Investigation and management of unintentional weight loss in older adults

#### Summary points Unintentional weight loss occurs in 15-20% of older adults (those over 65) and is associated with increased morbidity and mortality.1 Clinical and epidemiological studies have reported even higher prevalence in certain populations, with as many as 27% of community dwelling elderly people and 50-60% of nursing home residents being affected.1 2 w1 Weight loss may be the presenting problem or an incidental finding during a consultation for other reasons. There are no published guidelines on how to investigate and manage patients with unintentional weight loss, and responses range from doing nothing (if it is viewed as a normal part of the ageing process) to extensive blind investigation because of the fear that it represents underlying cancer. Observational studies have shown that in as many as 25% of cases no identifiable cause is found, despite extensive investigation.3 4 It is not clear how far clinicians should go to investigate older patients with unintentional weight loss in the absence of an obvious medical cause. We review the available evidence (mainly epidemiological and observational studies) and outline a structured approach to investigation and management of the older patient with unintentional weight loss. #### Sources and selection criteria We searched the literature for current …