Accurate evaluation is essential, however, because this problem is associated with increased morbidity and mortality. By continuing to browse the site you are agreeing to our use of cookies. , by unmasking problems such as anxiety). We review the available evidence (mainly epidemiological and observational studies) and outline a structured approach to investigation and management of the older patient with unintentional weight loss. Management is directed at treating underlying causes and providing nutritional support. 1, 2 When a patient has multiple medical problems and is taking several medications, the differential diagnosis of unintentional weight loss can be extensive. Evaluating and Treating Unintentional Weight Loss in the Elderly. Get access to this article and to all of thebmj. D. Please login, sign up for a 14 day trial, or subscribe below. Investigation and management of unintentional weight loss in older adults. A specific cause is not identified in approximately one quarter of elderly patients with unintentional weight loss. e. The leading causes of involuntary weight loss are depression (especially in residents of long-term care facilities), cancer (lung and gastrointestinal malignancies), cardiac disorders and benign gastrointestinal diseases. Get access to this article and to all of thebmj. Investigation and management of unintentional weight loss in older adults.
Unintentional weight loss in the elderly patient can be difficult to evaluate. Polypharmacy can cause unintended weight loss, as can psychotropic medication reduction (i. GRACE BROOKE HUFFMAN, M. Consequences of Weight Loss Pathophysiology Differential Diagnosis Evaluation Evaluation in the Long-Term Care Facility Treatment Final Comment References Elderly patients with unintentional weight loss are at higher risk for infection, depression and death. A reasonable work-up includes tests dictated by the history and physical examination, a fecal occult blood test, a complete blood count, a chemistry panel, an ultrasensitive thyroid-stimulating hormone test and a urinalysis. Medications that may cause nausea and vomiting, dysphagia, dysgeusia and anorexia have been implicated. com for 14 days. There are no published guidelines on how to investigate and manage patients with unintentional weight loss, and responses range from doing nothing (if it is viewed as a normal part of the ageing process) to extensive blind investigation because of the fear that it represents underlying cancer. , Brooke Grove Foundation, Sandy Spring, Maryland Am Fam Physician. 3 4 It is not clear how far clinicians should go to investigate older patients with unintentional weight loss in the absence of an obvious medical cause. Access to the full version of this article requires a subscription. Please login, sign up for a 14 day trial, or subscribe below. Upper gastrointestinal studies have a reasonably high yield in selected patients. Consequences of Weight Loss Pathophysiology Differential Diagnosis Evaluation Evaluation in the Long-Term Care Facility Treatment Final Comment References Article Sections. Access to the full version of this article requires a subscription. Observational studies have shown that in as many as 25% of cases no identifiable cause is found, despite extensive investigation. com for 14 days.
