Weight Loss in your Senior Parent – A Problem? Info for Seniors and Loved Ones in Arizona

Losing body mass is a common sign of aging. In fact, weight loss is far more common than weight gain as people reach and exceed the age of 65. But it is not necessarily cause for alarm. Dr. Asha Wurdeman offers suggestions for determining  if your loved one’s weight loss is healthy.

Signs That Your Loved One’s Weight Loss is Serious

Geriatricians become concerned when a patient’s Body Mass Index (BMI) drops below 21. BMI is measured by dividing the individual’s height in inches by their weight in pounds. A benchmark to watch for at home is a drop of 10 pounds or more within a six month period. For a nursing home dweller the benchmark is a 10 percent weight decrease over the same time period. This extreme level of weight loss is a strong indication of malnutrition and the individual should be tested to determine whether or not other indicators are also present.

Along with extreme weight loss, you should look for signs of malnutrition which include dehydration, a poor protein level and low cholesterol level – in particular when the Low Density Lipoprotein (LDL) or “good” cholesterol is low. In combination, these conditions are clear indicators that your loved one is malnourished and should receive immediate treatment to reverse the downward trend and rebuild physical health. A return to robust good health is more challenging when dealing with the inherent added physical frailty of an elderly patient.

Guidelines for Helping Your Loved One

Dr. Wurdeman offers a number of corrective approaches to reverse elderly weight loss that has deteriorated to the point of malnutrition.

• Monitor your loved one’s weight weekly and measure the percentage of food intake.
• Encourage your loved one to eat frequent snacks and drink nutritional supplement shakes in between meals so that her mealtime appetite will not be affected.
• Liberalize your loved one’s diet and remove restrictions on things such as salt or sugar to enhance the overall taste of food. The health risk caused by malnutrition will outweigh other health issues in the short-term.
• Have a professional assess your loved one’s ability to feed herself.
• If necessary, utilize outside help – like a Right at Home caregiver – to ensure that your loved one eats meals.

Incorporating Physical Activity

It may be beneficial to introduce your loved one to a physical activity program designed to increase muscle mass, Basal Metabolic Rate (BMR) and bone strength, which have been compromised by the lack of proper nutrition. Under the care of a trained medical professional, elderly weight loss degenerating to malnutrition can be successfully reversed.

Normal Elder Weight Loss

When assessing weight loss in the elderly, medical professionals determine if it is a case of normal body mass loss by evaluating three frequently occurring conditions, all considered to be a part of aging. The first is sarcopenia in which lean muscle, body water and the basal metabolic rate all decrease as body fat increases. This means the body needs fewer calories thereby causing the individual to feel less hungry. This common phenomenon is the reason we sometimes watch our elderly relatives as they pick at their plates and complain about a lack of appetite at mealtime.

The second is a decrease in stomach acid, affecting the body’s ability to absorb vitamins and nutrients into the system. This is particularly problematic with the water soluble Vitamin B12. The loss of stomach acid coincides with a decrease in digestive enzymes which can lead to constipation. These individuals also typically experience dry mouth, which is the primary reason for a decrease in their sense of taste and smell.

The loss of stomach acid causes food to be less nutritionally productive.  Your loved one may also feel abdominal discomfort due to constipation and may be generally less interested in food due to its lack of taste. Under these circumstances it is no wonder that eating becomes a chore rather than a pleasure.

The third condition is a loss of bone mass, or osteoporosis, partially due to the fact that our bodies become less able to synthesize Vitamin D, which inhibits our intake of calcium. Lack of bone density causes your loved one to weigh less. The inherent risk in osteoporosis is a marked increase in bone fractures, particularly in the hip.

For the small percentage of elderly that experience weight gain, it is generally attributable to a significant decrease in activity and/or a shift in muscle to fat ratio causing the body to burn fewer calories. Under these circumstances, increasing physical activity would help to control weight gain as well as strengthen muscle mass, which is advisable whenever physically possible.

Information gathered from interview with Dr. Asha (Patel) Wurdeman, a board certified family physician who recently completed a fellowship in Geriatric Medicine with experience in Hospice and Palliative Care in Los Angeles, California. Her practice will focus on health care of the elderly with aims to promote health and prevent disease and disability.

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