CAUSES OF WEIGHT-LOSS IN A COMMUNITY NURSING-HOME

Objective: To determine the causes of weight loss in nursing home resi dents. Design: Retrospective chart review of all weights over the prev ious 6 months and an in-depth examination of all residents who lost 5 or more pounds over that period. Setting: A for-profit community nursi ng home in an urban area. Subjects: All residents who had been in the nursing home for 3 or more months. Their mean age was 80.1 years, and 89% were female. Results: Weight loss of 5 pounds or more occurred in 19% of subjects. Only 15% of subjects had lost 5% of body weight, and 4% had lost more than 10% of their body weight. Depression accounted f or 36% of the weight loss. Other causes of anorexia included medicatio ns, psychotropic drug reduction, swallowing disorders, paranoia, demen tia with apraxia, gallstones, and obsessive-compulsive disorder. Incre ased energy utilization as a cause of weight loss was seen in two resi dents who wandered incessantly, one with tardive dyskinesia and one wi th chronic obstructive pulmonary disease. Dehydration was the cause of weight loss in two residents, and one resident had intentional weight loss for obesity. Cancer was the cause of weight loss in two resident s. Four of 30 residents had more than one cause of weight loss. One of 25 tube-fed residents displayed weight loss. Conclusions: A single ca use of weight loss can be identified in most nursing home residents. D epression is the most common cause of weight loss. Psychotropic drug r eduction may cause weight loss. The majority of causes of weight loss in a community nursing home are potentially treatable.