The full content of Annals is available to subscribers

Subscribe/Learn More  >
Editorials |

Occam's Razor, Geriatric Syndromes, and the Dizzy Patient

David A. Drachman, MD
[+] Article, Author, and Disclosure Information

University of Massachusetts Medical School; Worcester, MA 01655 (Drachman)

Grant Support: In part by grant AG05134, the Sterling Morton Charitable Trust, and the Harriet and Stanley Friedman Research Fund.

Requests for Single Reprints: David A. Drachman, MD, Department of Neurology, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655.

Requests To Purchase Bulk Reprints (minimum, 100 copies): Reprints Coordinator; phone, 215-351-2657; e-mail, reprints@mail.acponline.org.

Ann Intern Med. 2000;132(5):403-405. doi:10.7326/0003-4819-132-5-200003070-00010
Text Size: A A A

In the 14th century, English philosopher William of Ockham (Occam) stated: Pluralitas non est ponenda sine necessitate, or “Plurality must not be posited without necessity” (1). In medicine, the application of “Occam's razor,” the concept of parsimony in diagnosis, has become firmly entrenched as a fundamental principle. For persons older than 65 years of age, however—especially those who experience dizziness—Occam's razor is often too sharp and cuts too narrowly to be the instrument of choice (2). Senescence, the age-related changes that result in increased vulnerability to impairment and disease and in decreased survival (3), results in at least one chronic illness in most of the Medicare population. The serial accumulation of additional ailments, and of medications for their treatment, is nearly universal with advancing age. The concept of “geriatric syndromes” (4) reflects the recognition of multifactorial disorders that plague the elderly in particular, as the functions of organs and the defenses against disease decline and impairments accumulate.

First Page Preview

View Large
First page PDF preview





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $32.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.