The dwindles: failure to thrive in older patients.

Geriatric failure to thrive has three elements: (1) deterioration in the biologic, psychologic, and social domains; (2) weight loss or undernutrition; and (3) lack of any obvious explanation for the condition. It results from the combined effects of normal aging, malnutrition, and specific physical, social, or psychologic precipitants (e.g., chronic disease, dementia, medication, dysphagia, depression, or social isolation). Failure to thrive can be managed with a common sense approach by primary care physicians and health care providers such as social workers and dietitians; extensive referral is not necessary. The key to effective care is to identify all of the precipitants and intervene early enough to prevent progression.