Management Issues in the Elderly
People who are greater than 65 years of age are the fastest growing segment of the US population.1 By 2030 the population older than 65 years will double to approximately 70 million and the fastest growing segment of the population, those >84 years will triple. Age is associated with an increasing prevalence of multiple diseases and disabilities. Age is also associated with a decline in the functional reserve of multiple organ systems and a progressive restriction in personal and social resources. By virtue of have lived longer, increasing numbers of elderly patients (age >65 years) are being admitted to ICUs with diagnoses ranging from exacerbations of chronic illnesses and new onset of catastrophic health problems to trauma caused by home-related incidents and injury-resultant accidents that have occurred outside of the home. Elderly patients currently account for 42–52% of ICU admissions and for almost 60% of all ICU days.2 A disproportionate number of these ICU days are spent by elderly patients before their death. Forty percent of Medicare descendants are admitted to an ICU during their terminal illness, with descents accounting for one-quarter of all Medicare expenditure.3 Clearly ICU utilization by the elderly will increase exponentially over the next three decades.
KeywordsElderly Patient Diastolic Dysfunction Comprehensive Geriatric Assessment Sick Sinus Syndrome Lean Muscle Mass
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