Related Experiment Video
Updated: Dec 1, 2025
12:18
A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
Published on: January 11, 2020
7.8K
[To screen or not to screen after age 75 ?]
Ana Vilas Boas1, Kevin Selby1, Jacques Cornuz1
1Centre universitaire de médecine générale et santé publique, Unisanté, 1011 Lausanne.
Revue Medicale Suisse
|November 11, 2020
Summary
Individualized screening for older adults is crucial. Robust patients may benefit from screenings over age 75, while frail patients may not due to shorter life expectancy and time to benefit.
Area of Science:
- Geriatrics
- Preventive Medicine
- Health Policy
Background:
- The older population exhibits significant heterogeneity, with individuals varying in robustness, frailty, and dependency at similar ages.
- Standardized screening protocols may not be suitable for all elderly individuals due to diverse health statuses and life expectancies.
Purpose of the Study:
- To advocate for individualized screening decisions in elderly patients.
- To emphasize the importance of considering life expectancy, time to benefit (TTB), and patient preferences in screening guidelines.
Main Methods:
- This study is a conceptual analysis and literature review.
- It synthesizes evidence on the heterogeneity of aging and the principles of personalized medicine.
Main Results:
- Robust elderly patients with longer life expectancies may benefit from certain cancer screenings beyond age 75.
- Frail or dependent patients with shorter life expectancies may not benefit from the same screenings if their life expectancy is less than the TTB.
Conclusions:
- Screening decisions for older adults must be personalized, integrating remaining life expectancy, TTB, and patient values.
- Medical encounters provide opportunities to discuss preferences, define care goals, and plan for advanced care, optimizing screening strategies.
Related Concept Videos
01:30Preventive Healthcare Services
1.5K
Preventive healthcare services keep people healthy via frequent check-ups, screening, and counseling. They primarily aid in disease prevention rather than treating an acute or chronic illness. Preventive treatment also keeps individuals productive and energetic, allowing them to work well into their retirement years. Examples of preventive care services include:
1.5K
01:15Drug Dosing: Geriatric Patients
119
Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
119
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion
154
In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
154
01:27Pharmacodynamics in Geriatric Patients: Effects of Age
104
Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
104
01:00Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution
84
Drug distribution in the human body is influenced by several factors, including plasma protein concentration, body composition, blood flow, tissue-protein concentration, and tissue fluid pH. Among these, changes in plasma protein concentration and body composition due to aging significantly affect how drugs are distributed within the body. Specifically, aging is associated with a decrease in albumin levels by about 10% and an increase in α1-acid glycoprotein levels. These alterations are...
84
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism
100
Geriatric patients show significant variation in how their bodies process medications, which can change how effective and safe treatments are. The liver is the primary organ where drug metabolism occurs, involving two main types of chemical reactions: phase I and II. Phase I metabolism is driven by the cytochrome P450 enzyme system, which includes key types such as CYP3A, CYP2D6, and CYP2C9. Research indicates that while aging doesn't notably alter the levels or activity of these enzymes, it...
100