Preventive health care in elderly people needs rethinking

doi:10.1136/bmj.39241.630741.BE1

BMJ 2007;335:285-287 (11 August), doi:10.1136/bmj.39241.630741.BE1

Analysis

Preventive health care in elderly people needs rethinking

Dee Mangin, senior lecturer in general practice¹, Kieran Sweeney, honorary clinical senior lecturer in general practice², Iona Heath, general practitioner³

¹ Christchurch School of Medicine, University of Otago, Christchurch New Zealand, ² Peninsula Medical School, Royal Devon and Exeter Hospital, Exeter EX2 5DW, ³ Caversham Group Practice, London NW5 2UP

Correspondence to: D Mangin derelie.mangin@chmeds.ac.nz

Dee Mangin, Kieran Sweeney, and Iona Heath argue that, ratherthan prolonging life, preventive treatments in elderly peoplesimply change the cause of death—the manner of our dying

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

Single disease models should not be appliedto preventive treatments in elderly people
Preventive treatmentsin elderly people may select cause of death without the patient'sinformed consent
Preventive use of statins shows no overallbenefit in elderly people as cardiovascular mortality and morbidityare replaced by cancer
A more sophisticated model is neededto assess the benefits and harms of preventive treatment inelderly people

Preventive health care aims to delay the onset of illness anddisease and to prevent untimely and premature deaths. But thetheory and rhetoric of prevention do not deal with the problemof how such health care applies to people who have already exceededan average lifespan. In recent years, concerns about equityof access to treatments have focused on ageism. As a result,preventive interventions are encouraged regardless of age, andthis can be harmful to the patient and expensive for the health. . . [Full text of this article]

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Rapid Responses:

Read all Rapid Responses

Compression of morbidity, not prolongation of life, is the goal of Old Age preventive medicine: Anthony Oke
bmj.com, 10 Aug 2007 [Full text]
Prevention may not be benficial: Tim M Reynolds
bmj.com, 11 Aug 2007 [Full text]
Need for an individualized approach to preventive care in the elderly: Paddy B Quail
bmj.com, 11 Aug 2007 [Full text]
A patient's viewpoint: Raymond G Holder
bmj.com, 12 Aug 2007 [Full text]
More from a member of the public: Bob Smith
bmj.com, 13 Aug 2007 [Full text]
Re: A patient's viewpoint: Duane E. Graveline
bmj.com, 14 Aug 2007 [Full text]
Not fair on the older patient.: J THOMAS
bmj.com, 13 Aug 2007 [Full text]
The complexity of later life needs a scalpel rather than an axe: Desmond O'Neill
bmj.com, 14 Aug 2007 [Full text]
Not all preventive interventions are equal: Ashley R Bloomfield
bmj.com, 14 Aug 2007 [Full text]
Preventive health care in elderly people needs rethinking: Idris Williams
bmj.com, 14 Aug 2007 [Full text]
Appropriate care of the elderly: Lesley A M Evans
bmj.com, 14 Aug 2007 [Full text]
Evidence-Based Medicine in the Elderly: Dean J Noimark
bmj.com, 15 Aug 2007 [Full text]
Preventive health care in elderly: Patricia E Price
bmj.com, 15 Aug 2007 [Full text]
Saving Lives?: Gina Johnson
bmj.com, 16 Aug 2007 [Full text]
Primary Prevention- Ultimate Goal in Medicine??: Heong Keong Goh
bmj.com, 16 Aug 2007 [Full text]
Equitable health care: Erik Buskens
bmj.com, 16 Aug 2007 [Full text]
Saving Lives Versus Postponing Death: Joseph I. Yikona
bmj.com, 17 Aug 2007 [Full text]
Preventive health care in elderly people needs rethinking: Martin J. Connolly
bmj.com, 17 Aug 2007 [Full text]
Trade offs: Joan McClusky
bmj.com, 17 Aug 2007 [Full text]
Rethinking needed for each and every medication in elderly people: Doron Garfinkel
bmj.com, 20 Aug 2007 [Full text]
Challenging the QOF: Dougal J. Jeffries
bmj.com, 21 Aug 2007 [Full text]
Authors' response: Dee Mangin, et al.
bmj.com, 23 Aug 2007 [Full text]
We lack reliable data on harms attributable to treatments: Andrew Herxheimer
bmj.com, 31 Aug 2007 [Full text]
Essential geriatric care: Tamilmani A J
bmj.com, 1 Oct 2007 [Full text]