Email: [email protected]Copyright @ Forever Medic Online Pvt. Ltd Definition of Weight loss in the eld • Objectives: 1. Describe the significance of unintentional weight loss in the older patient. 2. Identify the factors and conditions associated with weight loss in the elderly. 3. Develop an appropriate approach to investigate and manage 1. weight loss in the older patient. 4. Describe the components of inter- disciplinary approach in the management of unintentional
MedicYatra provides the safe & best Weight loss treatment and procedure at its affiliate & trusted hospitals & clinics in various metro cities of India, like Mumbai, Delhi, Bangalore, Chennai, Pune etc.Our Associate Board certified doctors are extensively trained and vastly experienced and have performed hundreds of such cases at our state of the art JCI accredited hospitals & Clinics. Our aim is to provide you the best of the services at the most affordable costs. Don't forget to say hi at [email protected]
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
• No uniformly accepted definition of weight loss in the older patientDefinition varies with patient population setting . These include: 1. Community dwellers 2. Hospitalized patients 3. Nursing home residents
• The Minimal data set : use for nursing home patients, defines weight loss at 5 % or more in 1month or 10% or more in past 6 months.
• The nine D of weight loss in the older patients:1. Dentition 6. Depression 2. Dysgeusia 7. Dementia 3. Dysphagia 8. Dysfunction 4. Diarrhea 9. Drugs5. Disease(chronic) 10. “Dollars”(econonic
Evaluation: History• : Are there Side effects due to medication Food preference: Food access and ability to secure food
3. Weight loss with normal intake: Red Flag for Physiologic cause• Take a good History :
1. Document weight loss; up to 50% of wt loss is undocumented
2. Detailed medical, psychosocial and dietary history: ie. Dental: Inability to chew or swallow Functional: Is is due to Dementia or depression Medication
Use to Identify patients at risk and raise awareness.
2. The Short form Mini-nutritional Assessment): (MNA-SF) use as the first step for nutritional screening 3. SNAQ (Simplified nutritional Appetite questionnaire) training tool can predict weight loss in the older patients.
• Other diagnostic test based on History and physical:• Chest X-ray: Smokers• Skeletal X-ray: Focal bone pain• Renal USN/Cysto: Hematuria• Endo/Colonoscopy: Heme+, Reflux symptoms, dysphagia• CT/MRI: To further asses exam findings if other
Interventions:• Pharmacologic management: Evidence for use in geriatric weight loss is limited• Appetite stimulant: Mirtazapine: doses: 3.75-45mg; increase appetite and promote while treating depression. Cyproheptadine: 2-4mg with meals (CNS); no weight data. Megestrol: 400-800mg orally has been use to treat cachexia in AIDS and cancer patients. Shows some weight gain in LTC pts. Dronabinol: 2.5mg in older patients; side effects includes confusion, dizziness and somnolence. Benefit from antimemetic and analgesic effect.
• Unintentional weight loss in the elderly is increasing
unrecognized.• It is important to do nutritional screen periodically.• Identify patients at risk and intervene early• Treat underlying cause • No identifiable cause of weight loss may be found in some