Unintentional weight loss in older adults

Stajkovic, Svetlana; Aitken, Elizabeth; Holroyd‐Leduc, Jayna

doi:10.1503/cmaj.101471

Cited by 55 publications

(49 citation statements)

References 30 publications

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“…Although UWL has been extensively investigated in elders [1,10,11,15–18], studies have not explicitly analyzed the differences between older and younger patients. Reports indicate that 15–20% of adults aged ≥65 years have UWL [10,11] and that this prevalence is higher in community dwelling elders (27%) and nursing home residents (50–60%) [51].…”

Section: Discussionmentioning

confidence: 99%

“…In general, malignancies, nonmalignant organic disorders, and psychiatric disorders constitute the main etiologic groups of UWL [1,10–14]. Social factors are occasionally considered a separate group or, more commonly, included in the group of psychiatric causes (so-called psychosocial disorders) [10,11,15–17]. Unexplained UWL is comparatively common, accounting for 11–28% of cases [2–9].…”

Section: Introductionmentioning

confidence: 99%

“…Unexplained UWL is comparatively common, accounting for 11–28% of cases [2–9]. Reports have frequently concentrated on elders, in whom UWS is quite prevalent and somewhat behaves as a distinct clinical entity [10,11,15–18]. Because of complex multifactorial and interrelated causes, UWL in older subjects poses a harder diagnostic challenge.…”

Section: Introductionmentioning

confidence: 99%

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Unintentional weight loss: Clinical characteristics and outcomes in a prospective cohort of 2677 patients

et al. 2017

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BackgroundWhereas there are numerous studies on unintentional weight loss (UWL), these have been limited by small sample sizes, short or variable follow‐up, and focus on older patients. Although some case series have revealed that malignancies escaping early detection and uncovered subsequently are exceptional, reported follow-ups have been too short or unspecified and necropsies seldom made. Our objective was to examine the etiologies, characteristics, and long-term outcome of UWL in a large cohort of outpatients.MethodsWe prospectively enrolled patients referred to an outpatient diagnosis unit for evaluation of UWL as a dominant or isolated feature of disease. Eligible patients underwent a standard baseline evaluation with laboratory tests and chest X-ray. Patients without identifiable causes 6 months after presentation underwent a systematic follow-up lasting for 60 further months. Subjects aged ≥65 years without initially recognizable causes underwent an oral cavity examination, a videofluoroscopy or swallowing study, and a depression and cognitive assessment.ResultsOverall, 2677 patients (mean age, 64.4 [14.7] years; 51% males) were included. Predominant etiologies were digestive organic disorders (nonmalignant in 17% and malignant in 16%). Psychosocial disorders explained 16% of cases. Oral disorders were second to nonhematologic malignancies as cause of UWL in patients aged ≥65 years. Although 375 (14%) patients were initially diagnosed with unexplained UWL, malignancies were detected in only 19 (5%) within the first 28 months after referral. Diagnosis was established at autopsy in 14 cases.ConclusionThis investigation provides new information on the relevance of follow-up in the long-term clinical outcome of patients with unexplained UWL and on the role of age on this entity. Although unexplained UWL seldom constitutes a short-term medical alert, malignancies may be undetectable until death. Therefore, these patients should be followed up regularly (eg yearly visits) for longer than reported periods, and autopsies pursued when facing unsolved deaths.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Unintentional weight loss: Clinical characteristics and outcomes in a prospective cohort of 2677 patients

et al. 2017

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“…Such weight loss is also associated with higher rates of mortality (2,3), morbidity (4), and functional decline (5,6). Also of concern is the growing prevalence of obesity among the older adult population (7).…”

Section: Introductionmentioning

confidence: 99%

The Association of Dietary Patterns and Weight Change in Rural Older Adults 75 Years and Older

Hsiao

Mitchell²,

Wood

et al. 2014

Journal of Nutrition in Gerontology and Geriatrics

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Little is known about the relationship between weight change and dietary patterns (DP) in older adults, especially in those of advanced age (≥ 75 years). We examined the association of DP with obesity and five-year weight change in community-dwelling older adults (n = 270; mean ± SD age: 78.6 ± 3.9 years). Dietary data were collected from four, random, 24-hour dietary recalls over a 10-month period. Weight change was examined as: (1) 10-pound weight loss; (2) 10-pound weight gain; (3) 10% weight loss; and (4) 10% weight gain. Cluster analysis was used to derive 3 DP ("Health-conscious," "Sweets and dairy," and "Western"). Kaplan-Meier plots and Cox proportional hazards regression models were used. About 39% of participants lost at least 10 pounds during follow up. In the unadjusted model, five-year weight loss was not associated with dietary pattern. However, when stratified by gender, females who were characterized by the Sweets and Dairy and the Western DP were three and two times more likely to lose 10 pounds, respectively, compared to those in the Health-conscious DP (P < 0.05). These observations suggest that it is appropriate to recommend a Health-conscious DP for women 75 years and older who may be at risk for weight loss.

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“…Indeed, medical examiners and forensic pathologists often encounter emaciated bodies in postmortem examinations. Malnutrition is frequently associated with chronic diseases, which can lead to anorexia and in an increase in nutrient demands of the body [7,8]. In addition, malnourished persons may subsequently develop acute conditions, such as infection [8].…”

Section: Introductionmentioning

confidence: 99%