Harrison's PodClass: Internal Medicine Cases and Board Prep Ep 185: An 89-Year-Old with Lack of Appetite and Weight Loss
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Mar 5, 2026 A case about an 89-year-old with poor appetite and weight loss sparks a deep dive into aging biology and why normal aging is often asymptomatic. The five M's of geriatrics are explained and multimorbidity challenges are explored. Discussion covers underdiagnosed reversible conditions, common cognitive and mood disorders, and the importance of social support and patient preferences.
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Normal Aging Usually Doesn’t Cause New Symptoms
- Normal aging is not typically symptomatic and new symptoms should prompt evaluation rather than attribution to aging.
- The hosts discuss an 89-year-old with 4 months of poor appetite and 10 lb weight loss to illustrate that symptoms warrant workup, not dismissal.
Use The Five Ms To Guide Geriatric Care
- Use the five Ms of geriatrics to structure assessment: mentation, medication, mobility, multi-complexity, and matters most.
- Apply simple screening tools for cognitive, affective, fall risk, incontinence, and elder abuse to avoid missed diagnoses.
Multimorbidity Is The Norm After 80
- Multimorbidity is common: nearly half over 80 have three chronic conditions and a third have four or more.
- This prevalence makes presentations multifactorial and requires comprehensive evaluation and management.
