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4 - Ageing and health

Managing co-morbidities and functional disability in older people

Published online by Cambridge University Press:  05 June 2012

Carmel Dyer
Affiliation:
University of Texas at Houston
Sharon Ostwald
Affiliation:
University of Texas at Houston
Ian Stuart-Hamilton
Affiliation:
University of Glamorgan
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Summary

OVERVIEW

This chapter examines common syndromes encountered in older patients, their assessment (principally using the comprehensive geriatric assessment), issues in the clinical management of older patients, the effects of vulnerability and co-morbidity, and the management of these.

Introduction

O son, help your father in his old age, and do not grieve him as long as he lives; even if he is lacking in understanding, show forbearance; in all your strength do not despise him. For kindness to a father will not be forgotten.

Sirach 3:12–14

What is different about health in ageing people? Aren't all people simply as old as they feel? Does the approach to assessment and management differ from the approach recommended for younger people? Why are geriatric medicine specialists needed? When is care by a geriatrician appropriate and how old does one need to be before he or she should visit a geriatrician?

Chapter 2 outlined the biological changes that occur with ageing. Anyone over 40 who needs reading glasses can attest to the fact that there are physiological and functional changes that occur with advancing age. These changes occur at different rates in different individuals and can be affected by lifestyle and environment, but on average by age 75 one becomes, in the strict sense of the word, ‘geriatric’. The manifestations of multiple concomitant chronic diseases and their subsequent management are different in older people and present additional challenges to the geriatricians and gerontological advanced practice professionals who care for these patients.

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Publisher: Cambridge University Press
Print publication year: 2011

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