Geriatrics or geriatric medicine is a branch of medicine that focuses on elderly health and the aging process. Elderly health and the aging process through medical care are the focus of Geriatrics. Geriatrics also deals with the prevention and management of symptoms for older adults. Older adults commonly experience overlapping health problems that require multiple medications from Geriatricians. Geriatricians also develop geriatric care plans to address special health problems of elderly adults.
Elderly adults or adults who are 65 years of age and older are the common recipients of Geriatrics. Geriatric medicine also caters to younger adults through the Program of All-Inclusive Care for the Elderly (PACE). PACE provides comprehensive medical and social services for older adults who are 55 years old and above.
A study published in the Front Public Health journal mentions the different types of Geriatric health conditions that are experienced by older adults. The first type of Geriatric health condition is normal aging. Normal aging includes sensory changes, such as hearing loss, visual acuity, and vestibular function. Hearing loss and increased cerumen production due to aging are the factors that contribute to the difficulty of hearing. Visual acuity is experienced by older adults when they have problems with glare, which affects their vision at night. The vestibular function includes dizziness, which can be a factor in falls or collapses of older adults.
Normal aging also includes muscle strength and fat changes. Muscle mass and strength decline start in the forties, and by the age of 80, some aged people may have experience sarcopenia. Sarcopenia is the significant loss of muscle mass and strength.
Normal aging also includes immunosenescence. Immunosenescence is the age-related changes in the immune system. These changes weaken the older adults’ body’s capacity to fight infections and also slow wound healing.
Adults can also experience urologic changes related to normal aging. Urologic changes involve urinary bladder infection, which is more common in older women than older men.
The next type of geriatric health condition is somatic disease and multiple chronic conditions. Chronic diseases include cardiovascular disease, hypertension, cancer, osteoarthritis, diabetes mellitus, osteoporosis, and others. Multiple chronic conditions, according to the study, affects 62% of Americans. Americans getting multiple chronic conditions also increases because of the aging adult population and rising diabetes rates. Adults with multiple chronic conditions account to a large chunk of healthcare spending.
Another type of geriatric health condition is physical function. Physical function changes due to aging and accumulated pathology include changes in walking speed, mobility disability, disability in activities of daily living, falls, frailty, and incontinence. Walking speed declines with normal aging and additionally due to disease. The difficulty of walking is experienced by 73% of Americans aged 85 and older. Also, older adults experience disabilities in activities of daily living such as dressing, bathing, cooking, and using the toilet. Falls also contribute to morbidity and disabilities among older adults. Older adults also experience weakness, slowness, exhaustion, and unintentional weight loss due to aging. Lastly, due to the aging process, older adults also experience urinary incontinence. Urinary incontinence is caused by overactive bladder, stress incontinence, and functional incontinence.
The next type of geriatric health condition is psychological and cognitive. Psychological and cognitive include cognitive aging, dementia, and depression. Cognitive aging or cognitive impairment includes mild short-term memory loss, word-finding difficulties, and slower processing speed occurring and noticeable by the age of 85. These normal parts of aging also run the risk of driving-related accidents and financial exploitation of older adults. Older adults also have increased risks of dementia and Alzheimer’s disease as they age. Dementia prevalence around the world may increase from 47 million in 2015 to 131 million in 2050. Depression is not a normal condition related to aging but is a response to life events that occur with aging, such as bereavement, retirement, loss of income, and loss of physical, social, or cognitive function due to illness.
Geriatric symptoms or geriatric syndromes are conditions that are complex in nature and tend to occur more commonly in older adults. Older adults can experience geriatric syndromes such as dementia, depression, delirium, incontinence, vertigo, falls, spontaneous bone fractures, failure to thieve, and neglect and abuse. Geriatric syndromes are also interact and influence each other.
A study published in the Journal of American Geriatric Society defines geriatric syndromes as multifactorial conditions that happen when the accumulated effects of impairments in multiple systems render an older adult vulnerable to situational challenges.
The study adds that geriatric syndromes pose some special clinical considerations. The first clinical consideration is that there are multiple risk factors and organ systems involved in a given geriatric syndrome. The second is that geriatric syndromes’ underlying causes can be ineffective, burdensome, dangerous, and costly to diagnose and identify for older adults.
