Disease Presentation

The concept of atypical disease presentation has been described by many in the literature. The phrase geriatric giants has long been recognized and taught in geriatric medicine and refers to the usual way in which disease presents itself in aging individuals. The commonly cited geriatric giants include immobility, instabilty (falls), incontinence, and intellectual impairment. These four syndromes are often the way in which disease presents itself. Other terms have also been used to describe the way older adults present with disease and these include silent presentation and non-specific presentation.

Several studies conducted in the 1980s and 1990s have shown that atypical disease presentation may indeed be the most common type of disease presentation in the older adult. One study found that 36 percent of all elderly persons admitted to hospital presented atypically. When the population was stratified for frailty, 60 percent of those who were frail at the time of admission presented atypically, compared to 25 percent of those that were previously well. This emphasizes the interaction between frailty and atypical disease presentation.