Clinical Indicators Associated with Unintentional Weight loss and Pressure Ulcers in Elderly Residents of Nursing Facilities

Unintentional weight loss in older adults

“…1 Problematic weight loss in the older adult is defined by the United States Omnibus Budget Reconciliation Act of 1987 (Title IV: subtitle C: Nursing Home Reform) as a loss of 5% of body weight in one month or 10% over a period of six months or longer. 2,3 In this review, we focus on unintentional weight loss for which no organic cause can be found, although frequently, the loss of weight may be associated with chronic conditions. 3 Older patients who involuntarily lose substantial amounts of weight without an obvious cause can pose difficult diagnostic and management dilemmas for physicians.…”

“…2,3 In this review, we focus on unintentional weight loss for which no organic cause can be found, although frequently, the loss of weight may be associated with chronic conditions. 3 Older patients who involuntarily lose substantial amounts of weight without an obvious cause can pose difficult diagnostic and management dilemmas for physicians.…”

“…3 These factors included reduced functional ability, taking in 50% or less of the food served in three consecutive days, refusal of 50% or more of food replacement offered over a seven-day period, chewing problems, a serum albumin level less than 35 g/L with normal hydration status and a cholesterol level less than 4.1 mmol/L.…”

Body Weight Changes in Elderly Psychogeriatric Nursing Home Residents

“…Consequences of weight loss, which can vary from 4% to 65%, include an increased risk of infections, number of falls, and length of hospitalization; it even increases mortality risk (8,10,11). Causes of weight loss are summarized in Morley's mnemonic Meals on Wheels (Medication, Emotional, Alcoholism, Late-life paranoia, Swallowing problems, Oral problems, Nasocomial infections, Wandering, Hyperthyroidism, Enteric problems, Eating problems, Lowsalt or low-cholesterol and other diets, Stones and shopping problems) (12) and in Robbin's nine Ds (Dentition, Dysgeusia, Dysphagia, Diarrhea, Disease, Depression, Dementia, Dysfunction, and Drugs) (13).So far, the impact of these factors on body weight changes has been shown in retrospective or comparative studies (7,8,(14)(15)(16)(17)(18). Morley and Kraenzle (18) found in their retrospective study that depression is the most common cause of weight loss in nursing home residents.…”

“…Morley and Kraenzle (18) found in their retrospective study that depression is the most common cause of weight loss in nursing home residents. Gilmore and colleagues (15) found that, in nursing home residents, reduced functional ability, intake of 50% or less of food served for the past 3 consecutive days, and chewing problems were the most prevalent indicators of weight loss.…”