Physical examination of the aged patient

The aged patient presents challenges to the examining physician. Some of these relate to inefficient historical information transfer, reduced mobility, increased disease burden, cognitive and sensory alterations, and confusing background changes in the prevalence and interpretation of physical signs that would be unequivocally abnormal in the younger adult. This review suggests techniques to overcome these difficulties. Descriptions of methods of improving evaluation and interpretation are grouped into the following categories: general appearance and vital signs; skin; head and neck; respiratory and cardiovascular systems; abdomen, rectum and genitalia; musculoskeletal system; hands and fett; and neurologic and mental status evaluations. Several newly recognized signs are also described. The extra time, effort and ingenuity required for examination of the aged patient are richly repaid by enhanced diagnosis.