Constitutional Syndrome from a Geriatric Perspective
Published
Aug 24, 2022
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Carolina Muñoz Muñetón
https://orcid.org/0000-0001-5861-2411
Estephanía Chacón-Valenzuela
https://orcid.org/0000-0002-8697-8477
Alberto Rodríguez Varón
https://orcid.org/0000-0003-1222-0636
María Paula Vargas
https://orcid.org/0000-0002-7470-3054
Diego Chavarro-Carvajal
https://orcid.org/0000-0002-8584-3191
https://orcid.org/0000-0001-5861-2411
Estephanía Chacón-Valenzuela
https://orcid.org/0000-0002-8697-8477
Alberto Rodríguez Varón
https://orcid.org/0000-0003-1222-0636
María Paula Vargas
https://orcid.org/0000-0002-7470-3054
Diego Chavarro-Carvajal
https://orcid.org/0000-0002-8584-3191
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Abstract
Fatigue, anorexia, and involuntary weight loss are terms that have been included in the definition of constitutional syndrome. These accompany many diseases in which the diagnosis is made by specific symptoms and signs. However, in older adults the term can become more ambiguous and is not associated with malignancy in all cases. It is common for older adults to have loss of appetite and/or decreased food intake since anorexia and dysgeusia in the elderly are normal physiological changes that can affect their energy metabolism and general health. Additionally, comorbidities and some medications can have an effect on food intake and weight loss. This is why it is important to have other differential diagnoses of this clinical entity such as sarcopenia and frailty, which in their own diagnostic criteria include weight loss and fatigue; given the multiple differential diagnoses, constitutional syndrome can be a challenge in the elderly population and geriatric assessment is a useful tool to address it.
Keywords
Pérdida de peso, Anorexia, Fatiga, Astenia, Adultos mayoresweight loss, anorexia, fatigue, asthenia, older adults
References
1. Suárez-Ortega S, Puente-Fernández A, Santana-Báez S, Godoy-Díaz D, Serrano-Fuentes M, Sanz-Peláez O. Síndrome constitucional: entidad clínica o cajón de sastre. Rev Med Inst Mex Seguro Soc [internet]. 2013 Sep-Oct;51(5):532-5. Disponible en: https://www.imbiomed.com.mx/articulo.php?id=95899
2. Castro Alvirena JD, Verdejo Bravo C. Protocolo diagnóstico y tratamiento del síndrome constitucional en los pacientes mayores. Medicine. 2014;11(62):3720-4. https://doi.org/10.1016/S0304-5412(14)70834-0
3. Alibhai SMH. An approach to the management of unintentional weight loss in elderly people. Can Med Assoc J. 2005;172(6):773-80.
4. McMinn J, Steel C, Bowman A. Investigation and management of unintentional weight loss in older adults. BMJ. 2011;342(mar29 1):d1732-d1732. https://doi.org/10.1136/bmj.d1732
5. Landi F, Picca A, Calvani R, Marzetti E. Anorexia of Aging. Clin Geriatr Med. 2017;33(3):315-23. https://doi.org/10.1016/j.cger.2017.02.004
6. Clarkston WK, Pantano MM, Morley JE, Horowitz M, Littlefield JM, Burton FR. Evidence for the anorexia of aging: gastrointestinal transit and hunger in healthy elderly vs. young adults. Am J Physiol-Regul Integr Comp Physiol. 1997;272(1):R243-8.
