Geriatrics

More Specific Terms

Geriatrics is the branch of medicine that provides health care for the elderly; it differs from gerontology, study of the aging process itself. However, geriatrics is considered by some as 'medical gerontology'. The term geriatrics comes from the Greek geron meaning'old man' & iatros meaning 'healer'.

the prevalence & disabling effects of geriatric conditions among older adults result in substantial morbidity. [3]
Internal medicine house staff are often unaware of risks for adverse outcomes in hospitalized elderly [4], including:

Geriatrics differs from adult medicine in many respects. The elderly are physiologically different from younger adults (see age-related physiological changes). These differences include a diminished capacity to maintain homeostasis, resulting in an increased risk of complications from otherwise mild stress or pathology.
Geriatrics places a greater emphasis on functional ability, independence & quality of life than does adult medicine. These are the best indicators of longevity in the elderly.
The prevalence of dependence in the elderly is high, thus a geriatrician may often deal with caregivers.
The prevalence of cognitive impairment is high, thus a geriatrician may often deal with decision-making capacity, advance directives, durable power of attorney for health care...
a geriatrican must also be alert for signs of elder abuse.

One of the major problems in geriatrics is polypharmacy, part cultural, part situational, but nonetheless dangerous. The cultural part stems from advertisement, the media & other factors that convince Americans there is a medication for every ailment. Since the elderly in general have more ailments than younger adult patients, they take more medications. However, the elderly are the group of patients most at risk for drug interactions & they are at increased risk of complications from such drug interactions. What seems to be apparent is that the healthiest elderly are those on the fewest medications.

Geriatric Medicine: An Evidence-Based Approach, 4th ed, Cassel CK et al (eds), Springer-Verlag, New York, 2003
The Sepulveda VA GRECC Guide to Geriatric Assessment
Cigolle CT, Langa KM, Kabeto MU, Tian Z, Blaum CS. Geriatric conditions and disability: the Health and Retirement Study. Ann Intern Med. 2007 Aug 7;147(3):156-64. PMID: [1]
Fernandez HM et al, House staff member awareness of older inpatients' risks for hazards of hospitalization. Arch Intern Med 2008, 168:390 PMID: [2]
In: Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 29-Oct 2, 2004
Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004
Principles of Geriatric Medicine, 4th ed,, Hazzard et al (eds), McGraw-Hill, NY, 1999
Wikipedia: Geriatrics [3]
National Guideline Clearinghouse Occupational therapy interventions and physical activity interventions to promote the mental wellbeing of older people in primary care and residential care. ngc-guideline: [4]

geriatrics