The thematic analysis of the statements revealed five key issues related to the way in which the guidelines considered older people, describing them in general terms as frail people with altered pharmacology. All 20 guidelines used the term “elderly”, while some offered dosage recommendations based on age (chronological) that suggested a generalist or age-based approach in their representation of the term “elderly”, which was rarely justified. Any treatment recommendation presented by clinical guidelines that consider “older people” as a homogenous group of people may limit the clinical benefits of treatment. This variability when it comes to establishing a chronological “limit” age when defining the term “elderly” is another problem that prevents a uniform description of the term “elderly”.
The term elderly lacks a term equal to and opposite to old age; unlike geriatrics versus pediatrics, which describes an area of medicine and health care. The representation of the term “elderly” in guidelines should be based less on chronological age or on generic definitions that focus more on establishing a direct relationship between the characteristics of an individual patient and the pharmacology of the prescribed medication. As older people become more heterogeneous with age, a specific descriptor, such as “older age”, is inaccurate and misleading. Although these terms have mostly disappeared, there is still a commonly used term that must disappear, the term”old age”.
None of the 20 guidelines intentionally emphasized altering pharmacological pharmacology in older people to distinguish how the use of drug therapy might differ in “older people”. Any underlying characterization of older people seems to be very generic, not based on evidence and potentially biased. Chronological definitions of “older people” based on age, as presented in three guidelines, do not provide information about the actual health status or specific needs of a patient. Although most guidelines seem to consider the “elderly” population as a vulnerable population when it comes to using pharmacotherapy, few suggest the relationship between frailty and aging, or the relationship between real physiological changes and pharmacological manipulation of a drug.
Since the continuing perception of “aging” ranges from “awareness” to “evolution”, more and more attention is being paid to helping doctors prescribe to the “elderly”. The guidelines were qualitatively reviewed and analyzed to identify any references or definitions of “older people”. Aging, an inevitable process, is usually measured by chronological age and, by convention, a person aged 65 or older is referred to as an “old woman””.
