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January 19, 2000

Prescribing for Elderly Persons

Author Affiliations

Phil B.FontanarosaMD, Deputy EditorIndividualAuthorMargaret A.WinkerMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Fishbein FellowIndividualAuthor

JAMA. 2000;283(3):339-340. doi:10-1001/pubs.JAMA-ISSN-0098-7484-283-3-jac90010

To the Editor: Drs Rochon and Gurwitz1 document specific underuse of proven therapies and properly encourage application of effective agents for "seniors (65 years and older)." However, for purposes of pharmacological management, all elderly patients should not be grouped together because they fall roughly into 2 cohorts, those younger than 75 years and those of the rapidly increasing population aged 75 years or older. For the older group, reliable prospective studies are rare because they are complicated by multiple morbidities, frequent compromise of 1 or more organ systems, and substantial interindividual variability of general health. Because of these pathophysiological problems and sparse data, most decisions for older elderly patients will continue to be individualized and less accurately defined.