Abstract
Older adults require an individualized approach for preventive care decisions. While preventive guidelines are often written taking into account a patient’s age, clinicians also need to consider factors other than age—such as life expectancy, functional status, and patient preferences—when determining whether a given preventive test or treatment is appropriate for their older patients. In this chapter, we present a five-step, person-centered framework for making screening decisions in older adults, using cancer screening as a paradigm.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Walter LC, Covinsky KE. Cancer screening in elderly patients: a framework for individualized decision making. JAMA. 2001;285(21):2750–6.
Welch HG, Albertsen PC, Nease RF, Bubolz TA, Wasson JH. Estimating treatment benefits for the elderly: the effect of competing risks. Ann Intern Med. 1996;124:577–84.
Justice AC, Covinsky KE, Berlin JA. Assessing the generalizability of prognostic information. Ann Intern Med. 1999:130(6):515–24.
https://www.cancer.gov/about-cancer/understanding/statistics.
Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2016;315(23):2564–75. https://doi.org/10.1001/jama.2016.5989.
Lee SJ, Leipzig RM, Walter LC. “When will it help?” incorporating lagtime to benefit into prevention decisions for older adults. JAMA. 2013;310(24):2609–10.
Lee SJ, Boscardin WJ, Stijacic-Cenzer I, Conell-Price J, O’Brien S, Walter LC. Time lag to benefit after screening for breast and colorectal cancer: meta-analysis of survival data from the United States, Sweden, United Kingdom, and Denmark. BMJ. 2013;346
Van Zee KJ, Manasseh DM, Bevilacqua JL, et al. A nomogram for predicting the likelihood of additional nodal metastases in breast cancer patients with a positive sentinel node biopsy. Ann Surg Oncol. 2003;10(10):1140–51.
Ross PL, Gerigk C, Gonen M, et al. Comparisons of nomograms and urologists’ predictions in prostate cancer. Semin Urol Oncol. 2002;20(2):82–8.
Justice AC, Covinsky KE, Berlin JA. Assessing the generalizability of prognostic information. Ann Intern Med. 1999;130(6):515–24.
Inouye SK, Bogardus ST Jr, Vitagliano G, et al. Burden of illness score for elderly persons: risk adjustment incorporating the cumulative impact of diseases, physiologic abnormalities, and functional impairments. Med Care. 2003;41(1):70–83.
Schonberg MA, Davis RB, McCarthy EP, Marcantonio ER. External validation of an index to predict up to 9-year mortality of community-dwelling adults aged 65 and older. J Am Geriatr Soc. 2011;59(8):1444–51.
Flaherty JH, Morley JE, Murphy DJ, et al. The development of outpatient clinical glidepaths. J Am Geriatr Soc. 2002;50(11):1886–901.
Keeler E, Guralnik JM, Tian H, Wallace RB, Reuben DB. The impact of functional status on life expectancy in older persons. J Gerontol A Biol Sci Med Sci. 2010;65(7):727–33. PMID: 20363833.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Yourman, L.C., Guan, J.Y., Gupta, R. (2020). Individualized Decision-Making for Preventive Medicine in Older Adults. In: Chun, A. (eds) Geriatric Practice. Springer, Cham. https://doi.org/10.1007/978-3-030-19625-7_28
Download citation
DOI: https://doi.org/10.1007/978-3-030-19625-7_28
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-19624-0
Online ISBN: 978-3-030-19625-7
eBook Packages: MedicineMedicine (R0)