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Wasting away is no excuse for wasting medical resources.

Sudden loss of weight in elderly patients usually produces a vigorous search for some form of cancer. After this, there comes a host of costly diagnostic procedures that, more often than not, fail to reveal the cause. A study recently published in the Journal of the American Geriatries Society shows cancer as the culprit in only 16 percent of 45 patients aged 63 or older who had lost about 8 percent of their normal body weight during the previous six months. (This would be equivalent to a 14pound weight loss in a 180-pound person.)

Doctors performed an average of 23 specialized diagnostic procedures on each patient. Yet they found that a careful history and physical examination usually identified the cause of the weight loss, whenever the doctors could find a physical cause. They could find no explanation among 24 percent of the patients. In 18 percent, it was due to depression, in 11 percent to gastrointestinal problems, in 9 percent to an overactive thyroid, in another 9 percent to medications, and in 7 percent to neurological problems.

Although small, the study suggests that far more benefit comes from a thorough medical history and physical examination than from a lot of expensive tests. Searching for social and psychological factors, evaluating a patient's nutrition, and reviewing medications will likely reveal a cause for the weight loss, if any is to be found. If the doctor finds something suspicious during such an examination, specialized diagnostic procedures can then be carried out.
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Title Annotation:sudden weight loss in elderly may not be symptoms of cancer
Publication:Medical Update
Date:Oct 1, 1991
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