Guidelines of the Care of the Aged Patients

Abstract

Clinical gerontology is progressively becoming more and more relevant as a consequence of two well known phenomena: the growth of the elderly population and the high prevalence of many diseases in advanced age. Aged patients, in fact, account for the large majority of hospitalizations even for acute diseases, and their hospital stay is generally definitely longer than that of younger patients. According to data drawn from a sample population by the Italian ISTAT in 1982, the hospitalization rate steadily increased from 35.3 per thousand under the age of 13 to 177.2 per thousand over the age of 70; in the same, extreme age groups hospital stay averaged 10.3 and 23.6 days, respectively. The hospitalization rate of elderly patients is high also when a tipically acute disease, such as acute myocardial infarction, is taken into account: of the 2056 cases of acute myocardial infarction admitted to our geriatric intensive care unit from 1969 to 1982, 52% were aged 65 years or more, while 21% were older than 75 years (1). However, we think that the expanding role of geriatric medicine in different medical sciences derives by something more complex than merely quantitative epidemiological data. Management of elderly patients requires specific knowledge and skill, since it is made particularly difficult by the superposition of many, frequently coexisting diseases on changes which may be regarded as consequences of the “normal” aging process.