Understanding Adult Failure to Thrive (AFTT)
Adult Failure to Thrive (AFTT) is a syndrome, not a disease, involving a gradual decline in physical, cognitive, and functional abilities, primarily affecting older adults. This condition signifies a worsening state of health due to multiple interacting factors. Recognizing AFTT involves identifying a cluster of associated symptoms that are not typical consequences of aging.
Core Characteristics of AFTT
AFTT is characterized by a cluster of four main component syndromes that frequently occur together and influence one another.
1. Impaired Physical Function
This involves a noticeable reduction in mobility, including difficulty walking and increased risk of falls, along with persistent fatigue and a decline in the ability to perform daily activities such as bathing and dressing. Additionally, individuals may experience poor wound healing and increased infection risk.
2. Malnutrition
Key indicators of malnutrition include unintentional weight loss, often defined as more than a 5% loss over 3 months, decreased appetite, and dehydration. Low cholesterol and albumin levels in blood tests can also point to nutritional deficiencies.
3. Neuropsychiatric Impairment
Common neuropsychiatric characteristics are depression, cognitive decline marked by impaired memory and confusion, and a lack of motivation. Acute confusion states like delirium can also occur.
4. Social Withdrawal
Social withdrawal includes reduced interaction with others, a loss of interest in previously enjoyed social activities, and sometimes a sense of despair or "giving up".
Factors Contributing to AFTT
Various factors contribute to AFTT, often in combination:
- Medical Issues: Chronic conditions like heart disease, cancer, and diabetes.
- Medications: Side effects from multiple medications (polypharmacy) can cause anorexia or cognitive changes.
- Psychological Health: Depression, anxiety, and traumatic events.
- Social Circumstances: Isolation, lack of support, or financial stress.
- Sensory Problems: Vision or hearing loss can lead to isolation and functional decline.
- Oral Health: Dental problems, ill-fitting dentures, or difficulty swallowing can impact food intake.
Comparing Failure to Thrive and Frailty
FTT and frailty are related but distinct. For a comparison, {Link: Medscape Reference https://emedicine.medscape.com/article/2096163-overview} provides a table highlighting their differences.
Evaluation and Diagnosis
Diagnosis of FTT requires a comprehensive assessment. This includes a detailed medical history, physical examination, review of medications, nutritional assessment, laboratory tests, and screening for mental and social health.
Management and Treatment
Management of FTT is multidisciplinary and targets the identified causes. Treatment involves addressing underlying medical conditions, providing nutritional support (counseling, supplements), offering psychological support (therapy, medication), and promoting physical and social activity. Early intervention can sometimes reverse FTT, but in advanced cases, end-of-life care may be considered.
Conclusion
Recognizing what are the characteristics of failure to thrive in adults is vital for effective care. This syndrome requires a holistic approach to identify and address the complex interplay of physical, psychological, and social factors. Through comprehensive evaluation and tailored treatment, it may be possible to improve the quality of life and potentially reverse the decline associated with FTT in older adults.
For more information on geriatric care, you can refer to authoritative sources like the American Academy of Family Physicians.
