05/19/03

Bill Walsh
Newhouse News Service
 

Washington - People over 65 suffer the highest suicide rate in the nation, but are rarely diagnosed as being depressed. They are routinely discouraged from participating in clinical trials even for treatments that might help them. And they rarely receive preventive medical screenings to which they are entitled.

Those are some of the findings from a report expected to be released tomorrow by the nonprofit Alliance for Aging Research decrying what it sees as rampant age discrimination in the U.S. health care system.

The report will be presented at a hearing of the Senate's Special Committee on Aging that will feature testimony about misdiagnoses of illnesses among senior citizens, a problem said to stem from a lack of authoritative research and a shortage of health professionals trained in geriatrics.

"At the root of shoddy health care for America's seniors is the very common tendency of health care providers and patients alike to view many serious medical conditions in older people as simply a natural part of getting older," the report states.

"That attitude results in providers missing out on millions of opportunities every year to prevent, treat and enhance the lives of people over 65."

The Aging Committee has held several hearings in recent years raising concerns about the nation's ability to care for an over-65 population projected to double in size by 2030, when almost one in four Americans will fit into that age group. The report expected out tomorrow, "Ageism: How Health Care Fails the Elderly," takes aim at the quality of medical treatment for seniors - the most prolific users of the health care system.

It cites studies showing that seniors commit suicide at four times the national average as evidence of widespread depression - estimated to be 20 percent of the over-65 population - and poor detection.

One study found that 75 percent of seniors who kill themselves do so within four weeks of having seen a physician.

Experts say that the health-care system discourages many seniors from getting mental health treatment.

Medicare requires a 50 percent co-payment for mental health care, while ordinary medical treatment requires just a 20 percent co-payment.

"Mental health services in our country are designed for young- and middle-aged adults in good physical health, ignoring the unique needs of older adults who typically have concurrent medical conditions that complicate their care," according to the prepared testimony of Dr. Joel Streim, president of the American Association of Geriatric Psychiatry.

Seniors are also routinely steered away from clinical trials, the report said. In fact, a study by the International Longevity Center found that 40 percent of clinical trials between 1991 and 2000 explicitly excluded people over 75 years old.

Seniors are often left out of trials for drugs and medical treatments aimed at helping their age group. A Duke Medical Center study found that only 2 percent of trials for procedures to unclog arteries involved patients over 75. In heart disease trials, no participants were over 65.

The result, according to Robert Butler, president of the New York-based Longevity Center, is that physicians have little research on the effects of medical treatments on the elderly.

"This lack of representation increases the likelihood of adverse drug reactions and inappropriate treatments," Butler said.

The report found that making health care available doesn't always mean seniors get it. Medicare pays for preventive screening for flu, but one in three seniors never get a shot and even fewer get a subsidized vaccine for bloodstream infections or cancer. Experts blame a lack of public information about the benefits, but the report also says that doctors are "less aggressive when recommending preventive measures to the elderly."