Final answer:
The diagnosis of appendicitis is indeed challenging in older adults due to less pronounced symptoms, which is true. This can lead to delayed treatment, increasing the risk for complications like perforation and peritonitis, with a significant mortality rate.
Step-by-step explanation:
The statement that the diagnosis of appendicitis is difficult to establish in the older adult because symptoms of pain and tenderness may not be as pronounced, which can result in an increased risk for perforation, peritonitis, and mortality, is true. Appendicitis in the elderly may not present with typical symptoms seen in younger patients, and diagnosis might be delayed. Since the appendix is a small, narrow, blind-ended tube, material that becomes trapped can lead to irritation and infection, potentially causing rapid worsening of the condition. As the infection intensifies, there is a heightened risk of the appendix bursting, which can spread the infection to the peritoneal cavity resulting in peritonitis, a serious and life-threatening inflammation. The mortality from peritonitis, although decreased due to medical advances, remains significant. Prompt diagnosis and surgical intervention are critical to managing appendicitis effectively and reducing associated complications and mortality rates in older adults.