Shechar Dworski, BSc

As the North American geriatric population steadily increases, a greater emphasis is being placed on primary prevention in the form of screening and counseling, to avoid onset and/or advancement of disease. Treatment of advanced disease often requires much more invasive and time-intensive procedures, and is more stressful and risky for the patient. The periodic health exam is an opportune setting for a primary care physician to screen asymptomatic elderly patients for diseases commonly associated with aging or with a high-risk group. The physician's role is moving from treatment to prevention in our current social climate, since early detection often reduces onset and progression of disease, or at least reduces complications and increases survival rates.

Unlike their younger counterparts and the stronger elderly, when frail elderly become ill, early symptoms of chronic disease are rarely specific and localized ones. Instead, older patients usually manifest nonspecific symptoms, which quickly lead to loss of function. This creates dependency in a previously independent older person without giving any clues as to the cause of the problem. The functional expressions of disease include cessation or reduction of eating and drinking, dizziness, urinary incontinence, falling, weight loss, acute confusion, failure to thrive, and new onset or worsening of previous dementias.