Is a Patient 65 Years or Older Considered Elderly?
Yes, a patient aged 65 years or older is conventionally considered elderly in medical practice, though this chronological threshold does not fully capture biological age or clinical vulnerability. 1
Standard Age Definitions
The age of 65 is most often used referring to "old," "elderly," or "geriatric" patients across medical literature and international health organizations, representing a high quality of evidence. 1
The United Nations and World Health Organization both define older people as those aged 60-65 years or more in developed economies. 1
The Eastern Association for the Surgery of Trauma (EAST) guidelines specifically define patients older than 65 years as elderly. 1
Multiple medical societies, including those focused on colorectal cancer treatment, use ≥65 years as the standard definition of elderly patients. 1
Important Clinical Nuances
Chronological age does not correspond to biological age, and aging is correlated with para-physiological changes in organ systems that create altered responses to medical conditions and treatments. 1
Earlier Age Thresholds for High-Risk Situations
In trauma management, patients aged ≥55 years may require dedicated care protocols because they demonstrate significantly higher mortality rates after trauma, with mortality increases documented at ages 55,77, and 82 years. 1
Advanced Trauma Life Support (ATLS) teaching recommends transportation to a trauma center for any patient older than 55 years, recognizing increased vulnerability at this earlier threshold. 1
Some trauma data suggest mortality adjusted for injury severity increases at age 70, making this an alternative cutoff for considering patients elderly in trauma contexts. 1
Beyond Chronological Age
Frailty, comorbidities, and functional status are critical factors that define whether a patient should be managed as physiologically elderly, regardless of chronological age. 1
Heart disease, hepatic disease, renal disease, and cancer are risk factors for mortality that make patients more vulnerable and potentially requiring geriatric-focused care. 1
Assessment of frailty in all elderly trauma patients is strongly recommended based on moderate quality evidence. 1
Functional reserves decrease with age, leading to increased vulnerability that cannot be captured by age alone. 2
Practical Implications
For medication dosing (such as metformin), age 65 or greater increases the risk of adverse events due to greater likelihood of hepatic, renal, or cardiac impairment, requiring more cautious dosing and frequent monitoring. 3
Elderly patients (≥65 years) experience worse outcomes in colorectal cancer due to more advanced stage at diagnosis and suboptimal management compared to younger patients. 1
In appendicitis, patients over 65 years have higher post-operative mortality, morbidity, longer hospital stays, and higher complication rates with negative appendectomy (25% vs 3% in younger patients). 1