Question

Background:

• With current medical advances and the adoption of healthier lifestyles, people are living longer.
• 65+ years old is the fastest growing segment of the global population
• In 1994:
  • 65+ accounted for 13% of the population
• By 2030:
  • Developed Countries: 65+ age segment of population will be larger than <65 age in many developed countries
  • Developing Countries: 75% of elderly will be living in lower and middle income countries with less well-developed health care systems

Relevance to the EM Physician:

• Elderly account for 12% to 24% of all ED visits
• Older patients present with a higher level of acuity and generally have more serious medical illness.
  • Arrive more often by ambulance
  • Higher rates of test use and longer ED stays
  • 2.5 to 4.6 times higher risk for hospitalization
  • 5-fold higher admission rate to an ICU
  • More likely to be misdiagnosed
  • More frequently discharged with unrecognized / untreated problems.

Answer

Bottom Line:

• Emergency physicians and healthcare professionals practicing in acute care settings around the world will increasingly be relied upon to care for geriatric acute care patients. 
• Focus should be placed on education of healthcare practitioners, protocols for targeting high-risk geriatric populations, and the creation of emergency departments with resources to care for the elderly

References

University of Maryland Section of Global Emergency Health Author: Terrence Mulligan DO, MPH

 

Samaras N, Chevalley T, Samaras D, et al.  “Older Patients in the Emergency Department: A Review” Annals of EM Vol 56:3, Sept 2010, p 261-269.

WHO Global Burden of Disease. 2010.  www.who.int/healthinfo/global_burden_disease/GBD_report_2010update_full.pdf

United Nations. “World Population Ageing 1950-2050” 2011.  www.esa.un.org/wpp/