The Baby Boom and later life: is critical care fit for the future?

Populations around the world are ageing while in many developed countries the proportion of elderly patients admitted to critical care is rising. It is clear that age alone should not be used as a reason for refusing intensive care admission. Critical care in this patient group is challenging in many ways: with advancing age, several physiological changes occur which all lead to a subsequent reduction of physical performance and compensatory capacity, in many cases additionally aggravated by chronic illness. Subsequently, these age-dependent changes (with or without chronic illness) increase the risk for death, treatment costs and a prolonged length of intensive care and hospital stay. This review explores the potential of using co-morbidity and frailty to predict outcome and to help to make better decisions about critical care admission in the elderly. The authors explore the challenges of using different frailty assessment tools and offer a model for holistic approach to answer these questions.

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