Leg Edema among Older Adults

Daniel Tascona, MD, Nephrology Fellow, Queen’s University, Kingston, ON.
Karen Yeates, MD, FRCPC, Nephrologist, Kingston General Hospital, Assistant Professor of Medicine, Queen’s University, Kingston, ON.

Leg edema is a common condition among older adults. It increases the risk of ulcers and cellulitis. Edema may be broadly classified as either venous edema or lymphedema. Many conditions associated with leg edema show a substantial increase in prevalence with age. Chronic venous insufficiency (CVI) is the most common cause of chronic leg edema among older adults. Causes of leg edema can be subdivided as acute (<72 h) or chronic and unilateral or bilateral. The acute onset of unilateral leg edema is always suspicious for a deep vein thrombosis (DVT), whereas a more chronic onset would suggest CVI. A careful clinical history can be very helpful and will often suggest the likely etiology. Treatment should be guided by the suspected etiology and can be either pharmacologic, nonpharmacologic, or both.
Key words: edema, chronic venous insufficiency, lymphedema, deep venous thrombosis.