Unexplained weight loss in the elderly, cohort study of 77 patients with a13-month follow-up

Purpose. - In case of unexplained weight loss, chest X-ray, abdominal ultra sonography and gastroscopy are usually recommended. However, gastroscopy is not usually performed in elderly patients. Methods. - We evaluated 77 patients (mean age: 80 +/- 8 years) hospitalized in our geriatric unit between January 1995 and May 1997 for unexplained we ight loss. All patients underwent chest X-ray, abdominal ultrasonography an d gastroscopy. Results. - These investigations led to diagnosis in respectively 17, 15 and 46 patients. The etiology of weight loss was unique in 47 patients, while in 30 other patients at least two or three causes could be described. Gastr oscopy appeared to be the most useful test, as it allowed description of ei ght cases of cancer, 29 cases of peptic ulcer, two cases of candidosis, and one case of actinomycosis in patients who did not present any clinical sig n. Conclusion. - Sixty-five patients were followed-up for a mean period of 13 +/- 21 month; 33 patients died. The condition of 23 patients improved eithe r slightly or definitely. Simple investigations led to diagnosis in 95% of the cases. However, 42% of the patients died within 3 months. Gastroscopy a ppears to be the most valuable test leading to diagnosis in more than half of the cases. With adapted treatment, the condition of 75% of the patients with gastro-intestinal lesions improved. (C) 2001 Editions scientifiques et medicales Elsevier SAS.