Generating Germane Geriatrics

5 Jun

Generating Germane GeriatricsIn a sense, almost every issue of P&T contains a geriatrics theme. Heart disease, cancer, diabetes, Alzheimer’s disease (AD), and many of the other disease states that we report on each month affect the elderly to a greater extent than the rest of the population, which, as we know, is growing rapidly. Despite the seemingly obvious ramifications of this reality, some might ask: why a special geriatrics issue every year, when we already routinely cover these topics?

First, because of the significant effect of these and other diseases on the health care industry generally and on P&T committees specifically: the aforementioned diseases, for example, represent four of the top ten leading causes of death among Americans aged 65 years and older and, consequently, also represent some of the fastest-growing areas for drug research and development. Second, because we wanted to highlight some additional related problems that afflict the burgeoning older population and the impact of these problems on the P&T committee members who make decisions that directly affect elderly patients.
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The statistics on aging are startling; approximately 4.5 million Americans now have AD, and 7.7 million are expected to have it by 2030, when the youngest “baby-boomers” will be over age 65. The “oldest old” population is particularly susceptible to other illnesses, and research has shown that the coexistence of AD and other medical conditions drastically increases the cost of treatment for affected individuals. The average length of a hospital stay in 2000 was 6.4 days for older people and 4.6 days for all people.

The three feature articles in this issue discuss the implications of these statistics, the changing demographics, and the widespread problem of polypharmacy—what Dr. Stefanaccci would call “the perfect storm”—involving elderly patients and their caregivers. (Osteoporosis and other conditions affecting the elderly are covered in Drug News, Drug Forecast, and P&T Snapshot.) Dr. Riefkohl and coauthors review the relationship between medication use and falls in the elderly (accidents, including falls, are the fifth leading cause of death in older adults); Dr. Lewko and colleagues examine the problem of involuntary weight loss in the elderly (often resulting from polypharmacy); and Dr. Stefanacci discusses the expanding role of P&T committees in long-term care.

Although time and space constraints forced us to limit ourselves to three feature articles, fortunately, there is always next time. We welcome your suggestions for future topics and, of course, your article submissions to P&T. By the time you read this, plans for next year’s special issue will be under way. cialis professional 20 mg