Friday, June 29, 2018

Weakness in the Elderly

emDocs - June 28, 2018 - By Kim J and Dyer S - Edited by: Koyfman A and Long B
..."Regardless of experience, the complaint of weakness in an elderly patient proves challenging, as it is a vague and non-focal complaint that takes time to tease out the nuances. Nemec et al. reviewed 218 elderly patients presenting to the ED with a non-specific complaint and evaluated their 30 day outcomes. Nearly 60% of the population had a serious condition, defined as potentially life-threatening or those requiring early intervention to prevent health status deterioration within 30 days. Nemec consequently found a median of 4 comorbidities (most common were hypertension, coronary artery disease, and dementia) as well as a 6% mortality rate within 30 days. Thus, this article seeks to aid in the evaluation of the elderly patient with generalized non-focal weakness to help you determine who is at higher risk of having one of these serious conditions...
Take Home Points 
  • As mentioned, a thorough history and physical exam are crucial to the evaluation of elderly patients with non-focal generalized weakness. 
  • A CBC, BMP, Accucheck, and ECG are always warranted in the evaluation of generalized weakness in the elderly. 
  • Use your clinical history and exam to guide further lab testing and imaging as appropriate in each individual patient."