Differential Diagnosis for Failure to Thrive in a Medicare Patient
Single Most Likely Diagnosis
- Malnutrition: This is a common cause of failure to thrive in elderly patients, often due to inadequate dietary intake, dental issues, or swallowing difficulties.
Other Likely Diagnoses
- Chronic diseases: Conditions such as heart failure, chronic obstructive pulmonary disease (COPD), or chronic kidney disease can lead to failure to thrive due to decreased mobility, increased energy expenditure, or malabsorption.
- Depression: Elderly patients with depression may experience decreased appetite, leading to weight loss and failure to thrive.
- Dementia: Patients with dementia may have difficulty eating or swallowing, or may forget to eat, resulting in malnutrition and failure to thrive.
- Medication side effects: Certain medications, such as sedatives or antidepressants, can cause decreased appetite or increased metabolism, leading to weight loss and failure to thrive.
Do Not Miss Diagnoses
- Cancer: Although less common, cancer can cause failure to thrive due to tumor burden, malabsorption, or paraneoplastic syndromes.
- Infections: Chronic infections, such as tuberculosis or endocarditis, can lead to failure to thrive due to increased energy expenditure and malabsorption.
- Thyroid disorders: Both hyperthyroidism and hypothyroidism can cause weight loss and failure to thrive if left untreated.
- Adrenal insufficiency: This rare condition can cause weight loss, fatigue, and failure to thrive due to decreased cortisol production.
Rare Diagnoses
- Gastrointestinal disorders: Conditions such as celiac disease, Crohn's disease, or ulcerative colitis can cause malabsorption and failure to thrive.
- Endocrine disorders: Rare conditions such as growth hormone deficiency or adrenal insufficiency can cause failure to thrive.
- Neurological disorders: Conditions such as amyotrophic lateral sclerosis (ALS) or Parkinson's disease can cause difficulty eating or swallowing, leading to malnutrition and failure to thrive.
- Genetic disorders: Certain genetic conditions, such as cystic fibrosis or muscular dystrophy, can cause failure to thrive due to malabsorption or increased energy expenditure.