failure to thrive

Introduction

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

• organic
• non-organic
• often a precipitating event

Clinical manifestations

• weight loss
• sarcopenia
• physical frailty
• decubitus ulcers

Laboratory

• serum cholesterol: hypocholesterolemia
• serum albumin: hypoalbuminemia
• complete blood count (CBC): anemia of chronic disease

Differential diagnosis

• organic causes
  • cancer
  • organ failure
    • heart
    • liver
    • kidney
  • chronic infection
  • endocrine disorders
• non-organic (psychologic)
  • depression
  • dementia
  • psychosis
  • grief
  • suicidal ideation
• functional problems
  • immobility
    • arthritis
  • deafness
  • blindness
  • dental problems
• neglect or abuse
  • caregiver burnout
  • elder abuse

Management

• identify precipitating event
• multidisciplinary approach
• treat identifyable treatable causes
• refer to social work or Adult Protective Services if indicated
• respite care for burned-out caregiver

More general terms

• sign/symptom
• syndrome
• failure