Overview

Geriatric Medicine is the branch of medicine focused on health care of older adults. It aims to promote health by preventing and treating diseases and disabilities in elderly individuals. With the world’s aging population, geriatric medicine is increasingly vital for public health and clinical practice.

Key Concepts

1. Aging Process

  • Biological Aging: Gradual decline in physiological function due to cellular and molecular changes.
  • Chronological vs. Biological Age: Chronological age is years lived; biological age reflects physical and functional status.
  • Common Changes:
    • Reduced muscle mass (sarcopenia)
    • Decreased bone density (osteoporosis)
    • Slower cognitive processing
    • Altered pharmacokinetics

2. Principles of Geriatric Care

  • Comprehensive Assessment: Includes medical, psychological, functional, and social evaluation.
  • Multimorbidity: Elderly often have multiple chronic conditions (diabetes, hypertension, arthritis).
  • Polypharmacy: Use of multiple medications increases risk of adverse drug reactions.
  • Functional Status: Focus on activities of daily living (ADLs) and independence.

Common Geriatric Syndromes

Syndrome Description Impact
Delirium Acute confusion, fluctuating consciousness Increased morbidity
Falls Loss of balance, risk of fractures Loss of independence
Incontinence Loss of bladder/bowel control Social isolation
Frailty Decreased strength, endurance, physiological reserve Higher risk of complications
Dementia Progressive cognitive decline Memory loss, behavioral changes

Diagram: Aging and Organ Systems

Aging Effects on Organ Systems

Case Studies

Case 1: Polypharmacy and Falls

Background: Mrs. Smith, 82, takes 8 medications for hypertension, diabetes, and arthritis. She falls at home, sustaining a hip fracture.

Analysis:

  • Multiple medications (especially sedatives and antihypertensives) increase fall risk.
  • Comprehensive medication review and deprescribing can reduce adverse events.

Case 2: Dementia and Social Isolation

Background: Mr. Lee, 78, diagnosed with Alzheimer’s disease, lives alone and has limited social contacts.

Analysis:

  • Cognitive decline impairs daily functioning.
  • Social isolation worsens mental health and accelerates decline.
  • Community support and caregiver involvement are essential.

Case 3: Frailty and Hospitalization

Background: Mrs. Garcia, 85, admitted for pneumonia, develops delirium and loses ability to walk.

Analysis:

  • Frailty increases vulnerability to acute illness.
  • Early mobilization and multidisciplinary care can improve outcomes.

Real-World Problem: Aging Population and Healthcare Systems

  • By 2050, the global population aged 60+ will double to 2.1 billion (UN, 2022).
  • Increased demand for geriatric care strains healthcare resources.
  • Chronic diseases, disability, and long-term care needs challenge existing models.
  • Societal adaptation required: more geriatricians, integrated care teams, age-friendly policies.

Common Misconceptions

  1. Aging Equals Disease: Aging is a natural process, not synonymous with illness.
  2. Elderly Cannot Improve Function: Rehabilitation and exercise can restore independence.
  3. All Elderly Have Dementia: Most older adults retain cognitive abilities; dementia is not inevitable.
  4. Polypharmacy Is Necessary: Medication regimens should be regularly reviewed and minimized.
  5. Geriatric Care Is Only for the Very Old: Principles apply from age 65 onwards.

Surprising Facts

  1. Plastic Pollution and Aging: Microplastics have been detected in human organs, including those of older adults, potentially exacerbating age-related diseases (Leslie et al., 2022).
  2. Hospitalization Risks: Older adults are at higher risk for hospital-acquired complications, including delirium, infections, and functional decline.
  3. Longevity Trends: Centenarians (100+ years) are the fastest-growing age group worldwide.

Recent Research

A 2021 study published in The Lancet Healthy Longevity found that comprehensive geriatric assessment in hospitalized older adults significantly reduced mortality and improved functional outcomes (Ellis et al., 2021).

Integrated Care Model

  • Multidisciplinary Teams: Physicians, nurses, social workers, therapists collaborate for holistic care.
  • Patient-Centered Approach: Care plans tailored to individual goals and preferences.
  • Community Resources: Home care, telemedicine, and community programs support aging in place.

Diagram: Geriatric Assessment Domains

Geriatric Assessment Domains

References

  • Leslie, H.A., et al. (2022). “Discovery and quantification of plastic particle pollution in human organs.” Environmental Science & Technology, 56(3), 1642-1650.
  • Ellis, G., et al. (2021). “Comprehensive geriatric assessment for older adults admitted to hospital.” The Lancet Healthy Longevity, 2(1), e28-e36.
  • United Nations, World Population Ageing 2022.

Summary

Geriatric Medicine addresses the complex needs of older adults through holistic, patient-centered care. It emphasizes prevention, functional independence, and quality of life. With global aging, innovative models and public awareness are essential to meet the challenges ahead.