Merck Manual

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Overview of Prevention in Older Adults

By

Magda Lenartowicz

, MD, Altais Health Solutions

Reviewed/Revised May 2023
View PATIENT EDUCATION

For older adults, prevention focuses mainly on preventing disease, frailty, accidents (ie, unintentional injury), iatrogenic complications, and psychosocial problems and on maintaining the ability to perform activities of daily living. Not all older patients benefit from every preventive measure. Choice of preventive measures is guided by whether the patient’s general condition is

  • Healthy

  • Chronically ill

  • Frail and/or complex

Chronically ill people typically have several noncurable but treatable diseases, are usually functionally independent or minimally dependent, often take several prescription medications, and occasionally are hospitalized for exacerbations of their chronic diseases. Secondary Primary and Secondary Prevention Disease prevention is treatment intended to prevent a disease from occurring or worsening. Disease prevention measures benefit independent older people with minimal or no chronic disease and... read more and tertiary prevention of disease Tertiary Prevention Disease prevention is treatment intended to prevent a disease from occurring or worsening. Disease prevention measures benefit independent older people with minimal or no chronic disease and... read more and prevention of frailty Prevention of Frailty Frailty is loss of physiologic reserve, which makes people susceptible to disability due to minor stresses. Common features of frailty include weakness, slowed motor function, weight loss, muscle... read more are priorities, as are primary prevention of disease Primary and Secondary Prevention Disease prevention is treatment intended to prevent a disease from occurring or worsening. Disease prevention measures benefit independent older people with minimal or no chronic disease and... read more and prevention of iatrogenic complications Prevention of Iatrogenic Complications in Older Adults Iatrogenic complications are more common and often more severe among older adults than among younger patients. These complications include adverse drug effects (eg, interactions), falls, nosocomial... read more and accidents.

Chronically ill patients and their caregivers should learn about their diseases and treatment plans. Regular physician visits and prompt reporting of a change in symptoms can help reduce severe disease exacerbations, which can lead to hospitalization and functional decline.

Frail and/or complex people typically have many severe chronic diseases, are functionally dependent, and have lost their physiologic reserve. They are frequently hospitalized and institutionalized. For them, prevention of accidents and iatrogenic complications is most important.

Caregivers of frail older adults must work assiduously to prevent accidents by completing a home safety checklist and correcting any potential problems that are identified. Caregivers should watch for even subtle functional changes in older patients and promptly report any changes to a health care professional. If a patient has multiple unmet needs, especially when coupled with functional decline, a caregiver should consider seeking the care of a geriatric interdisciplinary team.

General preventive measures

Some preventive measures that apply to all older people include

More information

The following English-language resource may be useful. Please note that THE MANUAL is not responsible for the content of these resources.

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NOTE: This is the Professional Version. CONSUMERS: View Consumer Version
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