Medical Disorders in Older Persons

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Medical Disorders in Older Persons

The rise in life expectancy has led to much concern about the health consequences. The mean age of onset of most diseases have not changed  the increased life expectancy means that there will be more years of ill health. Many modifiable risk factors exist for most diseases that can prevent, delay the onset or ameliorate the consequences of many diseases  important role of health promotion. Most of the diseases that occur in older persons are covered elsewhere in relevant chapters of this handbook. The physiological changes that occur with age influence the onset, presentation and course of many diseases. “Uncommon presentations of common conditions is more common then common presentations of uncommon conditions”

Concepts of illness in the older person :
1) Impairment of homeostasis:
Decline inability to maintain homeostasis and a decline in the physiological reserve  the physiological response to illnesses is impaired  do not have the reserve of younger people to cope with delay in diagnosis and therapy  need prompter services.

2) Threshold effect:
As function progressively declines as part of ageing, inactivity and chronic illness, a threshold is reached in which further decline results in the inability to live independently. Important concept in the rehabilitation of the older person

3) Clinical difficulties:
In older people, disease is associated with increased diagnostic inaccuracy. There is also a decreased intolerance to inappropriate therapy (especially drug interactions). These are due to the greater multifactorial nature of disease in the older people, the later presentation of disease and the slowly progressive nature of many of the diseases.

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