The role of chiropractic care in older adults

By 2030, nearly one in five U.S. residents is expected to be age 65 or older [1]. An estimated 14% of patients treated by doctors of chiropractic (DCs) are 65 and older [2]. The most common reason for an older adult to see a DC is musculoskeletal pain, most often lower back pain [3]. Although the most common reason for older adults seeking chiropractic care is for musculoskeletal symptoms, DCs may also provide a diverse range of services to these patients [4]. Given this fact, for the purpose of this manuscript chiropractic care will be defined as; "the provision by a doctor of chiropractic of services related to patient assessment, maintenance of health, prevention of illness, and treatment of illness or injury". The focus of this manuscript is to describe the evidence for achievement of some of these goals in the older adult population. The purpose of this manuscript is to present an overview of information to the practicing chiropractor on utilization of specific management tools. This is not meant to be a systematic review of the literature or an evidence based guideline. The authors each have personal experience in evaluating and treating older adults as well as established expertise in research and publication in these areas. The authors recognize that there is a need for further research in the area of management of the older adult by DC's and discuss in the conclusion future research considerations.Although chiropractic encompasses many different treatment modalities, the authors have chosen to focus on five specific interventions that are commonly utilized by DCs: spinal manipulative therapy (SMT), acupuncture, physical activity/exercise, nutritional counseling and fall prevention [5,6]. These have been chosen not only because they are commonly utilized treatments, but also because they align with certain goals of Healthy People 2020: 1) to reduce the proportion of older adults with functional limitations and 2) to increase the proportion of older adults wi