Geriatrics

Geriatrics refers to medical care for older adults, an age group that is not easy to define precisely. “Older” is preferred over "elderly," but both are equally imprecise; > 65 is the age often used, but most people do not need geriatrics expertise in their care until age 70, 75, or even 80. Gerontology is the study of aging, including biologic, sociologic, and psychologic changes.

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.

Prevalence of prescription drug use increases substantially with age. Survey data from 2010–2011 indicate that almost 90% of older adults regularly take at least 1 prescription drug, almost 80% regularly take at least 2 prescription drugs, and 36% take at least 5 prescription drugs (1). When over-the-counter and dietary supplements are included, these prevalence rates increase substantially. Women take more drugs, particularly psychoactive and arthritis drugs. Drug use is greatest among the frail older adult, hospitalized patients, and nursing home residents; a typical nursing home resident takes 7 to 8 different drugs regularly.

Elder abuse is physical or psychologic mistreatment, neglect, or financial exploitation of older adults.

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 United States, health care services for older adults are funded mainly by Medicare, Medicaid, 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 older patients learn about health benefits and programs to which they are entitled.

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

For many older adults, driving an automobile is their preferred option for community transportation. 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.

For older adults, prevention focuses mainly on disease, frailty, accidents (ie, unintentional injury), iatrogenic complications, psychosocial problems, and maintaining ability to perform activities of daily living. Not all older patients benefit from every preventive measure. Choice of preventive measures is guided by whether the patient’s general condition is:

Every 4 years, the US Department of Health and Human Services (HHS) updates its strategic plan and defines its mission and goals. The current HHS strategic plan (2018-2022) includes the following 5 strategic goals (1):

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