The Negative Older Adult Autopsy: Why Do They Die?

Abstract

Individuals over the age of 65 are a significant segment of the population in the United States and other industrialized countries. This is also the group whose deaths are infrequently investigated or autopsied. However, when an autopsy is performed, the forensic pathologist may be left with final autopsy diagnoses that point to “old age” or “senescence” as the cause of death. This is an unacceptable certification on the death certificate, of no value to epidemiological studies, and of little comfort to the next of kin. Further investigation and analysis must be undertaken to adequately derive an accurate determination of the mechanism, cause, and manner of death. By closely examining and understanding the pathophysiology of three areas/systems, a proper certification can often be made. These areas are the heart, brain, and metabolic/endocrine system.