[The perspective of reference value -normal and abnormal in medicine]

Area of Science:

• Geriatric Medicine
• Clinical Chemistry
• Biostatistics

Context:

• Normal laboratory values are crucial for clinical decisions, but individual differences in the elderly complicate group-based normal value determination.
• Reference values, while common, only reflect average healthy population ranges and do not predict future health or independent living.
• Geriatric practice requires reliable laboratory parameters to assess lifestyle-related diseases and predict the risk of cognitive impairment and loss of independence.

Purpose:

• To highlight the limitations of traditional normal and reference values in geriatric populations.
• To emphasize the need for advanced methodologies in assessing laboratory parameters for predicting health outcomes in the elderly.
• To propose the use of longitudinal data for determining optimal clinical parameter ranges in lifestyle-related diseases.

Summary:

• Traditional laboratory values and reference ranges are insufficient for assessing health and predicting independent living in the elderly due to significant individual variability.
• Existing methods struggle to identify critical cut-off points for risk factors associated with cognitive impairment and maintaining independence.
• A novel approach utilizing longitudinal data is proposed to establish optimal ranges for clinical parameters relevant to lifestyle-related diseases in geriatric care.

Impact:

• This research calls for a paradigm shift in how laboratory data is interpreted in geriatric medicine.
• Developing new methodologies could lead to more accurate predictions of health status and the need for interventions to support independent living in older adults.
• Improved assessment of laboratory parameters will aid in the early identification and management of conditions affecting elderly populations, particularly those related to lifestyle and cognitive function.