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Geriatric failure to thrive.

Russell G Robertson¹, Marcos Montagnini

¹Department of Family and Community Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin 53226, USA. rrdoc@mcw.edu

American Family Physician

|August 5, 2004

Summary

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Failure to thrive in elderly patients involves multifactorial decline, including weight loss and inactivity. Early assessment and intervention for treatable causes are crucial for improving function and discussing end-of-life care.

Area of Science:

Geriatrics
Internal Medicine
Clinical Medicine

Background:

Failure to thrive (FTT) in the elderly is a complex condition characterized by multifactorial decline.
Key manifestations include weight loss, decreased appetite, poor nutrition, and inactivity.
Four prevalent syndromes—impaired physical function, malnutrition, depression, and cognitive impairment—predict adverse outcomes.

Purpose of the Study:

To outline the assessment and management of failure to thrive in elderly patients.
To emphasize the importance of identifying and treating reversible causes.
To highlight the role of FTT diagnosis in initiating end-of-life care discussions.

Main Methods:

Comprehensive initial assessments covering physical, psychological, functional, socioenvironmental, and nutritional status.

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Targeted laboratory and radiologic evaluations based on individual patient needs.

Thorough medication review to identify contributing side effects or drug interactions.

Main Results:

FTT is associated with chronic diseases and functional impairments.
Easily treatable causes should be prioritized for intervention.
Addressing FTT can help maintain or improve overall functional status.

Conclusions:

Failure to thrive diagnosis is a critical decision point in geriatric care.
Interventions should focus on reversible factors to improve patient outcomes.
The diagnosis necessitates discussions about end-of-life care to prevent prolonged suffering from futile treatments.