Quality of life often depends on health and health care. However, health care practitioners, especially when establishing therapeutic objectives, may underemphasize its importance to patients.

Geriatrics refers to medical care for the elderly, an age group that is not easy to define precisely. “Older people” is sometimes preferred but is equally imprecise; > 65 is the age often used. Gerontology is the study of aging, including biologic, sociologic, and psychologic changes.

Prevalence of prescription drug use among older adults increases substantially with age. Among people ≥ 65, 90% use at least 1 drug per week, > 40% use at least 5 different drugs per week, and 12% use ≥ 10 different drugs per week. Women take more drugs, particularly psychoactive and arthritis drugs. Drug use is greatest among the frail elderly, hospitalized patients, and nursing home residents; typically, a nursing home resident is given 7 to 8 different drugs on a regular basis.

Elder abuse is physical or psychologic mistreatment, neglect, or financial exploitation of the elderly.

A fall is defined as a person coming to rest on the ground or another lower level; sometimes a body part strikes against an object that breaks the fall. Typically, events caused by acute disorders (eg, stroke, seizure) or overwhelming environmental hazards (eg, being struck by a moving object) are not considered falls.

In the US, health care services for the elderly are funded mainly by Medicare, Medicaid, the Veterans Health Administration, private insurance, and out-of-pocket payments. In addition, many states offer health-related benefits and programs, such as subsidies for transportation, housing, utilities, telephone, and food expenses, as well as help at home and nutrition services. Health care workers should help elderly patients learn about health benefits and programs they are entitled to.

Gait disorders encompass a number of issues, including slowing of gait speed and loss of smoothness, symmetry, or synchrony of body movement.

For the elderly, prevention focuses mainly on disease, frailty, accidents (ie, unintentional injury), iatrogenic complications, and psychosocial problems. Not all elderly patients benefit from every preventive measure. Choice of preventive measures is guided by the patient’s general condition:

Because older adults tend to have multiple disorders and may have social or functional problems, they use a disproportionately large amount of health care resources. In the US, people ≥ 65 account for

Social issues influence an elderly person’s risk and experience of illness as well as a health care practitioner’s ability to deliver timely and appropriate care.

For adults, driving is the most important method of independent transportation. In 2011, there were 35 million licensed drivers ≥ 65 yr in the US, including many ≥ 80 yr ( Percentage of Drivers by Age and Sex). Progressive disease that impairs driving in older adults may have two serious adverse outcomes: injury or death resulting from a motor vehicle crash (MVC) or driving cessation.