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Age bias may hinder care of elders

Patient Safety Monitor Alert, March 9, 2005

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Patients over age 65 generally receive less aggressive treatment for cancer than younger patients, less preventive care for high blood pressure and cholesterol, and double the dose they need of some psychiatric medicines because of society's age bias, the Boston Globe reports.

Because senior citizens are often overlooked for tests of new treatments and medicines, doctors do not have the evidence they need to provide appropriate care.

The age bias often results from misguided attempts to protect seniors from being harmed by overly aggressive treatments, some doctors say. Last week, the Journal of the American Medical Association published research showing that aggressive chemotherapy reduced deaths from breast cancer and recurrences in women over age 65 as much as younger women. The University of Vermont researchers said that age by itself should not determine doctors' and patients' decisions about cancer treatment.

In addition, researchers at Columbia University have found that half of all senior citizens with advanced colon cancer do not receive chemotherapy after surgery to remove the tumor, although older patients who receive this treatment live longer.

Bias contributes to older patients receiving less than optimal therapy for cancer, said Dr. Edward Trimble, who leads the efforts at the National Cancer Institute to improve cancer care for the elderly. Other factors include concerns about the ability of frail seniors or those with multiple illnesses to tolerate aggressive treatments. However, patients and providers should make these decisions on a case-by-case basis, not on myths about what the average older person can handle.

Sometimes older patients dismiss health problems as symptoms of old age and fail to mention them to their doctors. This can also contribute to undertreatment, doctors said.

To read the complete Boston Globe article, click here.

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