Geriatric denial

Issue: BCMJ, vol. 52 , No. 10 , December 2010 , Pages 497 Editorials

Never before has our society included in its ranks so many individuals over the age of 65; being in your 90s is no longer a feat—over 100 is the new prize. This shift in demographics is partly due to better preventive measures such as im­proved nutrition and decreased smoking, and partly to better management of chronic diseases, especially cardiovascular disease. Many seniors are keeping fit and managing to live by the mantra, “age is just a number.”

However, physiologically age is not just a number but a very reliable predictor of future health problems. For example, many of us forget that one of the biggest risk factors for cancer is age itself. The same can be said for hip fracture. In spite of this, seniors continue to challenge previously held notions of appropriate behavior for their age, and seniors’ increased levels of activity and involvement are the beneficial result of the belief that age is just a number.

Balanced against this benefit is the risk of geriatric denial—denying risks to the extent that this denial has negative effects on health and lifestyle. Let me give some examples. 

• A retiree opting for a pension plan with higher income but no spousal survivor benefit; good idea until sudden death several years into retirement. 

• An individual with severe osteoporosis ignoring advice to remove obstacles in the home known to increase the risk of falls with the comment, “I just won’t fall.” 

• A senior with dizziness and several falls refusing to use a walker out of the home because “it makes me look old.” 

• Another senior who, upon losing a driver’s licence because arthritis prevents looking over either shoulder, declares, “I just won’t back up.”

Denial and ignoring the age factor can be beneficial, and somehow we all will need to work out where on the continuum we balance these factors against the reality of getting older. As I approach becoming eligible for my Old Age Pension, I find myself in­creasingly aware of being caught in this optimism/pessimism conundrum. Maybe that’s because the balance point differs among individuals and shifts with time.

Use your body and use your brain for as long as you can. Acknowledge that running today may have to switch over the years to cycling or walking, but that the important thing is remaining active. The Sudoku puzzle may take longer to solve, but keep at it. And remember, maybe the best mantra is, “Plan for the worst and hope for the best.”
—LML

Lindsay M. Lawson, MD. Geriatric denial. BCMJ, Vol. 52, No. 10, December, 2010, Page(s) 497 - Editorials.



Above is the information needed to cite this article in your paper or presentation. The International Committee of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.

About the ICMJE and citation styles

The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.

BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:

  • Only the first three authors are listed, followed by "et al."
  • There is no period after the journal name.
  • Page numbers are not abbreviated.


For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit www.icmje.org

BCMJ Guidelines for Authors

Leave a Reply