Anorexia due to Depression in the Elderly From the Viewpoint of Primary Care

Syuichi Tetsuka, Mieko Otsuka, Ritsuo Hashimoto, Hiroyuki Kato


Japan is currently an aging society with a huge proportion of elderly citizens. Consequently, the incidence and severity of anorexia and depression are predicted to increase in the future. In fact, at present, anorexia is common in the elderly. Anorexia is one of the major symptoms of depression in the elderly. More than 90% of patients with depression are thought to visit primary care physicians and the departments such as general medicine first instead of psychiatrists. Therefore, primary care physicians need to be vigilant for signs of depressive disorder to prevent suicide. Elderly patients have few negative emotions, such as feeling depressed, sad, or any other subjective drops in mood; this implies that elderly individuals might find it difficult to explain their symptoms to others and that the people around them might hardly notice any symptoms of depression. An 84-year-old woman started to gradually lose appetite. She has undergone various examinations, but an obvious physical organic abnormality was not found. Upon admission to our hospital, her weight was 38 kg and body mass index was 16.9 kg/m2. Based on diagnostic criteria and further evaluation, we diagnosed her as anorexia due to depression. After biopsychosocial approach including appropriate social support, as well as medical and mental therapies, her appetite improved gradually and she was able to regain her weight eventually. Elderly individuals have a tendency to get depression due to biologic and psychosocial causes. Many patients with depression are thought to visit primary care physicians and the departments such as general medicine first instead of psychiatrists. Therefore, the efficiency of primary care is underscored and primary care physicians need to be vigilant in detecting depression and preventing suicide. We think that general medicine will have a more important part in medical practice in the future in Japan.

J Med Cases. 2017;8(4):119-123


Anorexia; Depression; Elderly; Primary care; Biopsychosocial; General medicine

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