The World Health Organisation’s report raises a good point, in that major societal changes will be required as our population ages. Among their recommendations is an astute observation that the health of these ‘older people’ will play a pivotal role in allowing them to continue functioning and participating in society .
This lead the WHO to assert that key part of healthy aging is to increase or maintain functional ability . This puts chiropractic in an interesting position. The authors of the systemic review and consensus update, Hawk et al, cited a study which indicated “when the supply of DCs in a particular geographic region is greater, primary care medical visits decrease in the Medicare population in that region .” While this supported the idea that older adults may use chiropractic as the sole management for common musculoskeletal complaints, it also points to the chiropractor as being a vital, trusted part of the health-care team of these patients. Thus its important that we keep an eye out for the complexities that can arise in the age group.
The systemic review took in articles that had been published since the original consensus project was reviewed, so the publication dates fell between October 1, 2009 and January 31, 2016. The literature search was built around the questions 1) “What is the effectiveness of chiropractic care, including spinal manipulation, for conditions experienced by older adults,” and 2) What are the adverse events associated with chiropractic care, including spinal manipulation, among older adults?” This lead to a pool of 199 articles, but following the application of exclusion criteria, just 6 articles about effectiveness or efficacy and 6 articles on safety were left standing.
These were then put before a DELPHI (research) panel of 37, with 6 experts being non-chiropractors.
Interestingly, no serious adverse events related to the intervention (spinal manipulation/ chiropractic care) were found in any of the studies. This challenged a perceived ‘causal relationship with spinal manipulation .” Among the articles examined were:
Beyond looking at adverse effects though, the purpose of the review was to define the parameters of appropriate care for older adults.
Key findings from the review included:
The full review is available online, and is well worth a read if you are among the thousands of chiropractors who work with older adults in your practice. It’s a great thing that we are living longer. But unfortunately for many, chronic pain, ailing health and declining cognitive skills mean they aren’t truly living. Chiropractic care is in a unique position to be able to help people regain and maintain optimal neurological function. What this study does is raise awareness for the fact that there are some distinct complexities that can raise their heads with this cohort. It pays to know what to look for and how best to support these precious patients.
 Hawk C, Schneider M, Haas M, Katz P, Dougherty P, Gleberzon B, Killinger L and Weeks J (2017), “Best Practices for Chiropractic Care for Older Adults: A Systematic Review and Consensus Update,” JMPT, DOI: http://dx.doi.org/10.1016/j.jmpt.2017.02.001
 Staff Writer (2015), “WHO: Number of people over 60 years set to double by 2050; major societal changes required,’ World Health Organisation, http://www.who.int/mediacentre/news/releases/2015/older-persons-day/en/ retrieved 3 April 2017