Our medical system does not reflect the fact that all old people are not the same. All Americans 65 and older are lumped into a single group, as if bodies and behaviors don’t change over the last half-century of life. Included in this group over 65 are the two fastest-growing segments of our population: the 80 to 90-year-olds and the group over 100. We should be able to distinguish 70-year-olds from those a generation ahead of them, and recognize that better guidelines for treatment must be established. Consider this – medically speaking, there are 17 subgroups for children from birth through age 18 and five subgroups for adults. Just as treatment for an infant would not work for a teenager, treatment for a 70-year-old does not work for a 95-year-old. The “young old” and the “old old” differ in how they look and spend their days, they also differ biologically. There are differences in the immune system and in immunization needs, strengths and treatment. There are differences and changes in kidneys, heart, skin and other organs as well as differences in tolerance to drugs, chemotherapy, radiation and other procedures. Equally troublesome is the failure of studies to measure outcomes that reflect older people’s priorities. Most would rather live comfortably and independently for a shorter time than live for a slightly longer time confined to a bed or nursing home. In this 21st century, when the number of older adults will surpass the number of children worldwide, we need to target oldhood. Older adults also need to be included in clinical studies for greater emphasis and understanding of this growing segment of society. From: The New York Times, Sunday, August 13, 2017.
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