How far to investigate older people?

Abstract

For an older patient with multiple comorbidities, investigations should be focused on those problems or conditions that adversely affect quality of life and/or are likely to limit life expectancy Key factors that influence the decision whether to investigate an older patient include comorbid disease, likely life expectancy, cognitive status, disability and the patient's wishes. If a decision is taken not to investigate, the reasons behind this should be clearly documented Cognitive impairment is common in older patients and often missed in medical assessments. Detection is improved if standardised questionnaires such as the Abbreviated Mental Test are used routinely Disability is common in older patients but often poorly documented in case records. The routine use of simple questionnaires such as the Barthel Index (which records aspects of mobility, basic self-care and continence) is recommended.