title: General management of nonagenarian patients: a review of the literature.
abstract: The number of nonagenarian people in the world is steadily growing. This phenomenon will increase in future years: in 2050, world population prospects estimate 71.16 million people aged 90 years or older. The two main causes of death among people aged 85 years or more in Europe in 2003 were cardiovascular and cerebrovascular diseases and cancers. However, the elderly are often excluded from clinical trials; they are underrepresented in clinical registries and especially nonagenarians. Care (medical, surgical, oncology) of these very elderly is currently insufficiently based on scientific recommendations. For the physician, the choice to treat or not to treat very elderly patients (for fear of side effects) is difficult. Oncology is particularly affected by this problem. Here we review these different fields of internal medicine management of nonagenarian patients with a special focus on oncology and on comprehensive geriatric assessment as a base for all care decision taking.
authors.affiliation: Department of Medical Oncology, Lucien Neuwirth Cancer Institute, Saint Priest-En-Jarez, France.
authors.forename: Romain
authors.initials: R
authors.lastname: Rivoirard
authors.affiliation: Department of Radiotherapy, Instruction Armed Val-de-Grace Hospital, Paris, France.
authors.forename: Cyrus
authors.initials: C
authors.lastname: Chargari
authors.affiliation: Department of Radiotherapy, Lucien Neuwirth Cancer Institute, Saint Priest-En-Jarez, France.
authors.forename: Jane-Chloé
authors.initials: JC
authors.lastname: Trone
authors.affiliation: Department of Radiotherapy, Centre Antoine Lacassagne, Nice, France.
authors.forename: Alexander Tuan
authors.initials: AT
authors.lastname: Falk
authors.affiliation: Department of Radiotherapy, Lucien Neuwirth Cancer Institute, Saint Priest-En-Jarez, France.
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Guy
authors.affiliation: Department of Radiotherapy, Lucien Neuwirth Cancer Institute, Saint Priest-En-Jarez, France.
authors.forename: Houda
authors.initials: H
authors.lastname: Eddekaoui
authors.affiliation: Department of Radiotherapy, Lucien Neuwirth Cancer Institute, Saint Priest-En-Jarez, France.
authors.forename: Rima
authors.initials: R
authors.lastname: Lahmar
authors.affiliation: Department of Medical Oncology, Lucien Neuwirth Cancer Institute, Saint Priest-En-Jarez, France.
authors.forename: Cécile
authors.initials: C
authors.lastname: Pacaut
authors.affiliation: Department of Medical Oncology, Lucien Neuwirth Cancer Institute, Saint Priest-En-Jarez, France.
authors.forename: Benoite
authors.initials: B
authors.lastname: Mery
authors.affiliation: Department of Medical Oncology, Lucien Neuwirth Cancer Institute, Saint Priest-En-Jarez, France.
authors.forename: Avi
authors.initials: A
authors.lastname: Assouline
authors.affiliation: Department of Radiotherapy, Clinique Claude Bernard, Albi , France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Auberdiac
authors.affiliation: Department of Medical Oncology, Lucien Neuwirth Cancer Institute, Saint Priest-En-Jarez, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Moriceau
authors.affiliation: Department of Clinical Gerontology, University Hospital of Saint-Etienne, Charity Hospital, France.
authors.forename: Regis
authors.initials: R
authors.lastname: Gonthier
authors.affiliation: Department of Medical Oncology, Lucien Neuwirth Cancer Institute, Saint Priest-En-Jarez, France.
authors.forename: Aline
authors.initials: A
authors.lastname: Guillot
authors.affiliation: Department of Medical Oncology, Lucien Neuwirth Cancer Institute, Saint Priest-En-Jarez, France.
authors.forename: Yacine
authors.initials: Y
authors.lastname: Merrouche
authors.affiliation: Department of Radiotherapy, Lucien Neuwirth Cancer Institute, Saint Priest-En-Jarez, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Magné
mesh_terms: D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee; D002318:Cardiovascular Diseases / Q000628:therapy*; D004066:Digestive System Diseases / Q000601:surgery; D015577:Geriatric Assessment; D006620:Hip Fractures / Q000601:surgery; D006801:Humans; D009369:Neoplasms / Q000628:therapy*; D020521:Stroke / Q000188:drug therapy