Geriatric Failure to Thrive

Author: Linh Nguyen, MD

Overview

The Institute of Medicine‘s definition of geriatric failure to thrive (FTT) is a syndrome manifested by weight loss greater than 5% of baseline, decreased appetite, poor nutrition, and inactivity, often accompanied by dehydration, depressive symptoms, impaired immune function, and low cholesterol levels.

 

Key Points

 

Assessment

A complete work up for geriatric FTT should include:

Robertson and Montagnini, 2004 Geriatric Failure to Thrive, is a resource for more detailed information on geriatric failure to thrive and medication.

 

Diagnosis

Diagnosis of FTT should prompt end-of-life care options to prevent burdensome interventions that may cause/prolong suffering.

Common medical conditions associated with FTT are: 

 

Interventions

Interventions should be directed toward easily treatable causes of FTT with the goal to maintain or improve overall functional status. However, in selected patients based upon the patient's clinical picture and patient's preferences, the goal is to control symptoms, patient/family support at the end-of-life, and to forgo aggressive, life-prolonging, burdensome medical evaluation and treatment.

 

References

Bogardus Jr, S. T., Bradley, E. H., Williams, C.S., Maciejewski, P.K., van Doorn, C, & Inouye, S.K. (2001). Goals for the care of frail older adults: do caregivers and clinicians agree? The American Journal of Medicine, 110(2), 97-102

Fink, D.M., Cooper, J.W., Wade, W.E. et al (2003). Updating the Beer's criteria for potentially inappropriate medication use in older people. Archives of Internal Medicine, 163:2716-2724.

Mini Nutritional Assessment (1998). Nestle Research Center. Nestle Clinical Nutrition. Available at https://www.mna-elderly.com/practice/user_guide.htm

Robertson, R. G., & Montagnini, M. (2004). Geriatric failure to thrive. American Family Physician, 70 (2): 343-350.

Sarkisian, C.A., & Lachs, M.S. (1996). "Failure To Thrive" in Older Adults. Annals of Internal Medicine, 124(12):1072-1078.

Sheikh, J.L. & Yeavage, J.A. (1986). Geriatric Depression Scale (Short Form). Clinical Gerontology, 5:165.