Later life's complexity needs a scalpel rather than an axe

doi:10.1136/bmj.39311.447407.3A

BMJ 2007;335:361-362 (25 August), doi:10.1136/bmj.39311.447407.3A

Letters

Prevention in elderly people

Later life's complexity needs a scalpel rather than an axe

The first 150 words of the full text of this article appear below.

The key features of ageing are increased inter-individual variability,complexity, and comorbidity, which is why indicators of qualityof care based on single disease models work less well amongolder than younger people. However, it is a far cry from thisposition to the nihilism of Mangin et al.¹

Individualised health promotion for older people is highly effective²and is likely to be among the reasons for falling disabilityamong older Americans,³ to the point of stabilising healthcareexpenditure on older people. Health promotion among older peopleembraces a far wider repertoire of manoeuvres than the prescriptionof statins, and sadly, evidence is abundant that old age isassociated with a failure of doctors to provide health promotionto older people in a range of settings.⁴ ⁵

Rather than systematically withholding preventive options forolder people, clinicians should capitalise on other hallmarksof later life, wisdom and common sense, to develop . . . [Full text of this article]

Desmond O'Neill, associate professor, medical gerontology

Centre for Ageing, Neurosciences and the Humanities, Adelaide and Meath Hospital Dublin, Dublin 24, Republic of Ireland

des.oneill@amnch.ie

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Preventive health care in elderly people needs rethinking: Dee Mangin, Kieran Sweeney, and Iona Heath
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