The cause of anorexia and proportion of its recovery in older adults without underlying disease: Results of a retrospective study

It is difficult to determine whether or not end-of-life care is necessary for frail older adults complaining of anorexia without underlying disease, such as cancer or organ failure. The main reason for this is the lack of the specification of the anorexia cause and no understanding of the cause-prov...

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Bibliographic Details
Published in:PloS one 2019-10, Vol.14 (10), p.e0224354-e0224354
Main Authors: Maki, Nobuyuki, Nakatani, Eiji, Ojima, Toshiyuki, Nagashima, Tomoka, Harada, Takane, Koike, Fumiko, Tosaka, Naoki, Yoshida, Hiroshi, Shimada, Toshio
Format: Article
Language:English
Subjects:
Adults
Aged
Aged, 80 and over
Anorexia
Anorexia - diagnosis
Anorexia - epidemiology
Anorexia - etiology
Anorexia nervosa
Biology and Life Sciences
Blood tests
Cardiovascular diseases
Causes of
Computed tomography
Death
Decision making
Demographic aspects
Diagnosis
Diagnostic systems
Emergency medical care
Emergency medical services
End of life
Female
Frail elderly
Frail Elderly - statistics & numerical data
Gastrointestinal diseases
Health aspects
Humans
Infections
Male
Medical diagnosis
Medical examination
Medical prognosis
Medical tests
Medical treatment
Medicine and Health Sciences
Mortality
Older people
Palliative care
Patient care
Patients
People and Places
Physical examinations
Prognosis
Psychological aspects
Recovery
Research and Analysis Methods
Retrospective Studies
Tomography
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Summary:It is difficult to determine whether or not end-of-life care is necessary for frail older adults complaining of anorexia without underlying disease, such as cancer or organ failure. The main reason for this is the lack of the specification of the anorexia cause and no understanding of the cause-providing factor and the prognostic factor. This study aimed to clarify the cause of anorexia, and the determinant of the cause and recovery from anorexia. Retrospective chart reviews were conducted on patients with anorexia without an underlying disease who were aged ≥65 years and visited the emergency department of a single tertiary care center between 2016 and 2017. Patient characteristics at hospital visit, the cause of anorexia, and diagnostic modalities were summarized. The diagnosis-providing rate, recovery rate, and the association between them were analyzed. Eighty-three patients (mean age 82.3 years; 50.6% male) were investigated. In 67 patients (81%), the causes of anorexia were identified, including 18 patients (22%) with infection, 13 (16%) with benign gastrointestinal diseases, and 7 (8%) with cardiovascular diseases. In 16 patients (19%), the causes of anorexia were not identified despite examinations. The modality that most contributed to diagnosis was plain computed tomography followed by blood tests. The value regarding information in history-taking and physical examinations was limited. Sixty-five patients (78%) recovered. Only 73% of patients with a definite cause recovered; all patients with an unknown cause recovered. Older adults with anorexia are not always at the end of life, and efforts to identify the cause are crucial. Moreover, it is vital to realize the limitations associated with the treatment of infections and cardiovascular diseases.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0224354