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failure to thrive
In pediatrics:
- infant's weight gain & growth far below expected for age
In geriatrics:
- an unexplained decrease in function, structure or metabolic process in excess of the expected for an age-matched cohort
Etiology:
1) organic
2) non-organic
3) often a precipitating event
Clinical manifestations:
1) weight loss
2) sarcopenia
3) physical frailty
4) decubitus ulcers
Laboratory:
1) serum cholesterol: hypocholesterolemia
2) serum albumin: hypoalbuminemia
3) complete blood count (CBC): anemia of chronic disease
Differential diagnosis:
1) organic causes
- cancer
- organ failure
- heart
- liver
- kidney
- chronic infection
- endocrine disorders
2) non-organic (psychologic)
- depression
- dementia
- psychosis
- grief
- suicidal ideation
3) functional problems
- immobility
- arthritis
- deafness
- blindness
- dental problems
4) neglect or abuse
- caregiver burnout
- elder abuse
Management:
1) identify precipitating event
2) multidisciplinary approach
3) treat identifyable treatable causes
4) refer to social work or Adult Protective Services if indicated
5) respite care for burned-out caregiver
General
sign/symptom
syndrome
failure
References
- Stedman's Medical Dictionary 27th ed.
Lippincot, Williams & Wilkins
- Verdery RB, Clinics in Geriatric Medicine 11(4):653 1995