Chiropractic Care of the Older Patient:
Developing an Evidence-based Approach

This section is compiled by Frank M. Painter, D.C.
Send all comments or additions to:    Frankp@chiro.org

FROM:   Proceedings of the World Federation of Chiropractic Congress
                  2001 (May); 6: 245–246

Gleberzon, B.J.

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Introduction:   Geriatric care has assumed a more dominant position in the health care delivery system thoughout the industrialised world. This article provides a compilation of the available literature on geriatric chiropractic care with teh ultimate goeal of developing a body of knowledge to promote a "best practice" approach in this area of study.

Method:   A qualitative review of the literature was conducted, with interpretation and synthesis by the author. The search involved accessing Mantis, Medline and CINHAHL databases from 1993-2000, with key words chiropractic/chiropractors/manipulation and geriatric/older patients/elderly.

Results:   Fifty-seven articles were found within the search parameters. These articles were further separated into the following categories: chiropractic geriatric education (n = 3), demographic/epidemiological studies (n = 9), case studies (n = 25), clinical trials (n = 4) and clinical guidelines (n = 18). The most significant articles on chiropractic geriatric education document the process by which a "Model Curriculum" for chiropractic educators was developed. Demographic studies indicate that the population pyramid is assuming a rectangular shape due to the increase in the older population. A the same time, the use of complementary and alternative medicines (CAMs) has increased dramatically over the past two decades, especially among persons over the age of 50 years. The most commonly utilized CAM were chiropractors. Concurrently, medicine has become more interested in and accepting of CAMs. In one study, the average older chiropractic patient was female, white, married, high school graduate and retired. The most common chief complaint was chronic back pain of mild to moderate intensity. In addition to spinal manipulative therapy (SMT), the literature indicates chiropractors also provide nutritional advise, exercises, relaxation and other physical therapies. Other studies suggest that older patients receiving chiropractic care were less likely to have been hospitalized, to have used a nursing facility or to have used prescription medications, and more likely to report better health status, to exercise and to be mobile in their communities. Older patients also placed a high value on chiropractic maintenance care.

Conclusions:   This study indicated that, as a profession, chiropractic has recognized the importance of geriatric education. Several articles indicate that the utilization of chiropractic services of older patients is increasing, and other articles indicate that many different conditions have been successfully resolved by chiropractic care. Although the results of this article are encouraging, continued research is necessary to further develop an evidence-based approach to chiropractic geriatric care, especially in the areas of maintenance care and the management of non-musculoskeletal conditions.

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