Unexplained Weight Loss in Seniors

Unexplained Weight Loss in Seniors

Unexplained weight loss in seniors is a serious health concern. Over 25% of people 65 and older experience unexplained weight loss. That weight loss is associated with higher rates of hospitalization and increased mortality in seniors. 

Unexplained weight loss can indicate an undiagnosed medical condition or other health and quality of life issues that need to be addressed. Left untreated, unexplained weight loss can cause or exacerbate other health issues. Anyone experiencing unexplained weight loss should seek medical attention.

What is Unexplained Weight Loss?

Unexplained weight loss is a loss of at least 10 pounds or 5% of a person’s body weight that occurs within 6-12 months. Unexplained weight loss isn’t due to a conscious effort to lose weight. 

There are a number of reasons why seniors experience unexplained weight loss. The causes can be physical, emotional, or a complex combination of several age-related factors.

Medical Conditions That Cause Weight Loss 

Many medical conditions cause unexplained weight loss. Here are some common ones as well as ones you might not expect.

• Dysphagia (trouble swallowing)
• Crohn’s disease or ulcers
• Hyperthyroidism (an overactive thyroid gland)
• Dental problems—especially painful chewing
• Parkinson’s disease
• Experiencing frequent physical pain
• Cancer
• Parasitic infection

In some cases, a simple blood test can determine an underlying physical cause for weight loss. In other situations, further tests may be in order.

Medications Can Cause Weight Loss

Certain medications can cause unexplained weight loss. Some medications cause dry mouth, making eating less enjoyable. Others affect appetite, cause nausea or vomiting, or decrease a person’s sense of taste or smell.

Review all of your medications with your doctor to see if any cause weight loss. Ask your doctor or pharmacist whether any of your medications interact to create this side effect. If so, you may be able to switch out one of your medications for another that doesn’t cause weight loss.

Psychological Causes of Unexplained Weight Loss

In addition to physical causes, there can be psychological reasons for unexplained weight loss. One study even theorized that psychological factors are one of the biggest risk factors for unexplained weight loss in seniors. The risk is compounded by the social isolation that often comes with aging.

Depression and anxiety can both play a role in weight loss for seniors. Depression lowers motivation for daily activities, such as doing work to prepare food. Even pouring a bowl of cereal can feel like too much effort. Many people experiencing depression lose interest in eating. Anxiety can cause a loss of appetite and produces a surge of stress hormones that can suppress the desire to eat. 

Alcohol and drug use can also result in a sudden loss of weight. We don’t typically think of older people when we think of drug or alcohol problems. Being older doesn’t make someone immune to addiction, though. Close to one million older adults are reported to have a substance abuse disorder. 

Grief is another cause of unexplained weight loss. Grief causes a loss of interest in daily activities as well as a loss of appetite.

Dementia Can Cause Unexplained Weight Loss

Weight loss is among the many complications of dementia. Dementia includes several conditions where cognitive function declines. 

People with dementia sometimes forget to eat. Dementia causes temporal confusion, meaning people get time mixed up, often confusing daytime for the night and vice-versa. Older people may choose to keep their shades pulled down and stay indoors more, limiting the cues (sunlight and darkness) that help us tell the time of day. 

Dementia can make performing order of simple tasks difficult. Think of all the steps it takes to make a sandwich. We normally do it without thinking, but there are many steps involved. The order of 1) finding the bread 2) putting the bread on the counter, 3) getting a plate, 4) opening the bread, and so on can be daunting. Faced with what seems like a complex task, people with dementia may give up or lose focus before they complete the task. 

Aged-Related Reasons for Weight Loss

The simple act of aging can be a reason for unexplained weight loss. After the age of 65, men and women lose approximately a quarter to a third of a pound every year. This weight loss is normal, but several aspects of aging contribute to the risk of unexplained weight loss. 

• Loss of mobility (making food prep more challenging)
• Loss of muscle tone and overall energy
• More time being sedentary (which can decrease appetite)
• Less social activity
• Less daily structure
• Cognitive decline (not related to dementia)

Consequences of Weight Loss

Just as there are several causes of unexplained weight loss in seniors, there are several ways unexplained weight loss can impact senior health. 

One obvious consequence of sudden weight loss is poor nutrition. If someone is not getting an adequate daily intake of calories, they are probably not getting the proper nutrition. (This is why, in many cases, doctors recommend having one or two protein shakes per day to reverse weight, but not before a full evaluation. Check with your doctor before starting on these shakes.)

Other effects of unexplained weight loss:

• Lower energy
• Moodiness (hunger does that to us)
• Muscle weakness
• Loss of balance
• Increased confusion
• Increased risk of infections

As mentioned above, unexplained weight loss can lead to increased hospitalizations and increased mortality. It can also result in a poorer quality of life and a stronger likelihood of needing long-term care. 

The Vicious Cycle of Risk Factors

Unfortunately, the risk factors for senior weight loss don’t exist in a vacuum. Many cause or exacerbate other risk factors. For example, a loss of mobility impacts social activity which increases depression. Or, trouble swallowing causes weight loss, which increases the risk of falling. Symptoms compound one another and around and around again. 

To avoid this vicious circle, any unexplained weight loss should be evaluated promptly.

Treatment for Unexplained Weight Loss

Because there are so many factors that can cause weight loss in seniors, treatment must be highly individualized. This is a partial list of treatments and interventions. 

• A change in medication
• Food delivery services
• Nutritional shakes or supplements
• Talk therapy or medication for mental health
• Medication to improve appetite
• Physical therapy to improve mobility
• Treatment of underlying health issues

A comprehensive medical history, physical examination, and targeted diagnostic tests are vital tools in determining the best course of treatment for unexplained weight loss.