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Assessment in the Older Patient 

Assessment in the Older Patient
Chapter:
Assessment in the Older Patient
Author(s):

Rahul Rao

and Ilana Crome

DOI:
10.1093/med/9780199392063.003.0008
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date: 26 June 2019

Increased longevity and progressive increases in substance use in older people require clinicians to be proficient in assessing substance misuse in this age group. Assessment requires age-appropriate knowledge, skills and attitudes, taking into account atypical presentations that may challenge conventional diagnostic processes. A greater focus is needed on physical and social aspects of assessment, paying special attention to the influence of comorbid psychiatric and physical disorders. Physiological and pharmacological changes in older people alter the way that substances and other drugs are processed by the body and systemic effects on end-organ function. Such effects can include intoxication, withdrawal, and dependence. Assessment should take into account capacity, elder abuse, cultural competence, and the use of age-appropriate screening instruments. Such an approach will strongly influence treatment options and outcomes. The systematic approach outlined in this chapter is fundamental to the development of a successful treatment management plan.

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