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Part II Nutrition Assessment, Consequences, and Implications

for food, fluid, and nutrient intake, studies report that quantitative methods are necessary to provide estimations of energy intake

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biochemical data: medical tests, and procedures; and

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client history: cognitive decline, depression, neu- rological disease, hydration status, presence of infection, pressure ulcers, recent hospitalization.

Monitoring and evaluation of the above factors that are associated with UWL in older adults are needed to determine the effectiveness of medical nutrition therapy. As health care payment systems evolve, pre- venting rehospitalization within 30 days because of UWL will be of utmost importance to Accountable Care Organizations (ACO), administrators of facilities, and the RDN.

SUMMARY

Unintended weight loss refers to a significant amount of weight loss in a rapid period of time and to slow and insidious weight loss over several months. UWL in the older adult can be classified into three risk factor cate- gories: physiological, psychological, and social. UWL can be further categorized into three primary etiolo- gies: starvation, sarcopenia, and cachexia. An accurate assessment is essential given that UWL is associated with increased morbidity and mortality (2,45). If the individual has multiple medical problems and is taking several medications, the nutrition diagnosis of UWL can be multifaceted. To successively address these problems, the IDT must understand the physiological changes that occur with aging and the significance of weight loss in the aging adult. The treatment and man- agement of UWL is directed at identifying its underly- ing causes. More can be seen pertaining to UWL with use of Figure 7.4, the Guide to Prevent and Manage Unintended Weight Loss in Older Adults (see page 119) (22). While the evaluation continues, and if the cause is not well defined, the ultimate goal is to prevent further weight loss with interventions that are consistent with the individual’s wishes.

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