The causes of weight loss in elderly are many and may include natural, psychological, or non-medical. As you age it brings weight loss consisting of both fat mass and fat-free mass losses. Although, if you are overweight or obese, you are advised to lose weight for optimal health. But if you have lost 5% of your body weight in one month or 10% over a period of six months or longer. Then it is a signal of causing a sense of concern.
A sudden or extreme weight loss in elderly is an indicator of underlying disease such as functional decline, infections, decubitus ulcers, exacerbation of cognitive and mood disorders. (Source – 1) Even unintentional weight loss in older persons is associated with mortality. (Source – 2)
If you have or any member of your family has experienced a sudden weight loss in recent days, then read here to know more about why old people lose weight.
Causes of Weight Loss in Elderly
Deficient Dietary Intake
Aging is often associated with loss of appetite which results in a decline in food intake. Older people feel less hungry, eat less volume of foods and beverages daily, and have fewer snacks between meals. This results in consuming little energy and lacking some important nutrients.
According to a population-based study, people aged 60–74 years consume 500–700 fewer calories per day than their younger counterparts. If their daily calorie intake reduces from their recommended daily calories requirements, then a weight loss happens.
Additionally, studies on nutrition intake in old people have found that a lower intake of foods also decreases their intake of fiber, calcium, iron, zinc, magnesium, B vitamins, and vitamins C, D & E. (Sources – 3, 4)
Muscle Loss
Loss of muscle mass and strength is a part of the natural aging process. It is one of the vital causes of unexpected weight loss in elderly.
Muscle loss can start from age 40 and continue till one’s last breath resulting in a 50% or greater muscle loss. (Source – 5) According to a study, aging brings a reduction in myofibrillar protein synthesis which is thought to be responsible for muscle loss in the elderly.
Besides, older people generally have reduced appetite, dental issues, tainted taste, or have to follow low fat and low cholesterol diet. Due to this, they don’t consume the daily recommended amount of protein, as a result, they lack enough intake of protein which cannot prevent muscle loss.
Social Isolation
Older people often have smaller or no social networks and prefer to spend more time alone because of the loss of a partner or close friends, chronic illness, loss of mobility, or hearing loss. Studies have identified that social isolation and exclusion lead to reduce appetite, inadequate food intake, reduce physical activity, and poor dietary intake. (Sources – 6, 7, 8)
Mainly elderly males are at greater risk of poor dietary intake. Not only do they lack the knowledge to choose appropriate foods but also lack the motivation to plan and prepare nutritious meals.
Additionally, a variety of social factors such as poverty, lack of cultural participation, financial limitations, and inability to choose preferred foods are the causes of unintentional weight loss in elderly.
Decreased Serum Albumin Level
Albumin is a type of protein the liver produces. It is one of the most abundant proteins found in the blood which helps to keep fluid from leaking out of blood vessels. It also carries vital substances throughout our body, including hormones, vitamins, and enzymes.
For a healthy individual, the normal range is 3.5 and 5 grams per deciliter (g/dL). (Source – 9) As we age it starts decreasing and levels below 3.4 g/dL are considered low.
Low albumin levels can cause unexpected weight loss, loss of appetite, and other various liver and kidney diseases. (Source – 10)
Furthermore, according to one finding, low albumin levels also cause significant muscle loss in elderly people, eventually resulting in weight loss.
Depression
Older people are more likely to suffer from depression, however, it is not a normal part of aging. It happens due to some important life changes that generally occurred as we get old like the death of a loved one, retirement, chronic medical conditions, isolation etc.
Depression affects the same parts of the brain chemistry that control appetite leading to decreased appetite as a result can cause unintentional weight loss in elderly.
In fact, depression has been found as the most common cause of weight loss in the elderly, according to an observation by the Journal of the American Geriatrics Society.
Moreover, in a cohort study of 2,677 patients with unintentional weight loss, 16% of the participants reported depression as one of the causes of weight loss.
Dementia
Dementia is a syndrome of impairment in memory, communication, and thinking that severely interfere with our daily life. Although the likelihood of getting dementia increases with age, it is also not a normal part of aging.
Unintentional weight loss is common in patients with dementia and can affect one in every two or three dementia patients if reaches to its final stage. (Sources – 11, 12, 13)
People with dementia, due to their decreased mental state, generally forget to eat or refuse to eat. It, as a result, causes a decrease in energy intake leading to weight loss.
Cancer
Undoubtedly, the risk of developing cancer increases with age and it is more predominant in people aged 65 years or above. (Source – 14)
According to cancer.net:
- 40% of the patients with cancer report unexpected weight loss when first diagnosed with cancer.
- Up to 80% of people with advanced cancer undergo both weight loss and muscle loss also known as cachexia or wasting.
Cancer can contribute to a number of conditions such as changes in metabolism, loss of appetite and muscle, and malnutrition that causes weight loss in elderly. (Sources – 15, 16, 17, 18)
Diabetes
Older people are at higher risk of getting diabetes and it affects many older people. Diabetes in elderly is linked with insulin deficiency (Source – 19), as a result, their body cannot use glucose for energy and thus uses stored fat and muscles for energy (Source – 20), causing weight loss.
Tuberculosis (TB)
It has been long recognized that older people are vulnerable to tuberculosis. It is a serious infectious disease that usually affects the lungs.
Getting infected with tuberculosis disease is associated with loss of appetite and unintentional weight loss in elderly. (Sources – 21, 22)
Overactive Thyroid
Overactive thyroid (Hypothyroidism) is very common among elderly individuals and mostly occurs in aging women. It only takes place when our thyroid gland produces too much of the thyroxin hormone.
Overactive thyroid results in increased metabolism which accelerates the calorie-burning process despite increased food intake, causing unintentional weight loss. (Sources – 23, 24)
Medication Side Effects
Older people often take more medicine than younger people because of having more than one chronic medical disorder. Certain medications can produce side effects that may cause weight loss in elderly.
A retrospective chart review in a 718-bed long-term care facility looked at the reasons for 41 patients with recent weight loss. They found that more than 75% of the patients had received at least one medication known to potentially contribute to weight loss.
The common side effects may include loss of appetite, altered taste or smell, dry mouth, swallowing problems, nausea or vomiting.
Tips to Prevent Weight Loss in Elderly
The following tips may help older people to prevent unintentional weight loss:
- Help them to follow a healthy diet.
- Indulge them in daily physical activities. This will help to improve appetite in older people.
- Help them to participate in social and cultural activities.
- Make them have a regular sleep habits.
- Add vitamin and mineral supplements.
- Present them with a varied meal. (Source – 25)
- Encourage them to eat smaller meals and snacks frequently.
- Increase their daily protein intake and help them to consume 1 – 1.25 g/kg/d of high-quality protein. (Source – 26)
- Evaluate their medication regularly.
- Consult a registered dietitian or nutritionist to plan a healthy meal.
- Provide support from family members and caregivers as needed.
When to Consult a Doctor?
With aging, peoples’ weight generally fluctuates. But, if you keep losing weight without trying for a period of a few months. Then consult a doctor immediately.
The doctor will give you a physical examination and may ask various questions. He or she may actually want to uncover the symptoms that you are unaware of or you do not find serious.
For this, he or she may take blood tests and X-rays and may advise what to do next.
