This underreporting may not only be due to lowered expectations, but also to the increase in dementing illness and depression that may accompany aging. Other reasons may be that older people are often taken less seriously by physicians who write off their complaints as due to age and depression. Older patients may also fear that their complaints may lead to institutionalization. Institutionalization itself may cause older people to minimize their impairments because they are surrounded by other ill or impaired elderly, and therefore new problems seem insignificant when comparing them to the problems they see around them. Hypochondriasis is often attributed to older patients, but the reality is that older patients have more physical complaints because they have more diseases.
Hypochondriasis is actually more common in middle-age.
It should also be recognized that acute and chronic illness in older patients can have greater psychological and social consequences than in the young. This is largely due to the greater changes in function that disease can inflict on older patients, adversly affecting their ability to remain independent. Furthermore, not all conditions found need be treated if those treatments would lead to adverse effects on other conditons and an ultimate decrease in the person's general level of function. Illness may also represent a significant strain on an elderly person's often limited income thereby restricting availability and accessibility to appropriate health care systems. These issues raise the need for comprehensive geriatric assessment in the care of the elderly patient.