M. Bachir Tazkarji, MD, CCFP, CAQ Geriatric Medicine, Lecturer, Family Medicine Department, University of Toronto; Toronto Rehabilitation Institute, Toronto, ON.

As the population is aging, physicians from all specialties are expected to see more older adults at their outpatient practices and in the acute settings. Abdominal pain remains one of the most common and potentially serious complaints that emergency physicians encounter. Vascular pathology should be considered early in the diagnostic course of all older adults who have abdominal pain because the time for intervention is critical.
Key words: abdominal pain, older adults, management of acute abdominal pain.

Dr. Richard Lee, MD, CCFP(EM), FRCPC
Undergraduate Program Director
Emergency Medicine,
University of Alberta

Introduction
Approximately 13% of our population is comprised of persons who are aged 65 years or older. This age group represents the fastest growing segment of our population and it is expected that by the year 2030, it will amount to 20% of the total population. On average, the older person tends to visit the emergency department (ED) more frequently, stays longer, is more likely to be admitted, and also consumes more health care resources than does the younger person. Up to 10% of these elderly patients will present with their chief complaint being abdominal pain. Results from one survey found that 78% of emergency physicians believe that abdominal pain is more difficult to manage in the elderly when compared to a younger age group, and 86% found it more time consuming to treat elderly patients.¹

Fifty to sixty-three percent of elderly patients required admission--versus 10% in the younger age group--and 22.1-42% required surgery--versus 16% in the younger group.^1-3 The ability of the physician to correctly diagnose abdominal pain decreases dramatically as the age of the patient increases. Concurrently, there is a subsequent rise in the morbidity and mortality in this age group.