PEM is commonly notable in children below 5 years, but does it affect adults as well? Indeed, Generally, PEM manifests quite differently in adults that it does in children, weight loss, fatigue, hypothermia, oedema, generalized fat and muscle loss. Extended starvation periods can lead upto 50% weight loss
PEM in adults is usually as a result of starvation, catabolism or a combination of both. Depression is usually a contributing factor among older individuals. It tends to manifest with a depletion of fat stores though this may not be very apparent in obese persons. In certain cases, it may be difficult to determine actual weight loss which may be masked by oedema. It likely occurs among older patients with chronic illness who have a diet history of restrictive food intake. In addition the following symptoms may appear:
Atrophy
Reduced heart muscle mass
Hypothermia
Muscle wasting
Fatigue
Impaired wound healing
Prone to infections
Treatment should focus on addressing any underlying conditions. If certain conditions e.g. are present, they should be treated. Initial feedings should be provided in small quantities. Commercial formulas can be provided. Energy requirements should be provided at a rate of 60 kcal/kg while those of protein should be provided at a rate of between 1.2 to 2 g/kg.
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