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Chapter 31 - Endocrine Disorders

from Section III - Care of the Elderly by Organ System

Published online by Cambridge University Press:  30 June 2022

Jan Busby-Whitehead
Affiliation:
University of North Carolina, Chapel Hill
Samuel C. Durso
Affiliation:
The Johns Hopkins University, Maryland
Christine Arenson
Affiliation:
Thomas Jefferson University, Philadelphia
Rebecca Elon
Affiliation:
The Johns Hopkins University School of Medicine
Mary H. Palmer
Affiliation:
University of North Carolina, Chapel Hill
William Reichel
Affiliation:
Georgetown University Medical Center
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Summary

Dysfunction of the endocrine glands can occur at any point in the life cycle. Although many endocrine diseases will present with classic signs and symptoms, atypical presentation of hormonal dysregulation can make diagnosis in the elderly particularly challenging. Normal physiologic changes associated with aging, as well as medical comorbidities and medications, may all cloud the identification of endocrine dysfunction in this complicated population. As such, the diagnosis of endocrinopathies in the elderly population requires a careful medical history, detailed physical exam, rational biochemical workup, and, if necessary, directed imaging. The management of endocrine disorders can be equally complex. Many endocrine disorders are treated with medications that may complicate an already-lengthy list, causing unwanted side effects or even drug–drug interactions. If therapy includes possible surgical referral, careful assessment of the risk–benefit ratio and candidacy of the elderly patient is imperative. Endocrine guidelines have been designed to assist the clinician with accurate diagnosis and therapeutic decision-making; however, guidelines cannot supplant the need for patient-centered care in this vulnerable population in whom disorders of the endocrine glands fail to adhere to “textbook” scenarios.

Type
Chapter
Information
Reichel's Care of the Elderly
Clinical Aspects of Aging
, pp. 383 - 394
Publisher: Cambridge University Press
Print publication year: 2022

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