NEW YORK (Reuters Health) - Medical clinics designed to care for elderly people do not prolong patients' lives, but they may improve their ability to function independently and lower their risk of depression, new study results suggest.

The findings contradict those of a well-known study conducted 20 years ago, which suggested that these geriatric units reduced the death rate of patients in comparison with patients cared for in medical units treating patients of all ages.

Since that time, geriatric care has improved and expanded throughout the US healthcare system and as a result, hospitals may have less need for specialized geriatric care units, researchers suggest.

"At this point, there may be relatively little additional improvement in mortality that can be gained with the use of geriatric evaluation and management in a population of frail patients," according to Dr. Harvey Jay Cohen from the Veterans Affairs Medical Center in Durham, North Carolina, and colleagues.

Geriatric programs may consist of consultation services for patients, or entire units delivering care to elderly patients. The goal of all programs, explains Dr. Edward W. Camron in an accompanying article, is to prevent or delay a patient's entry into a nursing home.

In the study, nearly 1,400 frail patients at least 65 years old were treated at an inpatient geriatric unit or a conventional unit, and then at an outpatient geriatric clinic or a regular outpatient clinic. After one year, about 21% of patients in all treatment groups had died, the researchers report in the March 21st issue of The New England Journal of Medicine.

Patients treated in the geriatric units reported significantly less pain, more energy and better physical function upon discharge, compared with patients treated in conventional facilities, regardless of how long they had remained hospitalized.

One year later, patients treated in geriatric clinics remained in better mental health but there were no other differences. While specialized geriatric care initially costs more, the authors note, the overall costs for patients given both types of care were roughly equal after one year.

Nonetheless, geriatric programs may still be worthwhile for some patients, Camron notes in his editorial.

"Older patients and their families do value such benefits as better physical functioning and control of pain," he writes. "We could use more interventions that improve the quality of life with no increase in costs."

SOURCE: The New England Journal of Medicine 2002;346:874, 905-912.

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