Medicine in Older Patients: Evidence Based?
Increasingly, medical doctors are supposed to treat their patients according to clinical guidelines—a synthesis of existing literature, translated into standardized advice with respect to treatment of patients in a given situation. The implementation of such clinical guidelines has had great success: stringent cardiovascular risk management in combination with early revascularization therapies has resulted in a decreased risk of cardiovascular disease and associated complications including death in the last decades. In some Western countries, cardiovascular disease is no longer the number one cause of death, with cancer being the leading cause. However, despite the clinical guidelines, in older patients the risk of cardiovascular has not decreased. Rather, older patients often have multiple diseases, and implementation of all clinical guidelines for these individual diseases in one patient is burdensome, not effective or may even be harmful .