Editors

TimoStrandberg

Health Monitoring in the Elderly

Essentials

Comprehensive Geriatric Assessment (CGA) Assessment of Functional Capacity in the Elderly is an essential tool for investigating an elderly person with a variety of problems Comprehensive Geriatric Assessment for Older Adults Admitted to Hospital http://www.dynamed.com/prevention/comprehensive-geriatric-assessment#GUID-877D4765-EEC5-4B11-8787-D2D9AF3DE21C.
The causes of impaired functional capacity should be examined and efforts should be made to slow down their progression.
Non-targeted screening and health checks are not useful.
When considering examinations, it should be assessed whether they would be beneficial for the specific patient or lead to detrimental further examinations.

Investigations

Besides diseases, the person's functional capacity (ability to move, cognitive function, managing daily activities) and signs of the frailty syndrome (weight loss, sarcopenia, reduced mobility, slower walking speed, decreased muscle strength) should be assessed Assessment of Functional Capacity in the Elderly.
On the threshold or in the early phase of retirement, before the development of any evident disease, risk factors (such as hypertension, hyperglycaemia, alcohol consumption, risk of falls) that can be addressed and influenced by therapeutic measures should be assessed.
- Incipient frailty and sarcopenia can be treated by ensuring adequate nutrition Assessment of Nutritional Status in the Elderly and supporting physical activity.
Any screening should be targeted according to recommendations.
- Population screening for malignant tumours Population Screening for Cancer
- Screening for and prevention of colorectal cancer Screening and Prevention of Colorectal Cancer
- Low-energy fractures, suspicion of osteoporosis Osteoporosis
In people living in 24-h care, measures to prevent pressure sores, urinary incontinence, reduced mobility and falls are emphasized.
- Regular review of the medication list Managing the Medication of Elderly People is important.
- Yearly laboratory investigations (for untargeted screening) are not considered justified.
Screening or more extensive diagnostics are useless if
- there is no effective treatment available for the disease
- earlier examinations have been negative
- the person in question has a severely limited functional ability or suffers from dementia
- the expected quality or duration of life is limited because of some other cause.

References

Stuck AE, Egger M, Hammer A, Minder CE, Beck JC. Home visits to prevent nursing home admission and functional decline in elderly people: systematic review and meta-regression analysis. JAMA 2002 Feb 27;287(8):1022-8. [PubMed]
Vitality in later years : food recommendation for older adults. National nutrition council and Finnish Institute for Welfare and Health. THL Directions 9/2020. http://urn.fi/URN:ISBN:978-952-343-517-9
SPRINTT (Sarcopenia and physical frailty in older people: multi-component treatment strategies) project http://www.imi.europa.eu/projects-results/project-factsheets/sprintt

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Information

Editors

Health Monitoring in the Elderly

Essentials

Investigations

References