Geriatric Syndrome

Unintentional Weight Loss: Outpatient Workup

Unintentional weight loss of 5% or more over 6–12 months in an older adult is clinically significant and warrants a structured workup — it is independently associated with increased mortality, sarcopenia, frailty, falls, and undiagnosed malignancy or dementia. This guide presents a stepwise outpatient approach grouped by the 'Meals on Wheels' framework: medications (digoxin, SSRIs, metformin, NSAIDs), emotional issues (depression), elder abuse, late-life paranoia, swallowing problems, oral problems, no money, wandering and dementia, hyperthyroidism/hypothyroidism, enteric problems, eating problems, low-salt/low-cholesterol diets, social problems, and stones. Initial workup includes CBC, CMP, TSH, ferritin, B12, HIV when appropriate, age-appropriate cancer screening, chest imaging, and depression and cognitive screening. Covers when to escalate workup, when to involve dietitian and SLP, and when to reframe goals to comfort and quality of life.

Full clinical workflow, red flags, dosing, and documentation below. Subscribe to read the full guide.