Many studies are being published that show certain treatments are associated with lower general mortality. Often these benefits are very small, and the old (over 75) are not included.
For example, recent news stories about the SPRINT study published in the New England Journal of Medicine said that the ideal blood pressure now should be 120/80 or lower. However this study only looked at people with increased risk of heart disease. They also did not include diabetics, where another study showed increased risk if we lowered blood pressure to 120 from 140.
These results can be confusing. I would recommend that if the blood pressure can be lowered without complications (like dizziness, falls, etc.) that is ideal. But to be too aggressive can be dangerous.
Many older patients are taking statins such as Lipitor. These drugs have been shown to prevent inflammation in the arteries and decrease the risk of heart disease.However life span is shorter in older individuals, so are these drugs really helping?
Using a model of the U.S. population, researchers estimated the effects of treating all adults aged 75 to 94 with statins for primary prevention over 10 years. They found, based on statistics that there was a definite but small benefit; however a 10-30% increase in risk for adverse events could cancel out the cardiovascular benefits.
So yes, if well tolerated certainly continue statins in the elderly; but with any side effects (most common being muscle pain) we should not hesitate to stop them without too much concern!
Finally, we all know colonoscopy every 10 years after the age of 50 can prevent up to 80% of colon cancer deaths. But when do we stop? When life expectancy is less than 10 years, the risk of screening (as opposed to follow-up for disease) colonoscopy is higher than any potential benefits. For most people this is at age 75; for some in the early 80's; but really never over 85.
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