Overview of Prevention in Older Adults

For older adults, prevention focuses mainly on disease, frailty, accidents (ie, unintentional injury), iatrogenic complications, psychosocial problems, and maintaining 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 older people have minimal or no chronic disease and are functionally independent. Primary and secondary prevention of disease Primary and Secondary Prevention Disease prevention is treatment intended to prevent a disease from occurring or worsening. Independent, older people with minimal or no chronic disease, as well as older people with several... 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 the most beneficial measures for this group.

Chronically ill people typically have several noncurable but treatable diseases, are usually functionally independent or minimally dependent, often take several prescription drugs, 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. Independent, older people with minimal or no chronic disease, as well as older people with several... read more and tertiary prevention of disease Tertiary Prevention Disease prevention is treatment intended to prevent a disease from occurring or worsening. Independent, older people with minimal or no chronic disease, as well as older people with several... 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. Independent, older people with minimal or no chronic disease, as well as older people with several... 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 should learn about their diseases and treatment plans, as should their caregivers. 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/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 practitioner. 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.