Five Treatments to Discuss With Your Doc

Five treatments for the elderly should be limited said panel of experts

/ Author:  / Reviewed by: Robert Carlson, M.D

(RxWiki News) As people grow old, they often face increasing health issues. While certain treatments may be helpful to younger adults, the American Geriatrics Society (AGS) has recommended some treatments elderly patients may want to avoid.

A panel of experts reviewed research and announced the top five treatments that elderly patients should talk about with their doctors. The top five included treatments for conditions like dementia, blood sugar control, urinary problems and insomnia.

"Talk to a doctor about all of your treatments."

An expert panel was asked to create a top five list of treatments or tests that the elderly should be discussing with their doctors. The panel reviewed all the available research on a variety of treatments and tests.

While the list is based on treatments that are commonly used in elderly patients, the panel concluded that doctors and patients should proceed with caution when considering these treatments.

The AGS Top Five:

  1. Avoid feeding tubes. Reason: Feeding tubes don’t appear to offer any added benefit over eating food (oral feeding). Feeding tubes have been linked with making patients uncomfortable and agitated, which often leads to use of extra medicines to calm them down.
  2. Antipsychotics should not be the first choice to treat psychological symptoms for people with dementia. Reason: Antipsychotics don’t show a clear benefit for symptoms like aggression or disruptive behavior, and the medicines can have nasty side effects that impact heart health and raise the risk of stroke.
  3. Don't aim for tight control of blood sugar in older patients with diabetes. Reason: Trying to tightly control blood sugar with medicines raises the risk of dropping into low blood sugar, which can cause people to be light headed and fall. AGS recommends a broader range of blood sugar control (HbA1c between 7 and 9 percent) if it can be achieved without medication.
  4. Older patients with insomnia, agitation or delirium should not be treated with sedatives. Reason: Benzodiazepines, like lorazepam, and hypnotics, like Ambien, have been linked to higher rates of falls and accidents in the elderly.
  5. Don’t give antibiotics to the elderly who have bacteria in their urine but no symptoms of urinary tract infection.  Reason: Bacteria in the urine, without any pain or symptoms of urinary infection, is less harmful than the possible side effects of antibiotics. Antibiotics can cause nausea, diarrhea and allergic reactions. Symptoms of infection should be present before a patient takes antibiotics.

The recommendations from the American Geriatric Society were published February 21 as part of the Choosing Wisely web series by the ABIM Foundation. Choosing Wisely aims to get patients and doctors talking about medical care and medical testing.

Reviewed by: 
Review Date: 
February 24, 2013
Last Updated:
February 28, 2013