Cachexia is a diagnosis applicable to many geriatric patients that may be overlooked and under-documented. It is often easier for the provider to identify cachexia than malnutrition.

UpToDate states that cachexia “is generally defined as weight loss from loss of muscle mass.”


  • Often results from unintentional weight loss
  • Is associated with increased mortality
  • Is used in many risk adjustment coding models that track quality

Providers should evaluate the following types of patients for evidence of cachexia and document if appropriate:

  • Malignancy
  • Nonmalignant gastrointestinal disease
  • Chronic infectious diseases e.g., HIV, Hepatitis C, etc.
  • Advanced chronic diseases e.g., heart failure, chronic lung diseases, advanced CKD
  • Severe neurological diseases e.g., stroke, dementia, Parkinson disease, etc.
  • Rheumatologic disorders
  • Psychiatric disorders
  • Substance use disorders

Patients with cachexia may also have indicators for the diagnosis of malnutrition, which should be documented in addition to cachexia if clinically substantiated. A dietician can often assist with determining if the patient meets the criteria for malnutrition as well as the appropriate severity of malnutrition.

Reference: UpToDate

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