Can adults have FTT? Understanding Adult Failure to Thrive

While commonly associated with infants, a significant percentage of older adults experience a similar decline in health and function, known as Adult Failure to Thrive (AFTT). This syndrome is a serious, multifaceted condition that can impact an adult's overall well-being and longevity, raising the crucial question: Can adults have FTT?

Quick Summary

Yes, adults can experience Failure to Thrive (FTT), a complex syndrome most often affecting older adults and characterized by an overall decline in physical and mental health, including weight loss, decreased appetite, and reduced activity.

Key Points

• Yes, adults can have FTT: While associated with infants, 'Adult Failure to Thrive' (AFTT) is a genuine and serious geriatric syndrome affecting older adults.

• Recognize key symptoms: AFTT is characterized by unintentional weight loss, decreased appetite, reduced activity, and withdrawal from social interactions.

• Causes are multifactorial: AFTT is not a single disease but results from a combination of medical conditions, medication side effects, depression, and social factors.

• Diagnosis requires a comprehensive approach: There is no single test for AFTT; diagnosis involves a thorough medical history, physical exam, and caregiver interviews.

• Timely intervention is crucial: Early identification and a multi-pronged treatment approach focusing on nutrition, physical activity, and social support can often reverse the decline.

• AFTT is not a normal part of aging: Unexplained decline in health should always be medically investigated and is not an inevitable consequence of getting older.

What is Adult Failure to Thrive (AFTT)?

Adult Failure to Thrive (AFTT) is a complex geriatric syndrome characterized by a decline in an older adult's health and functioning. Unlike pediatric FTT, which focuses on growth, AFTT involves a combination of worsening symptoms, often linked to underlying health issues. It's not a disease itself but a state of deterioration indicating a serious problem. Recognizing this decline is vital for timely help, as it's not a normal part of aging.

AFTT Symptoms: Recognizing the Warning Signs

The key signs of AFTT can be subtle and include unexplained weight loss, decreased appetite, reduced physical activity, cognitive decline, depression, and difficulty with daily activities.

Causes of Failure to Thrive in Adults

AFTT often stems from multiple factors—physical, psychological, and social. Medical causes include chronic diseases, medication side effects, and sensory impairments. Psychological and social factors involve depression, anxiety, social isolation, and significant life events. Socioenvironmental and economic issues like poverty and limited access to care can also contribute.

Diagnosis and Management of AFTT

Diagnosing AFTT requires a thorough health evaluation, including medical history, physical exam, tests, and caregiver interviews. Treatment is tailored to the individual and their specific causes, often involving a multidisciplinary team. Strategies include nutritional support, medication review, physical and occupational therapy, mental health support, and social/environmental adjustments.

Comparing Pediatric and Adult Failure to Thrive

Failure to Thrive differs between age groups. Pediatric FTT typically involves a failure to gain weight or grow in infants and young children, affecting expected development. Adult FTT primarily affects older adults, presenting as a global decline in function and health, not a single disease. Causes and intervention focuses also differ between the two.

Prognosis and Conclusion

AFTT can sometimes be reversed with prompt intervention. Addressing the underlying factors can enhance quality of life. If the condition is irreversible, care may shift to comfort measures, possibly including hospice. It is important to remember that failure to thrive is not a normal aspect of aging, and any unexplained decline warrants a medical assessment to identify reversible causes. Resources for understanding hospice eligibility for conditions like failure to thrive are available from sources such as the {Link: CMS website https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=34558&ver=40}.

Frequently Asked Questions

What is the primary difference between FTT in adults and children?

While pediatric FTT is a failure to meet growth milestones, adult FTT (AFTT) is a failure to maintain a previous level of function. Children fail to achieve expected development, whereas adults experience a decline from their baseline health.

Is AFTT the same as frailty?

AFTT is often an endpoint of progressive frailty. Frailty is a measureable condition of decreased physiological reserve, while AFTT is a more severe and often pathological syndrome of global decline that can occur alongside or as a result of frailty.

Can AFTT be reversed?

Yes, in many cases, AFTT is reversible with appropriate medical intervention. Treatment focuses on identifying and managing the underlying causes, such as addressing malnutrition, adjusting medications, and treating depression.

What medical conditions are linked to AFTT?

Many chronic illnesses, including cancer, congestive heart failure, chronic lung disease, and dementia, are commonly associated with AFTT. Untreated infections can also be a cause.

How can caregivers help someone with AFTT?

Caregivers can assist by monitoring food and fluid intake, ensuring medication compliance, encouraging gentle physical activity, and providing social stimulation. It is crucial to report any significant decline to a healthcare provider.

Are medication side effects a major cause?

Yes, polypharmacy (the use of multiple medications) is a significant contributor to AFTT. Certain drugs can cause appetite loss, cognitive changes, or sedation, all of which can trigger or worsen AFTT.

When should hospice care be considered for AFTT?

Hospice is typically considered when the condition becomes irreversible, and a physician certifies that the patient's life expectancy is six months or less. It focuses on comfort and quality of life rather than curative treatment.