Older patients present “atypically” for several reasons. Some of them relate to the doctor’s beliefs and attitudes.
Physicians know that children are physiologically, anatomically, and socially different from adults so we do not expect their presentation of illness to be the same as in adults. However we often forget that after 70 many people (not all) are physiologically, anatomically, and socially different from how they were during their middle (“not old”) years.
If we assessed kids, expecting them to be the same as adults, we would frequently go wrong (First rule of pediatrics: “Children are NOT just little adults!”). Similarly, if we go into the room thinking that older people are the same as middle-aged adults, we will frequently go wrong (First rule of geriatrics: “Old people ARE just old adults – but they’re different!”).