Common Problems of the Elderly

  • James P. Richardson
  • Aubrey L. Knight


Older patients are a challenging but satisfying part of most family physicians’ practices. Optimal care of geriatric patients occurs when the precepts of continuity of care, the team approach to the management of illness, the importance of the family, and the biopsychosocial model are followed. Because of the prevalence of chronic disease in the elderly, cure may be elusive, but appropriate care always improves the quality of the older adult’s life. Some common problems of the elderly are reviewed in this chapter. More complete discussions may be found in textbooks of geriatric medicine.1,2


Nursing Home Urinary Incontinence Stress Incontinence Pressure Ulcer Spinal Cord Injuries26 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Hazzard WR, Bierman EL, Blass JP, Ettinger WH, Halter JB, editors. Principles of geriatric medicine. 3rd ed. New York: McGraw-Hill, 1994.Google Scholar
  2. 2.
    Kane RL, Ouslander JG, Abrass IB. Essentials of clinical geriatrics. 3rd ed. New York: McGraw-Hill, 1994.Google Scholar
  3. 3.
    Tinetti ME. Falls. In: Hazzard WR, Bierman EL, Blass JP, Ettinger WH, Halter JB, editors. Principles of geriatric medicine. 3rd ed. New York: McGraw-Hill, 1994:1313–20.Google Scholar
  4. 4.
    King MB, Tinetti ME. Falls in community-dwelling older persons. J Am Geriatr Soc 1995;43:1146–54.PubMedGoogle Scholar
  5. 5.
    Hornbrook MC, Stevens VJ, Wingfield DJ, et al. Preventing falls among community-dwelling older persons: results from a randomized trial. Gerontologist 1994;34:16–23.PubMedCrossRefGoogle Scholar
  6. 6.
    Vetter NJ, Lewis PA, Ford D. Can health visitors prevent fractures in elderly people? BMJ 1992;304:888–90.PubMedCrossRefGoogle Scholar
  7. 7.
    Province MA, Hadley EC, Hornbrook MC, et al. The effects of exercise on falls in elderly patients: a pre-planned metaanalysis of the FICSIT trials. JAMA 1995;273:1341–7.PubMedCrossRefGoogle Scholar
  8. 8.
    Tinetti ME, Baker DI, McAvay G, et al. A multifactorial intervention to reduce the risk of falling among elderly people living in the community. N Engl J Med 1994;331:821–7.PubMedCrossRefGoogle Scholar
  9. 9.
    Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc 1986;34:119–26.PubMedGoogle Scholar
  10. 10.
    US Department of Health and Human Services. Clinical practice guideline: urinary incontinence in adults. Rockville, MD: DHHS, 1992:38–65. AHCPR Publ. No. 92–0038.Google Scholar
  11. 11.
    Michocki RJ, Lamy PP, Hooper FJ, Richardson JP Drug prescribing for the elderly. Arch Fam Med 1993;2:441–4.PubMedCrossRefGoogle Scholar
  12. 12.
    Ray WA, Griffin MR, Schaffner W, et al. Psychotropic drug use and the risk of hip fracture. N Engl J Med 1987;316:363–9.PubMedCrossRefGoogle Scholar
  13. 13.
    Vestal R. Clinical Pharmacology. In: Hazzard WR, Andres R, Bierman EL, Blass JP, editors. Principles of geriatric medicine and gerontology. 2nd ed. New York: McGraw-Hill, 1990:201–11.Google Scholar
  14. 14.
    Acute Pain Management Guideline Panel. Acute pain management: operative or medical procedures and trauma; clinical practice guideline. Rockville, MD: Agency for Health Care Policy and Research, Public Health Service, US Department of Health and Human Services, 1992. AHCPR Publ. No. 92–0032.Google Scholar
  15. 15.
    American Pain Society. Principles of analgesic use in the management of acute pain and cancer pain. 3rd ed. Skokie, IL: American Pain Society, 1992.Google Scholar
  16. 16.
