Education and training serve as the foundation for implementing changes in the behavior and practice of clinicians. If we are to improve the care of the elderly, particularly in the domain of infections, then efforts must be directed toward pathways and approaches to better inform the practitioner on the current information on aging and infection and the complex issues involved with care of the elderly.
Adult infectious disease fellowship training programs should seriously consider incorporating into their curriculum information that is relevant to the care of the elderly with infection, i.e., biology of aging (especially gerontoimmunology); geriatric pharmacology; and the epidemiology, clinical manifestations, diagnostic approach, treatment, prognosis, and prevention of the most common and important infections afflicting older people. In addition, an understanding of geriatric syndromes (e.g., urinary incontinence, dementia, falls, osteoporosis) and issues of long-term care is essential for the infectious disease specialists who may care for older patients.
Conversely, geriatric fellowship training programs would better serve elderly patients with an intensive curriculum on the broad issues of immune changes with aging, important infections in the elderly, antimicrobial pharmacology, and unique aspects of infectious diseases with aging.
Major professional societies and organizations that sponsor continuing medical education programs for practicing physicians should regularly include in their courses or conferences topics that address the diagnosis, treatment, and prevention of infections in the elderly. Those organizations that also publish a journal should devote a section on geriatric health care issues including infections in the elderly.
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