Differential Diagnosis for 88-year-old with Parkinson's and Gradual Weight Loss
- Single most likely diagnosis:
- Parkinson's disease progression: Gradual weight loss is a common symptom in advanced Parkinson's disease due to increased energy expenditure, difficulty eating, and gastrointestinal symptoms associated with the disease.
- Other Likely diagnoses:
- Dysphagia: Common in Parkinson's patients, leading to malnutrition and weight loss due to difficulty swallowing.
- Depression: Frequently co-occurs with Parkinson's disease and can cause significant weight loss.
- Gastrointestinal issues: Conditions like gastroparesis or constipation, which are common in Parkinson's patients, can lead to malabsorption and weight loss.
- Medication side effects: Certain medications used to treat Parkinson's disease can cause nausea, vomiting, or decreased appetite, leading to weight loss.
- Do Not Miss diagnoses:
- Malignancy: Although less likely, cancer can cause significant weight loss and must be ruled out, especially in the elderly.
- Infections: Chronic infections, such as pneumonia or urinary tract infections, can cause weight loss in elderly patients.
- Thyroid disorders: Hyperthyroidism can lead to weight loss, even in the absence of other symptoms.
- Adrenal insufficiency: A rare but potentially life-threatening condition that can cause weight loss.
- Rare diagnoses:
- Prion diseases: Rare neurodegenerative disorders, such as Creutzfeldt-Jakob disease, can cause rapid weight loss and neurological decline.
- Whipple's disease: A rare bacterial infection that can cause weight loss, diarrhea, and neurological symptoms.
- Amyotrophic lateral sclerosis (ALS): A progressive neurological disease that can cause weight loss and muscle wasting.