7. Wallace JI, Schwartz RS. Epidemiology of weight loss in humans with special reference to wasting in the elderly. Int J Cardiol. 2002;85(1):15-21. https://doi.org/10.1016/s0167-5273(02)00246-2
8. Landi F, Russo A, Liperoti R, Tosato M, Barillaro C, Pahor M, et al. Anorexia, physical function, and incident disability among the frail elderly population: results from the ilSIRENTE study. J Am Med Dir Assoc. 2010 May;11(4):268-74. https://doi.org/10.1016/j.jamda.2009.12.088
9. Yeh S-S, Blackwood K, Schuster MW. The cytokine basis of cachexia and its treatment: are they ready for prime time? J Am Med Dir Assoc. 2008 May;9(4):219-36. https://doi.org/10.1016/j.jamda.2008.01.003
10. González Barón M, Camps C, Carulla J, Cruz JJ, Lorenzo A, Montalar J, et al. Estudio de la astenia tumoral: constitución del grupo ASTHENOS. Rev Clínica Esp. 2002;202(10):525-8. https://doi.org/10.1016/S0014-2565(02)71135-1
11. Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146-57.
12. Gingrich A, Volkert D, Kiesswetter E, Thomanek M, Bach S, Sieber CC, et al. Prevalence and overlap of sarcopenia, frailty, cachexia and malnutrition in older medical inpatients. BMC Geriatr. 2019;19(1):120. https://doi.org/10.1186/s12877-019-1115-1
13. Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16-31. https://doi.org/10.1093/ageing/afy169
14. Evans WJ, Morley JE, Argilés J, Bales C, Baracos V, Guttridge D, et al. Cachexia: a new definition. Clin. Nutr. 2008;27(6):793-9.
15. Syed Q, Hendler KT, Koncilja K. The impact of aging and medical status on dysgeusia. Am J Med. 2016;129(7):753.e1-753.e6. https://doi.org/10.1016/j.amjmed.2016.02.003
16. Tuccori M, Lapi F, Testi A, Ruggiero E, Moretti U, Vannacci A, et al. Drug-induced taste and smell alterations: a case/non-case evaluation of an Italian database of spontaneous adverse drug reaction reporting. Drug Saf. 2011;34(10):849-59. https://doi.org/10.2165/11593120-000000000-00000
17. Steinbach S, Hundt W, Vaitl A, Heinrich P, Förster S, Bürger K, et al. Taste in mild cognitive impairment and Alzheimer’s disease. J Neurol. 2010;257(2):238-46. https://doi.org/10.1007/s00415-009-5300-6
18. Suto T, Meguro K, Nakatsuka M, Kato Y, Tezuka K, Yamaguchi S, et al. Disorders of “taste cognition” are associated with insular involvement in patients with Alzheimer’s disease and vascular dementia: “Memory of food is impaired in dementia and responsible for poor diet”. Int Psychogeriatr. 2014;26(7):1127-38. https://doi.org/10.1017/S1041610214000532
19. Kashihara K, Hanaoka A, Imamura T. Frequency and characteristics of taste impairment in patients with Parkinson’s disease: results of a clinical interview. Intern Med. 2011;50(20):2311-5. https://doi.org/10.2169/internalmedicine.50.5935
20. Kraenzle D. Causes of weight loss in a community nursing home. J Am Geriatr Soc. 1994 Jun;42(6):583-5.
2. Castro Alvirena JD, Verdejo Bravo C. Protocolo diagnóstico y tratamiento del síndrome constitucional en los pacientes mayores. Medicine. 2014;11(62):3720-4. https://doi.org/10.1016/S0304-5412(14)70834-0
3. Alibhai SMH. An approach to the management of unintentional weight loss in elderly people. Can Med Assoc J. 2005;172(6):773-80.
4. McMinn J, Steel C, Bowman A. Investigation and management of unintentional weight loss in older adults. BMJ. 2011;342(mar29 1):d1732-d1732. https://doi.org/10.1136/bmj.d1732
5. Landi F, Picca A, Calvani R, Marzetti E. Anorexia of Aging. Clin Geriatr Med. 2017;33(3):315-23. https://doi.org/10.1016/j.cger.2017.02.004
6. Clarkston WK, Pantano MM, Morley JE, Horowitz M, Littlefield JM, Burton FR. Evidence for the anorexia of aging: gastrointestinal transit and hunger in healthy elderly vs. young adults. Am J Physiol-Regul Integr Comp Physiol. 1997;272(1):R243-8.
