Medications are often reviewed as the first step in determining the cause of weight loss. A speech pathologist may be consulted to determine if the patient has any swallowing problems.
Weight loss is frequently seen in individuals with Alzheimer’s disease. Weight loss may occur throughout the course of Alzheimer’s disease, but becomes more common as the disease progresses.
From a scientific standpoint, there is growing evidence that weight loss later in life can be an early warning sign of mental decline and the development of Alzheimer’s disease. Because the brain regulates so many of the body’s functions – including hunger and satiety – scientists say it makes sense that the effects of Alzheimer’s disease in the brain would affect many different aspects of bodily function including weight.
There are many causes of weight loss in the elderly and in persons with Alzheimer’s disease. These are addressed in the Q&A below.
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Yes. Conditions that can lead to weight loss include:
Weight loss is a side effect of many medications that an elderly person or person with Alzheimer’s disease may take. The types of medications include:
Other reasons for weight loss in persons with Alzheimer’s disease include:
Other events in the lives of the elderly, such as grief and mourning the loss of a spouse or life-long friends as well as social isolation, can also lead to weight loss.
The doctor will gather the patient’s medical history and conduct a physical exam to look for the medical issues that often underlie the cause of the weight loss and need treatment. Many doctors review a patient’s medications as the first step since they are often the cause of loss of appetite and weight. All current prescription and over-the-counter medications and supplements should be reviewed.
A speech pathologist may be consulted to determine if the patient has any swallowing problems.
Treatment should be focused on the identified causes of weight loss. If other health problems are suspected to contribute to weight loss, they need to be identified and treated. Current medications that are no longer required should be discontinued. Prescription medications, over-the-counter products and supplements that are thought to be a source of weight loss should be discontinued and replaced (if needed) with medications that are not associated with weight loss. An appetite stimulant, such as megestrol acetate (Megace®), dronabinol (Marinol®), mirtazapine (Remeron®), or growth hormone secretagogues may be prescribed.
A speech therapist may recommend a feeding strategy if there are reversible causes for the eating problems.
In individuals with advanced Alzheimer’s disease in their final stages of illness, oral feeding by hand (by an assistant) or placement of a feeding tube are the two main options. The goal of hand feeding is to continue to provide food and beverage as long as still pleasurable and comfortable for the patient. Hand feeding requires a caregiver’s assistance for approximately 45 to 90 minutes per day. The goals of long-term tube feeding (usually through a PEG tube [percutaneous endoscopic gastrostomy]) are to improve malnutrition, prevent aspiration (food, drink, secretions, stomach content that enter the airways [lungs] instead of the digestive tract), and extend life. Tube feeding is not without its risks, which include dislodgement of the tube, blockage, leakage, and development of pressure sores. The decision to place a feeding tube in a person with end-stage Alzheimer’s disease is difficult and requires understanding, careful thought, and counseling of family members by the healthcare team, religious personnel, hospice personnel and other responsible individuals.
Last reviewed by a Cleveland Clinic medical professional on 05/23/2019.
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