Geriatric medicine for the primary care physician

Approximately two out of three older adults in the United States have multiple chronic conditions, and treatment for these conditions account for nearly 66% of the country’s health care budget, according to the CDC. Adults aged 65 years and older will account for 20% of the U.S. population by 2030, the CDC estimates.

Here, Healio.com/Family Medicine highlights the most important findings in geriatric care from 2015 that primary care physicians should know.

Cost of dementia 57% greater than other diseases in final years of life

Compared with costs associated with heart disease, cancer or other causes, patients with dementia face the largest health care expenditures, totaling more than $287,000 in the last 5 years of life, according to recently published data.

Results demonstrated that on average, the cost per decedent was $175,136 among those who died from heart disease, $173,383 among those who died from cancer and $197,286 among those who died from other causes. The average cost faced by patients with dementia was $287,038. Read more.

Wheelchair users at increased risk for death from road traffic collisions

Between 2006 and 2012, individuals using wheelchairs were significantly more likely to be killed in a motor vehicle crash, compared with those not using wheelchairs.

Men in wheelchairs were five times more likely than women in wheelchairs to be involved in a fatal crash (P < .001). Men aged 50 to 64 years were 75% more likely to be involved in a fatal road collision, compared with men of the same age who were not using wheelchairs, according to the researchers. Read more.

HIV screening among older adults fluctuating in recent years

Despite the CDC’s 2006 recommendation that health care providers screen older patients for HIV, regardless of symptoms, a large proportion of older adults are not being tested.

Results demonstrated that overall, the number of older adults who had been tested for HIV within the previous year decreased following the CDC’s recommendations (P < .001). Read more.

At least 10% of older adults experience elder abuse

Physicians need to be alert for cases of elder abuse, which researchers estimate is prevalent in at least 10% of people aged60 years or older.

Risk factors for elder abuse include being a woman, being younger, a shared living environment, having a lower income, isolation, functional impairment and poor physical health. Read more.

Older adults face increased risk of stroke after shingles

Herpes zoster or shingles increased the short-term risk for stroke among older adults.

Researchers found that adults aged at least 50 years were at a 50% increased risk for stroke in the 3 months following an episode of herpes zoster. Read more.

Older patients with diabetes are often overtreated

Physicians were not likely to cut back on BP and glycemic medication treatments in older patients with diabetes after they reach low BP or hemoglobin A1c levels.

Researchers found that this practice was common despite guidelines from the American Diabetes Association, the American Geriatrics Society and the ABIM's Choosing Wisely campaign for less aggressive treatment. Read more.