Older adults are prone to developing age-related diseases and geriatric syndromes, such as cardiovascular diseases, ischemic heart disease, urinary incontinence, vascular dementia, multiple sclerosis, and other age-related diseases. These health conditions are different in terms of the approach to treatment as compared to younger adults. Younger adults do not usually have or experience polypharmacy, vague presentation of symptoms, and multiple health conditions at once like older adults.
There are several reasons to see a geriatric physician. The first reason is when the older adult has become frail or impaired. Becoming frail is accompanied by weakness, slowness, exhaustion, and unintentional weight loss. Becoming impaired is related to hearing, speech processing, visual, muscle function, cognition, communication, and balance. Geriatricians can give strength and balancing exercises or prescribe a physical therapy course or assistive devices to help older adults keep independent at home longer.
The next reason to see a geriatric physician is when the older adult has multiple conditions that require complex care and medication routines. Having multiple chronic conditions or multimorbidity is the coexistence of two or more chronic health conditions. Chronic health conditions include heart disease, cancer, chronic lung disease, heart attack, stroke, Alzheimer’s disease, diabetes, and chronic kidney disease, according to the National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP). The National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), under the Centers for Disease Control and Prevention, helps American people and communities to prevent chronic diseases and also promotes health and wellness for all. Geriatricians can review all the older adults’ geriatric medicines and determine the ones needed from the medicines that can be shelved.
Another reason to see a geriatric physician is when the older adult can no longer get adequate support from caregivers. Primary care providers and families can feel a lot of stress caring for their older loved ones with multiple chronic diseases or with complex treatment and care routines. Geriatricians are specially trained professionals that can cater to the health needs of older adults to improve their quality of life. They also work with other health care professionals such as primary care physicians, nurses, pharmacists, social workers, community-based service providers, physical therapists, direct care workers, and other medical professionals.
The common age that defines geriatric is 65 for older people because it is the age that determines the eligibility for Medicare in the United States. Medicare is the federal health insurance program for people who are 65 years old and older, younger people with disabilities, and people with end-stage renal disease.
On the other hand, some people with age-related conditions may require geriatrics expertise at a younger age which is why some programs like the Program of All-Inclusive Care for the Elderly (PACE) have lower age eligibility. The age eligibility for PACE is 55 years old and older.
Yes, geriatric means elderly, according to a survey of major medical journals from 1996 to 2006, published in the Journal of American Geriatric Society. The survey results show that three out of 4 major geriatric journals preferred the term elderly over older adults at a rate of 4:1 over general journals.
On the other hand, a study published in the Journal of Geriatric Physical Therapy defines the term elderly as ageist. Ageist means a stereotype is promulgated, and treatment is delivered differently on the basis of age. The term elderly is commonly used to describe people who are frail and dependent and not people who are robust and independent.
A geriatric patient is an older adult who suffers from multiple medical conditions. Multiple medical conditions are brought about by chronic diseases and aging. Treatments for multiple medical conditions can be complex because treatment or medicine for one condition may have adverse drug reactions on the second condition.
A geriatric patient is also an older adult who experiences functional impairment or physical frailty. Functional impairment or physical frailty due to aging can be dangerous if older adults or frail patients encounter accidents and injuries such as falls. Falls are a major cause of morbidity and disability among older adults. Older adults may need an extended care or other models of care.
A geriatric patient is an older adult who has a disease associated with aging such as dementia, incontinence, or osteoporosis. There are several aging-associated diseases the requires the specialty of a geriatrician. A geriatrician are health care professionals that receive specialized training in wellness and preventive health, including chronic medical conditions management.
Lastly, a geriatric patient is an elderly patient who is managing multiple medications. Managing multiple medications can be difficult for elderly patients, especially when these medications can cause side effects that can interfere with the well-being of older adults and elderly patients. Older adults and elderly patients can benefit from geriatricians because of their advanced training in geriatric medicine and assessment. They are trained for longer appointments to give more time to older adults and elderly patients to discuss their medical concerns.
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