Abstract

Weight loss and malnutrition present a significant challenge to providers in the long term care arena who frequently must evaluate and treat residents for these issues. Reasons for the incidence of unintentional weight loss includes multiple comorbid conditions, polypharmacy, depression and the cachexia of aging. The purpose of this review was to identify current research related to the use of appetite stimulants in long term care. Methods: a review of the literature was conducted from 1956 to present with a focus on long term care, appetite stimulants and weight loss. Results: Traditional approaches to address this issue have included comprehensive nutritional assessment, oral supplements and the use of appetite stimulants. These have included medications such as mirtazepine, oxandrolone, dronabinol, and megesterol acetate. Of these medications, megesterol acetate has been the most widely studied but with mixed results. Providers are encouraged to provide a comprehensive approach to the management of unintentional weight loss in nursing home residents and to consider an appetite stimulant as a last resort, if at all.

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