The number of people aged over 65 years in the United States are predicted to be more than 74 million people by the year 2030. At the present time, one in every eight persons falls into this category. With 85 million baby boomers, the largest population reaching 60 years, one of every five Americans is projected to be over 65 by 2030. Persons aged over 85 years constitute one of the fastest-growing portions of the population (Display 8-1). By the year 2030, the population 85 years and over could increase by 21%. For health care workers, this means that most of their patients will be 65 years or older; therefore, they must understand the changes that occur as one ages. The radiographer must understand that age 65 is an arbitrary age that has been designated for convenience as the age at which a person is eligible for Medicare benefits, Social Security benefits, and retirement from many positions. Many persons at this age are still quite youthful and productive; therefore, all persons must be assessed on an individual basis, not merely by their chronologic age (Display 8-2).

The human body undergoes normal physiologic and anatomic changes as it ages. These changes do not occur uniformly in all people, so it is not correct to say that all persons begin to demonstrate the changes of age at the same time. Lifestyles, culture, and hereditary factors contribute to the aging process. When an elderly patient is admitted to the imaging department, the radiographer must be able to differentiate between the normal changes of aging.

The elderly person is more frequently burdened with major illnesses that are chronic rather than acute in nature. Heart disease, cancer, and strokes are the cause of 80% of deaths in persons aged over 65 years. Hypertension, arthritis, diabetes mellitus, pulmonary disease, and visual and hearing impairments are also common conditions requiring long-term care. These conditions result in a great deal of physical discomfort and a multitude of social and psychological problems.

Large numbers of medications are prescribed and consumed by the elderly. Many of these medications affect the patient’s response level. Often, problems attributed to the aging process are the result of multiple medication consumption, which is frequently called polypharmacy.

Depression is a common and debilitating emotional problem of the aged person. The threat of becoming a burden to one’s family, the fear of losing one’s good health, or the necessity of giving up an independent lifestyle owing to chronic disease result in feelings of helplessness and hopelessness that can give rise to a major depressive episode. Symptoms of depression in the elderly person are often confused with dementia. Symptoms of dementia, including disorientation, confusion, gross memory deficits, paranoid ideation, hallucinations, and depression, are not part of the normal aging process. When these symptoms are present in an elderly patient, the radiographer must remember that they are indicative of a disease process. Persons with Alzheimer disease present with symptoms of dementia, which may occur in persons aged over 65 years, although it may occur at an earlier time. Persons with Alzheimer disease or other diseases that produce symptoms of dementia are frequently seen for a radiographic imaging examination. Recent studies have indicated that of people aged over 85 years about 50% suffer from Alzheimer disease at various stages.

When caring for a patient who exhibits symptoms of dementia, remember that the person may not be able to understand or retain directions. The radiographer will have to explain to the patient what is to be done and then assist him or her in following the directions. The patient who is confused or has a paranoid ideation may become frightened when confronted by the forbidding atmosphere of the radiographic imaging department. Allowing a familiar person to be present in the examination room to assist the patient may make the patient feels more secure and allow the procedure to be accomplished more effectively.

Persons who are depressed may be so preoccupied that they do not respond to outside stimuli. It may be necessary to give the same instructions a number of times to a depressed person and then to assist the patient in following directions.

When an examination of the geriatric patient is complete, the radiographer must assist him or her to return to the dressing room or lavatory, because the stress of the procedure may result in forgetfulness. Make certain that the patient is attended before leaving him or her. The elderly patient must not be left alone in the radiographic imaging room, because he or she may become confused and may be in danger of falling from the examining table.

Older adults may not have the same symptoms of a disease as a younger adult. They may have nonspecific symptoms, such as dizziness, falls for no apparent reason, infections without fever, or urinary incontinence. These are symptoms of disease and not a part of the normal aging process. The radiographer must be able to differentiate what is normal from what is pathologic. As aging progresses, the body systems change in a gradual manner. A brief overview of how the body systems change with normal aging, as well as the precautions the radiographer must consider because of these changes, follows.