Team McCallum

R&D for Lifetime of Life

How old do I look, doc?

Physicians often begin a physical examination with an assessment of whether a patient looks older than his or her actual age. This practice suggests an implicit assumption that patients who appear older than their actual age are more likely to be in poor health. Dr Stephen W Hwang and colleagues decided to test whether this actually works or not, by getting 58 doctors in Toronto to use it on 126 patients.

The researchers knew of some interesting previous findings. For example, in a Danish study of 387 sets of same-sex twins age 70 years and older, 20 nurses and 21 individuals who were not health care providers were asked to estimate the age of each twin based on their photograph. Apparent age was significantly associated with survival over the 7-year period after the photographs were taken, even after adjustment for age, sex, and physical and cognitive functioning, and the twin who was rated as looking older was more likely to die first.

The 126 patients were scored by the research team using validated scales for both physical health and mental health. Then they were photographed, so this picture could be presented to each doctor. And as doctors normally know their patient’s age before they see the person, Dr Hwang told them the real age in advance. The doctors did not know any of the medical details recorded by the team. The question was simply “How old do you think this person looks?”

The doctors were a mix of recently qualified and more experienced physicians, but the researchers found that neither group performed better than the other on estimating the age of the patient.

With estimates that were 5 years (or less) older than the patient’s real age, their was no consistent link between estimated age and the health of the patient, although some doctors were consistently better than average. But when the doctors estimated an age 10 years older than the patient really was, there was a strong chance that the patient had a significant illness.

It did not work the other way. Estimating that a patient was the same age, or even younger than the real age, did not imply health. This group still contained patients with significant problems. The exercise was valid only if the doctor estimated 10 years older, when the news was bad.

So, how old do I look, doc?

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November 6, 2010 - Posted by | Health, Medical conditions, Success

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