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:
- 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.
Download the complete tip, Cachexia.