The term « failure to thrive » is frequently used to describe older adults whose independence is declining.
The term was exported from pediatrics in the 1970s and is used to describe older adults with various concurrent chronic diseases, functional impairments, or both.
Despite this heterogeneity, failure to thrive has had its own International Classification of Diseases, Ninth Revision (ICD-9) code since 1979 and has been approached as a clinically meaningful diagnosis in many review articles.
This conceptual framework, however, can create barriers to proper evaluation and management.
The most worrisome of these barriers is the reinforcement of both fatalism and intellectual laziness, which need to be balanced with a deconstructionist approach, wherein the major areas of impairment are identified and quantified and have their interactions considered.
Four syndromes known to be individually predictive of adverse outcomes in older adults are repeatedly cited as prevalent in patients with failure to thrive : impaired physical functioning, malnutrition, depression, and cognitive impairment.
The differential diagnosis of contributors to each of these syndromes includes the other three syndromes, and multiple contributors often exist concurrently.
Some of these contributors are unmodifiable, some are easily modifiable, and some are potentially modifiable but only with the use of resource-intensive strategies. (...)
Mots-clés Pascal : Diminution, Autonomie, Article synthèse, Etiologie, Vieillard, Homme
Mots-clés Pascal anglais : Decrease, Autonomy, Review, Etiology, Elderly, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0316247
Code Inist : 002B30A01C. Création : 10/04/1997.