Diagnostic dilemmas in acutely ill elderly people

The atypical and non-specific clinical presentations of disease in elderly people may produce diagnostic confusion. Laboratory investigations can be especially important in achieving the correct diagnoses in the older age group. Accurate interpretation of laboratory data from elderly patients necessarily requires a knowledge of the effects of ageing on the biochemical and haematological parameters of healthy individuals, so that involutional changes are not misinterpreted as representative of disease and, conversely, significant deviations from normal values are not attributed to the ageing process. In addition, the laboratory data on elderly subjects may be further complicated by specific effects of illness in the aged. Co-existent pathology or multiple drug therapy, which are most common in old people, also cause changes which should be recognised by laboratory and clinical staff alike.