Discover the labs that are best suited for helping patients who are 65 and over. The patients in this age group may struggle with multiple chronic diseases. An astounding estimation of up to 98% of people older than 60 years old have ‘multimorbidity’ or over two least two chronic health conditions. Disease burden increases with age and becomes more prevalent. Therefore, it’s vital to offer comprehensive care that involves regular lab testing to help these patients manage their conditions effectively. Functional labs are excellent practitioner tools that can provide clinical guidance to help facilitate tailored treatment protocols for geriatric patients to improve their health outcomes and quality of life. This article will cover the functional labs to offer older patients to help them reduce their multimorbidity disease risk and optimize their overall health and function.

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Who Are Geriatric Patients?

Currently, there is no specific age that defines geriatric patients. From a medical standpoint, chronologically, patients are considered “geriatric” at the age of 65 and older. However, this may not be accurate as, with any age group, health varies, and other factors need to be considered along with age. Along with accompanying age, the term geriatrics also considers other factors namely, frailty and activities of daily living (ADL). These factors may include when patients should consider seeing a geriatrician as their primary care provider. Patients may consider seeing a geriatrician with a decline of functionality that increases their vulnerability to disability or frailty, where they have difficulty with daily activities. This population has a unique set of health needs that can be addressed by a specialist such as a geriatrician. These specialists can develop comprehensive care plans that can help address multimorbidity, impaired function, cognitive issues, and other health problems. Although patients are considered geriatric at the age of 65, most of the patients who see a geriatrician are ages 75 and older.

What Are Common Conditions That This Population Experiences? 

Cardiovascular disease (CVD) is the number one condition of geriatric patients. As previously mentioned, this patient base is more likely to have multiple health conditions. Here are some of the common conditions or health concerns that this population experiences:

• Dementia
• Delirium
• Recurrent falls
• Depression
• Anxiety
• Weight changes
• Urinary incontinence
• Anemia
• Arthritis
• Diabetes
• Chronic pain
• Digestive issues
• Chronic fatigue
• Sleep disturbances

What Are The Benefits of Regular Lab Testing For Geriatric Patients?

There is no specific age requirement to be considered geriatric. As we age, our ability to function and perform daily tasks can start to decline. Older adults may have additional health concerns that younger adults don’t have, as illnesses, medications, and diseases may affect this population differently. Regular lab testing can benefit these patients by providing guidance into the underlying factors contributing to their multiple conditions. These tests can help personalize a care plan that addresses their specific needs to prevent and manage illness. They can also give valuable insights so that various treatment options can be presented to these patients to optimize their care and overall health. This collaboration in care can help patients feel empowered and in control of their health choices.

Top Labs To Run Bi-Annually On Geriatric Patients

Functional labs can help older adults address their specific health needs and goals. These are the top labs to consider running bi-annually on geriatric patients:

Basic Blood Panel

The basic blood panel consists of a Complete Blood Count (CBC) and Comprehensive Metabolic Panel (CMP). A CBC and a CMP can help establish a baseline of overall health and assess for conditions that can cause chronic fatigue in older adults. A CBC measures immune and red blood cells, and abnormalities can indicate conditions like anemia that can be common for these patients. A CMP will assess kidney and liver function along with other metabolic functions. These tests can help assess and manage conditions associated with this group.

Comprehensive CardioMetabolic Screening

A primary health concern is that almost 70% of geriatric patients will experience CVD with other conditions. Evaluating cardiovascular markers and other health markers is an essential part of comprehensive care for this population. The Comprehensive CardioMetabolic Test provides an extensive profile of cardiovascular and metabolic health with insights into the relevant markers for many conditions that older adults are at risk for. It helps to assess the risk of conditions such as CVD and diabetes. Assessing for diabetes is also important for older adults, as diabetes complications can have a negative impact on balance and mobility. This test also measures levels of inflammation, which can be indicated in patients who have chronic pain or arthritis. Inflammation is also a main characteristic of many chronic diseases that affect this group. These markers should be screened regularly for these patients to help improve their CVD and metabolic health and manage chronic low-grade inflammation.

Micronutrient Panel

Inadequate nutrition is a widespread issue for older patients. Nutritional deficiencies can also impact overall health and lead to the development of other chronic conditions that affect these patients. The micronutrient panel can help assess the patient's nutrient status. It analyzes over 40 nutrients, vitamins, minerals, antioxidants, and amino acids needed for proper body function. The results of this test can help create targeted nutritional interventions to ensure adequate nutrient levels are maintained for this set of patients. This test should be routinely implemented in practice for geriatric patients.

Thyroid Panel

Thyroid impairment is common in aging individuals, leading to decreased function and energy levels. It can also create cognitive impairments and mood changes, including anxiety and depression. This thyroid panel evaluates eight different thyroid hormones, including TSH, T4, T3, and Anti-TPO. A comprehensive thyroid panel should be regularly tested for geriatric patients as imbalances in these hormones can affect their cognitive and metabolic function. Regular monitoring can allow for strategies to rebalance any abnormal levels of thyroid and to improve their associated symptoms for these patients.

Gastrointestinal (GI) Profile

GI issues in elderly patients are prevalent. This population is at risk for all GI disorders, including ulcers, IBD, IBS, and Celiac. Analyzing overall gut health and function in older adults can be beneficial if they have digestive complaints. GI Effects is an excellent functional lab that assesses digestion, inflammation, the health of the microbiome, and immune function. This stool test also provides a screening on microbe sensitivity on various prescription medications and supplements that may be helpful for patients who may already be on multiple treatments so precise approaches can be made to balance their digestive health.

Hypothalamic-Pituitary-Adrenal (HPA) Axis Test

During the course of aging, the HPA axis may be disrupted, which can lead to negative health outcomes in older adults. This disruption can impact sleep patterns in these individuals and reduce their quality of sleep. The HPA axis can also affect stress responses and regulation in this population, decreasing their resilience to stress. The DUTCH Plus test can assess HPA function for these patients. This is a simple urine test that they can collect at home. This test offers valuable insights into stress hormones responsible for regulating energy production, sleep, mood, metabolism, and other issues that may affect geriatric patients. This information can help determine effective strategies to improve all the related issues of HPA dysfunction for these individuals and enhance these patient’s overall quality of life.

Additional Labs to Check 

Other additional tests to consider for geriatric patients include a mammography screening for women older than 65, a colonoscopy for patients 50 and older, and continued blood pressure monitoring. These tests have been shown to decrease mortality rates for this population and are considered typical screenings for this age group.

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Summary

As the population ages, the burden of disease risk increases. Geriatric patients most likely have multiple conditions that need to be addressed that contribute to the clinical complexity of these patients. Although there isn’t an age specification for geriatric patients, most geriatricians have patients who are aged 75 or older. This population has overlapping health conditions that require comprehensive care approaches. As part of this care approach, functional labs can offer guidance on customized treatments to address the multimorbidity of this group. These tests can monitor the varying health conditions to help improve their health outcomes. Providing the options for these tests can also allow a collaborative approach with these patients and have them feel empowered in their care.