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Diagnosing cachexia

A Laviano & A Paldino

Cachexia is a clinically relevant factor, and its presence should be proactively investigated in hospitalized patients and outpatients. Unfortunately, a unifying definition and generally accepted diagnostic criteria do not yet exist, contributing to the skepticism of many doctors toward nutrition diagnosis in patients. However, the key features of cachexia are the presence of weight loss, increased inflammatory response and muscle wasting. It is now also accepted that the cachexia syndrome progresses from the stage of precachexia to overt cachexia to refractory cachexia. Direct measurement of muscle mass is still not routinely considered in daily clinical practice, owing to a number of reasons. However, the functional assessment of muscle strength may provide relevant insights into the deterioration of muscle mass during cachexia.