Epidemiology of weight loss in humans with special reference to wasting in the elderly
Epidemiology of weight loss in humans with special reference to wasting in the elderly
复制标题
DOI：
10.1016/s0167-5273(02)00246-2
复制
发表时间：
2002-09-01
影响因子：
3.5
通讯作者：
Schwartz, RS
中科院分区：
文献类型：
--
作者：
Wallace, JI;Schwartz, RS
老年人的意外体重减轻是临床实践中经常发生的问题。尽管仅随着年龄的增长观察到体重略有下降，但临床上重要的体重减轻（正常体重减少5%或更多）几乎总是疾病，废用和/或心理社会因素的结果。与体重减轻相关的不良健康结果包括功能能力下降和发病率和死亡率增加。病例系列和前瞻性研究有助于确定老年人体重减轻的最常见原因，本文对此进行了综述。了解这些常见的潜在病因有助于指导对体重减轻患者进行适当且具有成本效益的评估。在许多情况下，原因是可以补救的，通过适当的干预，体重减轻可能会减缓或逆转。在某些情况下，没有明确的病因可以确定，但病人仍然可以响应营养支持治疗，包括高热量喂养和食欲刺激剂。然而，单独增加热量摄入通常不足以减轻由慢性炎症或其他严重疾病状态（恶病质）引起的体重（特别是肌肉质量）损失。潜在的策略，以帮助减少瘦体重的损失和功能下降，往往伴随着体重减轻包括合成代谢药物，运动/体力活动，和细胞因子抑制。本文回顾了流行病学的体重减轻，特别注意的恶病质的问题，在老年人。提供诊断和治疗算法，以帮助指导临床评估，并为治疗干预，老年人提出体重减轻。(C)2002年由Elsevier Science爱尔兰有限公司出版。
Unintentional weight loss in older adults is a problem that occurs frequently in clinical practice. Although slight declines in weight have been observed with aging alone, clinically important weight loss (decrements of 5% or more of usual body weight) is almost always the result of disease, disuse, and/or psychosocial factors. Adverse health outcomes associated with weight loss include decreased functional abilities and increased morbidity and mortality. Case series and prospective studies have helped to identify the most common causes of weight loss in older adults, and are reviewed herein. Knowledge of these frequent underlying etiologies can help guide an appropriate and cost-effective evaluation of patients presenting with weight loss. In many cases the causes are remediable and weight loss may slow or reverse with appropriate intervention. In some cases no clear etiology can be identified but the patient may still respond to nutritional support therapies that include hypercaloric feeding and appetite stimulants. Increasing caloric intake alone, however, is usually not sufficient to mitigate against losses in body mass (especially muscle mass) that are the result of chronic inflammatory or other severe disease states (cachexia). Potential strategies to help reduce losses in lean body mass and the functional decline that often accompanies weight loss include anabolic agents, exercise/physical activity, and cytokine inhibition. This article reviews the epidemiology of weight loss in older adults with special attention to the problem of cachexia. Diagnostic and treatment algorithms are provided to help guide clinical evaluation of, and therapeutic interventions for, older adults presenting with weight loss. (C) 2002 Published by Elsevier Science Ireland Ltd.