7. Wallace JI, Schwartz RS. Epidemiology of weight loss in humans with special reference to wasting in the elderly. Int J Cardiol. 2002;85(1):15-21. https://doi.org/10.1016/s0167-5273(02)00246-2
8. Landi F, Russo A, Liperoti R, Tosato M, Barillaro C, Pahor M, et al. Anorexia, physical function, and incident disability among the frail elderly population: results from the ilSIRENTE study. J Am Med Dir Assoc. 2010 May;11(4):268-74. https://doi.org/10.1016/j.jamda.2009.12.088
9. Yeh S-S, Blackwood K, Schuster MW. The cytokine basis of cachexia and its treatment: are they ready for prime time? J Am Med Dir Assoc. 2008 May;9(4):219-36. https://doi.org/10.1016/j.jamda.2008.01.003
10. González Barón M, Camps C, Carulla J, Cruz JJ, Lorenzo A, Montalar J, et al. Estudio de la astenia tumoral: constitución del grupo ASTHENOS. Rev Clínica Esp. 2002;202(10):525-8. https://doi.org/10.1016/S0014-2565(02)71135-1
11. Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146-57.
12. Gingrich A, Volkert D, Kiesswetter E, Thomanek M, Bach S, Sieber CC, et al. Prevalence and overlap of sarcopenia, frailty, cachexia and malnutrition in older medical inpatients. BMC Geriatr. 2019;19(1):120. https://doi.org/10.1186/s12877-019-1115-1
13. Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16-31. https://doi.org/10.1093/ageing/afy169
14. Evans WJ, Morley JE, Argilés J, Bales C, Baracos V, Guttridge D, et al. Cachexia: a new definition. Clin. Nutr. 2008;27(6):793-9.
15. Syed Q, Hendler KT, Koncilja K. The impact of aging and medical status on dysgeusia. Am J Med. 2016;129(7):753.e1-753.e6. https://doi.org/10.1016/j.amjmed.2016.02.003
16. Tuccori M, Lapi F, Testi A, Ruggiero E, Moretti U, Vannacci A, et al. Drug-induced taste and smell alterations: a case/non-case evaluation of an Italian database of spontaneous adverse drug reaction reporting. Drug Saf. 2011;34(10):849-59. https://doi.org/10.2165/11593120-000000000-00000
17. Steinbach S, Hundt W, Vaitl A, Heinrich P, Förster S, Bürger K, et al. Taste in mild cognitive impairment and Alzheimer’s disease. J Neurol. 2010;257(2):238-46. https://doi.org/10.1007/s00415-009-5300-6
18. Suto T, Meguro K, Nakatsuka M, Kato Y, Tezuka K, Yamaguchi S, et al. Disorders of “taste cognition” are associated with insular involvement in patients with Alzheimer’s disease and vascular dementia: “Memory of food is impaired in dementia and responsible for poor diet”. Int Psychogeriatr. 2014;26(7):1127-38. https://doi.org/10.1017/S1041610214000532
19. Kashihara K, Hanaoka A, Imamura T. Frequency and characteristics of taste impairment in patients with Parkinson’s disease: results of a clinical interview. Intern Med. 2011;50(20):2311-5. https://doi.org/10.2169/internalmedicine.50.5935
20. Kraenzle D. Causes of weight loss in a community nursing home. J Am Geriatr Soc. 1994 Jun;42(6):583-5.
How to Cite
Muñoz Muñetón, C., Chacón-Valenzuela, E., Rodríguez Varón, A. ., Vargas, M. P. ., & Chavarro-Carvajal, D. . (2022). Constitutional Syndrome from a Geriatric Perspective. Universitas Medica, 63(3). https://doi.org/10.11144/Javeriana.umed63-3.cons
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