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 info@medicyatra.com
Top Rated Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
Definition of Weight loss in the elderly
1. Email: enquiry@medicyatra.com
Definition of Weight loss in the elderly
• 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
7. weight loss in the older patient.
4. Describe the components of inter-disciplinary approach in the
management of unintentional weight loss in the older patient.
Copyright @ Forever Medic Online Pvt. Ltd
2. Email: enquiry@medicyatra.com
Definition of Weight loss in the elderly
• No uniformly accepted definition of weight loss in the older patient
Definition 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.
Copyright @ Forever Medic Online Pvt. Ltd
3. Email: enquiry@medicyatra.com
Epidemiology of Unintentional weight loss :
• Prevalence:
13% to 27% in frail older community patients
50% to 65% of nursing home residents
Copyright @ Forever Medic Online Pvt. Ltd
5. Email: enquiry@medicyatra.com
Etiology of weight loss in the elderly
• 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. Drugs
5. Disease(chronic) 10. “Dollars”(econonic
factors)
Copyright @ Forever Medic Online Pvt. Ltd
7. Email: enquiry@medicyatra.com
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
Copyright @ Forever Medic Online Pvt. Ltd
8. Email: enquiry@medicyatra.com
Evaluation: Physician Exam
• Use information from H&P
1.Comprehensive: Emphasize on oral cavity , respiratory
an GI exam
2.Calculate: Body mass index(BMI) = wt(kg)/ht(m2):
. .
3. Cognition: mood and affect
.
Copyright @ Forever Medic Online Pvt. Ltd
9. Email: enquiry@medicyatra.com
Evaluation
• Assessment Tools:
1. DETERMINE checklist:
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.
Copyright @ Forever Medic Online Pvt. Ltd
10. Email: enquiry@medicyatra.com
Lab tests:
• Test should be based on clues from history physical
exam
• In general, Initial test are:
1. Complete blood count
2. Electrolytes, BUN/Cr , albumin
3. TSH
4. Urinalysis
5. Stool guiac
Copyright @ Forever Medic Online Pvt. Ltd
11. Email: enquiry@medicyatra.com
Other diagnostic studies:
• 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
evaluations are negative.
Copyright @ Forever Medic Online Pvt. Ltd
12. Email: enquiry@medicyatra.com
Management of weight loss:
• Identify and treat the under-lying cause.
• Addressed important associated factors
• Involve a dietician and social worker early
• Nonpharmacologic and pharmacologic approach to
treatment
Copyright @ Forever Medic Online Pvt. Ltd
13. Email: enquiry@medicyatra.com
Management:
• Non pharmacological :
1. less restricted diet: diabetics, CHF,
hypercholesterol
2. Oral nutritional supplements
3. Enhance protein and energy intake: between
meals
4. Optimized diet texture in consult with speech
therapy
5. Encourage oral intake: greater than 75% of meal
6. Use flavor enhancers: patients with hyposmia
7. Exercise: To stimulate appetite.
Copyright @ Forever Medic Online Pvt. Ltd
14. Email: enquiry@medicyatra.com
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.
Copyright @ Forever Medic Online Pvt. Ltd
15. Email: enquiry@medicyatra.com
Summary:
• 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
patients. Keep close follow-up.
Copyright @ Forever Medic Online Pvt. Ltd
16. Email: enquiry@medicyatra.com
Future research:
• Future: Cytokines such as interleukins, interferon, TNF alpha,
hypothalamic monoaminergic neurotransmission play roles in
cachexia.
• Interference with these factors may be effective therapeutic
strategy in patients with anorexia along with CCK antagonist.
• There is Research on Feeding associated gene products
which will enhance understanding of the mechanisms of
anorexia.
Copyright @ Forever Medic Online Pvt. Ltd