT-26 scores (≥ 20). Comparisons between participants with probable ARFID and the non-ARFID group, as well as correlation analyses between NIAS scores and behavioral, affective, and sensory variables, were performed. Across the whole sample, NIAS scores were negatively correlated with body mass index (BMI) (r = − 0.239, p = 0.011) and pleasure associated with natural odors (r = − 0.353, p < 0.001) but not with mood/anxiety symptoms. Prevalence of probable ARFID was 13.3%. Individuals with probable ARFID had a significantly lower BMI than those in the non-ARFID group (t = 2.750, p = 0.007, Cohen’s d = 0.79). The proportion of participants living alone was significantly higher in the probable ARFID group than in the non-ARFID group (χ² = 5.814, p = 0.016, Cramer’s V = 0.24). A probable ARFID prevalence of 13.3% suggests that restrictive eating patterns consistent with ARFID are not uncommon among community-dwelling older adults. In addition, NIAS scores were associated with reduced chemosensory pleasure but not with depression or anxiety symptoms. These results may suggest that factors contributing to probable ARFID in older adults differ from those typically reported in younger populations. Overall, the findings highlight the need for improved screening of ARFID symptoms and further investigation of age-specific mechanisms underlying restrictive eating in later life. Avoidant/Restrictive Food Intake Disorder (ARFID) is an eating disorder in which people limit the amount or type of food they eat, but not because they are worried about their weight or body shape. Most research on ARFID has focused on children and young adults, and much less is known about how it appears in older people. In this study, we surveyed adults aged 65 years and older in a Turkish community to explore restrictive eating patterns and probable ARFID symptoms. Participants answered questions about their eating habits, mood, anxiety, and how much pleasure they experience from tastes and smells. About 13% of participants showed signs consistent with probable ARFID. Those with probable ARFID tended to have lower body weight and were more likely to live alone. Restrictive eating was also linked to reduced pleasure from sensory experiences such as smells in nature and food-related sensations. However, these eating patterns were not clearly related to symptoms of depression or anxiety. These findings suggest that restrictive eating and probable ARFID may occur in a meaningful number of older adults and may have different causes than in younger people. Greater awareness and screening of restrictive eating in older adults may help identify individuals who could benefit from support.