Intervene to Counter Weight Loss in Elderly: Depression Is Usually the Biggest Culprit

By McNamara, Damian | Clinical Psychiatry News, June 2004 | Go to article overview

Intervene to Counter Weight Loss in Elderly: Depression Is Usually the Biggest Culprit


McNamara, Damian, Clinical Psychiatry News


MIAMI -- Aggressive intervention to counter weight loss in the elderly can go a long way to improve quality of life and prevent morbidity and mortality, Dr. Jonathan T. Stewart said at a psychopharmacology update sponsored by the University of Miami.

"The first thing to do is notice the problem--that is the take-home message," Dr. Stewart said. "This is an area that doctors all ignore--and probably one of the long-range quality of life issues where we can make a difference."

Psychiatrists are well positioned to monitor elderly patients' weight and determine their ability to gain weight. Involuntary weight loss is a very strong predictor of 1-year mortality in the elderly, as well as a strong predictor of institutionalization, said Dr. Stewart, chief of the geropsychiatry section at Bay Pines Veterans Affairs Medical Center in St. Petersburg, Fla.

An estimated 10%-25% of the elderly are malnourished, but rates are considerably higher in medical settings. In one study, about 30% of geropsychiatry clinics, outpatients were malnourished, as were an estimated 30%-60% of older patients on medical-surgery wards. Dr. Stewart said.

Patients should be educated about the consequences of malnutrition; increased risk of infection, poor wound healing, loss of bone mineral density, increased risk of fractures and falls, and decreased functional capacity.

Begin by identifying potential psychiatric, medical, drug-related, and social causes. Treatment is mostly common sense. He suggested aggressive treatment of medical and or psychiatric causes, as well as removing any offending medications. Get rid of dietary restrictions when possible. "Explain why they really don't want to be drinking 1% milk," Dr. Stewart said. Encourage patients to maintain good dental hygiene and to exercise.

Maintaining weight is one of the biggest aspects of keeping an elderly patient well, Dr. Stewart said at the meeting, which was also sponsored by the Florida Psychiatric Society. "Keeping people from becoming frail is frequently an uphill battle in geriatric psychiatry."

Depression is the major culprit for weight loss in the elderly, Dr. Stewart said. "Depression is the biggie--the most important cause of involuntary weight loss in the elderly."

Control issues, such as a power struggle between patient and nurses in a nursing home, also should be considered. Alcoholism and drinking at the expense of eating are common. Another possible condition is "depletion," a state in which people do not eat right when they are near to death, explaining that the burden of living has become too great.

Delusions can play a role, although specific delusions about poisoning are rare, Dr. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Intervene to Counter Weight Loss in Elderly: Depression Is Usually the Biggest Culprit
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.