Geriatrician Questions Sleep Disorders

My father has lost his appetite and sleeps odd hours. What is the problem?

My father is 84 years old and he is unable to take in his food properly. He seems to have lost his appetite. Apart from this he is also sleeping at odd hours and seems to be tired all through the day. What could be the reason behind this?

5 Answers

Hello,

If your father suddenly lost his appetite, it is time to bring him to see a doctor to rule out some serious health conditions or medication side effects. Some illnesses can cause changes in taste and appetite, for example: dementia such as Alzheimer's, stroke, Parkinson's disease, chronic heart failure, chronic renal failure, etc. Some medication side effects such as dry mouth or a metallic, bitter or salty taste may cause a loss of appetite. Also, any acute infection can impair appetite. If loss of appetite is not caused by medication side effects or health conditions, then there are other reasons why your father could not want to eat:

1) Living and eating alone can cause reduced appetite. Elderly who live alone might not be eating because preparing meals has become too difficult.
2) Difficulty chewing due to dental problems, dry mouth, gum problems, toothache, etc.
3) As a person ages, they can lose a significant number of taste buds and normal food might be unappetizing for them.
4) Regular exercise and activity helps boost appetite.
5) Depression is known to impair appetite and is common in older people with reported rates of 9% in community dwelling older people.

Depression affects one in ten people over 65 years and it should be treated. What are the common symptoms of depression in older people?
-Sadness
-Fatigue
-Sleeping problems, insomnia or oversleeping
-Loss of appetite
-Apathy
-Fatigue
-Aches or pains, headaches

Depression is not a part of normal aging! Certain medications and some medical conditions can cause the same symptoms as depression. If your father does not have any acute or exacerbation of chronic medical conditions, he should be evaluated for possible depression.
He could be depressed. He should have baseline labs, CBC, cmp, thyroid function test, b12, folate levels, and a urine test to R/O infection. If the tests are negative or normal, he can be tried on an antidepressant.
Check for depression. There are several depression screening tests you can see online; also, do basic work up including tsh, bcc, cmp. If everything is negative, probably need a CT scan of the head, but need to be seen by MD.
Sometimes, Dementia (or memory loss) masks depression and depression can mask dementia. ​With the concomitant weight loss, I would suggest that your father see a geriatrician (or a physician that specializes in making sure our elders still function as much as possible). The geriatrician will perform a simple "memory check" by simply asking questions and scoring the
answers.

He/she will try to look at your father holistically by taking into account other medical conditions, what medications your father is on, and how much your father can do for himself.

I hope this helps.
There are a variety of things that could cause this, including Alzheimer's disease, thyroid dysfunction and issues with electrolytes. I highly recommend he have a physician see him, do a cognitive evaluation and a lab workup.