RESIDENT: Eating Disorders in Late Life

Learning Objectives:

1. Summarize the epidemiology of eating disorders in late life
2. Identify the physiological and psychosocial factors that contribute to eating disorders in the elderly
3. Describe the psychiatric comorbidities associated with eating disorders in elderly populations

 Literature Reference:

Gadalla TM. Eating disorders and associated psychiatric comorbidity in elderly Canadian women.Arch Womens Ment Health. 2008;11(5-6):357-362.

Lapid MI, Prom MC, Burton MC, McAlpine DE, Sutor B, Rummans TA. Eating disorders in the elderly. Int Psychogeriatr. 2010;22(4):523-536.

Patrick JH, Stahl ST. Understanding disordered eating at midlife and late life. J Gen Psychol. 2009;136(1):5-20.

Abstract

Major Neurocognitive Disorder, more commonly termed dementia, is a disorder characterized by a decline in cognition involving one or more cognitive domains such as learning and memory, language, executive function, complex attention, perceptual-motor, and social cognition. It is estimated that 1-in-2 Canadians over the age of 80 years suffer from dementia. For this reason, dementia is a familiar presentation in the practice of geriatric psychiatry, geriatric medicine, and neurology. Common dementia syndromes include: Alzheimer’s Disease, frontotemporal dementia, vascular dementia, dementia with Lewy Bodies, and Parkinson Disease dementia. Among those with dementia, there is a subset of individuals with Rapidly Progressive Dementia (RPD). While RPD is ill defined in the scientific literature, definitions generally identify progression from symptom onset to dementia in less than 12 to 24 months. The etiologies of RPD vary widely from limbic encephalitis and Creutzfeldt-Jakob disease to variants of Alzheimer’s Disease (the most prevalent cause of dementia). Many of the etiologic possibilities that cause RPD are potentially treatable with appropriate diagnosis and early intervention. Due to the rapid course of decline, and the possibility of treatable underlying etiologies, it is essential to have a systematic and comprehensive approach to the diagnosis of RPD. This presentation outlines the common definitions of RPD, discusses the varied etiologies that can present as RPD, and provides a systematic approach to the diagnosis and initial management of a patient presenting with RPD.