Summary
Definition
History and exam
Other diagnostic factors
- self-report
- inconsistent history
- agitated state
- social isolation
- physical injuries
- malnutrition and volume depletion
- improper medicine use
- substance abuse
- carer dominance
- pressure ulcers
- shabby appearance
- genital bleed or wound
Risk factors
- age >75 years
- dementia
- dependence on a carer for personal care
- depression or other mental illness in the carer
- substance abuse by the older person or the carer
- financial dependence of the carer on the older adult
Diagnostic investigations
1st investigations to order
- FBC
- platelet function studies
- basic metabolic profile (including urea and creatinine)
- clinical photograph
- x-rays
Investigations to consider
- CT head
- CT abdomen
- serum levels of relevant medicines
- toxicology screen (urine and blood)
Treatment algorithm
Contributors
Authors
Assistant Professor
Department of Family and Geriatric Medicine
School of Medicine
University of Louisville
Louisville
KY
Disclosures
JPG declares that she has no competing interests.
Professor Emeritus in Geriatrics
Department of Family and Geriatric Medicine
School of Medicine
University of Louisville
Louisville
KY
Disclosures
JGOB declares that he has no competing interests.
Dr Josephine P. Gomes and Professor James O'Brien would like to gratefully acknowledge Dr Angela R. Wetherton and Dr Senthil R. Meenrajan, previous contributors to this topic. ARW and SRM declare that they have no competing interests.
Peer reviewers
Assistant Professor
Mayo Medical School
Jacksonville
FL
Disclosures
KM has been paid as a speaker at the American College of Physicians annual meeting. KM has also been paid for consultation for the physician excellence program.
Assistant Professor of Medicine
University of Colorado School of Medicine and the Denver Veterans Affairs Medical Center
Denver
CO
Disclosures
CL declares that she has no competing interests.
Associate Professor of Medical Gerontology
Department of Medical Gerontology
School of Medicine
Trinity College Dublin
Dublin
Ireland
Disclosures
DON declares that he has no competing interests.
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