Weight loss in advanced Alzheimer's disease, part I: Contributing factors and evaluation
Weight loss is a common occurrence in advanced Alzheimer's disease. Part I of this two-part article discusses the factors associated with the pathophysiology and progression of Alzheimer's disease that may promote weight loss, and the appropriate evaluation of weight loss and malnutrition. Factors such as abnormal eating behaviors, behavioral disturbances, oropharyngeal dysphagia, taste and smell dysfunction, and the effects of proinflammatory cytokines influence the balance between energy intake and energy expenditure, making stability more difficult to maintain and promoting a tendency toward weight loss. Many other conditions along with medication effects may also contribute to weight loss and nutritional decline. Appropriate nutritional care for the patient with Alzheimer's disease with weight loss starts with a thorough assessment to identify all the contributing factors. The evaluation should include a review of medications, medical history, and a thorough physical examination.
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