    World Health Organization. Cancer pain and palliative care: report of a WHO expert committee. Geneva: WHO, 1990:1–75. World Health Organization Technical Report Series 804.Google Scholar
  17. 17.
    Bistrian BR, Blackburn GL, Vitale J, et al. Prevalence of malnutrition in general medical patients. JAMA 1976;235:1567–70.PubMedCrossRefGoogle Scholar
  18. 18.
    White JV, Dwyer JT, Posner BM, Ham RJ, Lipschitz DA, Wellman NS. Nutrition Screening Initiative; development and implementation of the public awareness checklist and screening tools. J Am Diet Assoc 1992;92:163–7.PubMedGoogle Scholar
  19. 19.
    Richardson JP. Health maintenance for the elderly. In: Taylor RB, editor. The manual of family practice. Boston: Little, Brown, 1997;24–7.Google Scholar
  20. 20.
    United States Preventive Services Task Force. Guide to clinical preventive services. 2nd ed. Baltimore: Williams & Wil-kins, 1996.Google Scholar
  21. 21.
    Kemper P, Murtaugh CM. Lifetime use of nursing home care. N Engl J Med 1991;324:595–600.PubMedCrossRefGoogle Scholar
  22. 22.
    Richardson JP. Outpatient evaluation for nursing home admission. In: Yoshikawa TT, Cobbs EL, Brummel-Smith K, editors. Ambulatory geriatric care. 2nd ed. St. Louis: Mosby-Year Book, in press.Google Scholar
  23. 23.
    Brandeis GH, Morris JN, Nash DJ, Lipsitz LA. The epidemiology and natural history of pressure ulcers in elderly nursing home residents. JAMA 1990;264:2905–9.PubMedCrossRefGoogle Scholar
  24. 24.
    Reuler JB, Cooney TG. The pressure sore: pathophysiology and principles of management. Ann Intern Med 1981;94: 661–6.PubMedCrossRefGoogle Scholar
  25. 25.
    Longe RL. Current concepts in clinical therapeutics: pressure sores. Clin Pharm 1986;5:669–81.PubMedGoogle Scholar
  26. 26.
    Sather MR, Weber CE Jr, George J. Pressure sores in the spinal cord injury patient. Drug Intell Clin Pharm 1977;11: 154–69.Google Scholar
  27. 27.
    Berlowitz DR, Wilking SVB. Risk factors for pressure sores: a comparison of cross-sectional and cohort-derived data. J Am Geriatr Soc 1989;37:1043–50.PubMedGoogle Scholar
  28. 28.
    Allman RM, LaPrade CA, Noel LB, et al. Pressure sores among hospitalized patients. Ann Intern Med 1986;105:337–42.PubMedCrossRefGoogle Scholar
  29. 29.
    Pinchcofsky-Devin GD, Kaminski MV Jr. Correlation of pressure sores and nutritional status. J Am Geriatr Soc 1986;34: 435–40.PubMedGoogle Scholar
  30. 30.
    Guralnik JM, Harris TB, White LR, Cornoni-Huntley JC. Occurrence and predictors of pressure sores in the National Health and Nutrition Examination Survey follow-up. J Am Geriatr Soc 1989;36:807–12.Google Scholar
  31. 31.
    Knight AL. Medical management of pressure sores. J Fam Pract 1988;27:95–100.PubMedGoogle Scholar
  32. 32.
    National Pressure Ulcer Advisory Panel. Pressure ulcers prevalence, cost and risk assessment: consensus development conference statement. Decubitus 1989;2(2):24–8.Google Scholar
  33. 33.
    Richardson JP, Knight AL. The prevention of tetanus in the elderly. Arch Intern Med 1991;151:1712–17.PubMedCrossRefGoogle Scholar
  34. 34.
    Seiler WO, Stahelin HB. Decubitus ulcers: treatment through five therapeutic principles. Geriatrics 1985;40:30–44.PubMedGoogle Scholar
  35. 35.
    Pressure Ulcer Guideline Panel. Pressure ulcer treatment. Am Fam Phys 1995;51:1207–22.Google Scholar

Copyright information

© Springer Science+Business Media New York 1998

Authors and Affiliations

  • James P. Richardson
  • Aubrey L. Knight

There are no affiliations available

Personalised recommendations