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Related Experiment Video

Updated: May 5, 2026

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"Failure to thrive" in older adults

C A Sarkisian1, M S Lachs

  • 1New York Hospital-Cornell Medical College, New York, USA.

Annals of Internal Medicine
|June 15, 1996
PubMed
Summary

Failure to thrive in older adults, often diagnosed with a single code, requires a deconstructed approach. Identifying and addressing key impairments like physical decline, malnutrition, depression, and cognitive issues is crucial for better management.

Area of Science:

  • Geriatric Medicine
  • Clinical Gerontology

Background:

  • The term "failure to thrive" is commonly used for older adults experiencing declining independence.
  • It originated in pediatrics and is applied to older adults with multiple chronic diseases or functional impairments.
  • Despite its heterogeneity, it has been treated as a distinct diagnosis, potentially hindering effective evaluation and management.

Purpose of the Study:

  • To examine the medical etymology of "failure to thrive."
  • To propose a rational approach to the evaluation and management of this condition.
  • To encourage a deconstructionist approach, identifying and quantifying specific areas of impairment.

Main Methods:

  • Literature review of the medical etymology of "failure to thrive."
  • Analysis of the interplay between common syndromes associated with failure to thrive: impaired physical functioning, malnutrition, depression, and cognitive impairment.

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  • Examination of modifiable versus non-modifiable contributors to these syndromes.

    • Main Results:

    • The "failure to thrive" diagnosis can foster fatalism and intellectual laziness, impeding a thorough assessment.
    • Four key syndromes (impaired physical functioning, malnutrition, depression, cognitive impairment) are prevalent and interconnected.
    • Easily modifiable contributors should be prioritized for intervention to improve overall functional status.

    Conclusions:

    • A deconstructionist approach is essential for evaluating and managing "failure to thrive" in older adults.
    • Interventions should target easily remediable factors to improve functional status.
    • Further research with robust process and outcome data is needed to guide aggressive treatment strategies for less modifiable contributors.