Department of Internal Medicine, Universidad Simón Bolívar, Barranquilla, Colombia.
Biomedical Scientometrics and Evidence-Based Research Unit, Department of Health Sciences, Universidad de la Costa, Barranquilla, Colombia.
J Prev Med Public Health. 2024 Sep;57(5):508-510. doi: 10.3961/jpmph.24.364. Epub 2024 Sep 27.
Population aging is a global health priority due to the dramatic increase in the proportion of older persons worldwide. It is also expected that both global life expectancy and disability-free life expectancy will increase, leading to a significant rise in the proportion of individuals with extreme longevity, such as non-agenarians and centenarians. The inaccuracy of clinical evidence on therapeutic interventions for this demographic could lead to biased decision-making, influenced by age-related beliefs or misperceptions about their therapeutic needs. This represents a potential clinical ageism scenario stemming from gaps in clinical evidence. Such biases can result in 2 significant issues that adversely affect the health status and prognosis of older persons: polypharmacy and therapeutic inertia. To date, documents on polypharmacy in non-agenarians and centenarians account for less than 0.35% of the overall available evidence on polypharmacy. Furthermore, evidence regarding therapeutic inertia is non-existent. The purpose of this letter is to discuss polypharmacy and therapeutic inertia as potential clinical ageism scenarios resulting from the clinical evidence gaps in extreme longevity.
人口老龄化是一个全球性的健康重点，因为全球老年人的比例急剧增加。预计全球预期寿命和无残疾预期寿命都将增加，导致具有极端长寿的个体（如非百岁老人和百岁老人）的比例显著上升。对于这一人口统计学的治疗干预措施的临床证据的不准确性可能导致基于年龄的偏见决策，受到对他们治疗需求的年龄相关信念或误解的影响。这代表了源自临床证据差距的潜在临床年龄歧视情况。这种偏见可能导致 2 个严重问题，对老年人的健康状况和预后产生不利影响：多药治疗和治疗惰性。迄今为止，关于非百岁老人和百岁老人的多药治疗的文件在多药治疗总体可用证据中所占比例不到 0.35%。此外，关于治疗惰性的证据是不存在的。这封信的目的是讨论多药治疗和治疗惰性作为源自极端长寿的临床证据差距的潜在临床年龄歧视情况。
