Disease Presentation

The management of elderly patients who present with atypical disease presentations begins with initial recognition of their illness. All too often recognition that the person is sick goes unnoticed. It is not uncommon for health care providers, patients, and their families to attribute some of the symptoms as synonymous with aging, and they may not even seek medical attention. It is of paramount importance to recognize when illness is present and to seek medical attention. It is then the responsibility of the health care providers to recognize this call for help, investigate appropriately, and treat reversible causes.

It is important to target investigations in order to identify the most common cause for the atypical presentation of an illness. Simple investigations including blood work, cultures, and x-rays are often invaluable in pinpointing a cause. It is also important to review all medications that the individual is taking including prescription drugs, over-the-counter preparations, and alcohol use. Inquiring about compliance with medications is also prudent, because missing some medications or taking too many of an other can equally be the cause of the atypical disease presentation. Once the cause is found, appropriate medical management can proceed.

Of paramount importance in the treatment of older, frail adults, particularly in hospital, is appropriate treatment strategies to prevent further complications of hospitalization. It is well known that elderly adults, once hospitalized, are at increased risk of complications from both the treatment as well as bed rest. It is important to be cognizant of this and promote early mobilization, adequate nutrition, and appropriate maintenance of physical functioning to try to avoid these complications.