Challenges and strategies in the care of older adults across the continuum of intensive and post-intensive care medicine

Intensive Care Medicine | Published: 22 December 2025

Abstract

Older adults have composed more than half of ICU patient-days for the past 25 years, and these numbers are only expected to grow as the worldwide population of older adults doubles by 2050. For older adults, conditions such as frailty, disability in functional activities, and multimorbidity are more strongly associated with ICU and post-ICU outcomes than chronological age, and recent work shows that the prevalence of these conditions among older ICU patients is increasing over time. In response to this demographic shift, the science of aging-focused critical care has rapidly expanded over the past decade, and we now know more about how to care for older ICU patients than ever before. However, challenges in the care of older adults across the continuum of ICU and post-ICU care remain. In this narrative review, we discuss these challenges, propose strategies and future research to address them, and discuss best practices for the care of older ICU patients in the context of the state of the science.