Medline ® Abstracts for References 1,2
of 'Approach to the patient with unintentional weight loss'
Involuntary weight loss.
Med Clin North Am. 2014 May;98(3):625-43. Epub 2014 Mar 21.
Involuntary weight loss remains an important and challenging clinical problem, with a high degree of morbidity and mortality. Because of the frequency of finding a serious underlying diagnosis, clinicians must be thorough in assessment, keeping in mind a broad range of possible causes. Although prediction scores exist, they have not been broadly validated; therefore, clinical judgment remains ever essential.
Division of General Internal Medicine, Department of Medicine, University of Washington, 4245 Roosevelt Way Northeast, Box 354760, Seattle, WA 98105, USA. Electronic address: email@example.com.
Unintentional weight loss in older adults.
Gaddey HL, Holder K
Am Fam Physician. 2014 May;89(9):718-22.
Unintentional weight loss in persons older than 65 years is associated with increased morbidity and mortality. The most common etiologies are malignancy, nonmalignant gastrointestinal disease, and psychiatric conditions. Overall, nonmalignant diseases are more common causes of unintentional weight loss in this population than malignancy. Medication use and polypharmacy can interfere with taste or cause nausea and should not be overlooked. Social factors may contribute to unintentional weight loss. A readily identifiable cause is not found in 16% to 28% of cases. Recommended tests include a complete blood count, basic metabolic panel, liver function tests, thyroid function tests, C-reactive protein levels, erythrocyte sedimentation rate, glucose measurement, lactate dehydrogenase measurement, and urinalysis. Chest radiography and fecal occult blood testing should be performed. Abdominal ultrasonography may also be considered. When baseline evaluation is unremarkable, a three- to six-month observation period is justified. Treatment focuses on the underlying cause. Nutritional supplements and flavor enhancers, and dietary modification that takes into account patient preferences and chewing or swallowing disabilities may be considered. Appetite stimulants may increase weight but have serious adverse effects and no evidence of decreased mortality.
Ehrling Bergquist Family Medicine Residency Program, Offutt Air Force Base, NE, USA.