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I absolutely cringe when someone refers to an older person as "X years young" or "Young lady". (It's almost always a female patient, not male that's being refered to.) I think it's demeaning to the patient.
I always speak to my patients as intelligent people who want the best for their health. Even with my ER time constraints I try to explain what is going on, what we're going to do to evaluate it, and what the plan of treatment is. I think people rise or descend to the level that we expect of them.
I must admit that I will occasionally insult the intelligence of some drunk fool, but that's another thing entirely.