title: Approach to preventive care in the elderly.
abstract: OBJECTIVE
  To guide family physicians in creating preventive screening and treatment plans for their elderly patients.
  
  
  METHODS
  The MEDLINE database was searched for Canadian guidelines on primary health care and the elderly; guidelines or meta-analyses or practice guidelines or systematic reviews related to mass screening in those aged 80 and older and the frail elderly, limited to between 2006 and July 2016; and articles on preventive health services for the elderly related to family practice or family physicians, limited to English-language publications between 2012 and July 2016.
  
  
  RESULTS
  Estimating life expectancy is not an easy or precise science, but frailty is an emerging concept that can help with this. The Canadian Task Force on Preventive Health Care offers cancer screening guidelines, but they are less clear for patients older than 74 years and management plans need to be individualized. Estimating remaining years of life helps guide your recommendations for preventive screening and treatment plans. Risks often increase along with an increase in frailty and comorbidity. Conversely, benefits often diminish as life expectancy decreases. Preventive management plans should take into account the patient's perspective and be mutually agreed upon. A mnemonic device for key primary care preventive areas-CCFP, short for cancer, cardiovascular disease, falls and osteoporosis, and preventive immunizations-might be useful.
  
  
  CONCLUSIONS
  Family physicians might find addressing the following areas helpful when considering a preventive health intervention: age, life expectancy (including concept of frailty), comorbidities and functional status, risks and benefits of screening or treatment, and values and preferences of the patient.
authors.affiliation: Assistant Professor of Family Medicine at the University of Toronto in Ontario and a practising family physician with the Summerville Family Health Team in Toronto.
authors.forename: Bachir
authors.initials: B
authors.lastname: Tazkarji
authors.affiliation: Associate Professor of Family Medicine at the University of Toronto, a practising family physician with the Toronto Western Family Health Team, and an attending physician in the Geriatric Rehabilitation Program of the University Health Network. robert.lam@uhn.ca.
authors.forename: Robert
authors.initials: R
authors.lastname: Lam
authors.affiliation: Family physician practising at the St Clair Medical Clinic in Toronto.
authors.forename: Shawn
authors.initials: S
authors.lastname: Lee
authors.affiliation: Research Associate in the Department of Family and Community Medicine at Toronto Western Hospital.
authors.forename: Soumia
authors.initials: S
authors.lastname: Meiyappan
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control; D000368:Aged; D002170:Canada; D002318:Cardiovascular Diseases / Q000517:prevention & control; D015897:Comorbidity; D005194:Family Practice; D016330:Frail Elderly; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D009369:Neoplasms / Q000517:prevention & control; D010024:Osteoporosis / Q000517:prevention & control; D011314:Preventive Health Services / Q000379:methods*; D011320:Primary Health Care