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</a> <ul id="toc-Cognition-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Geriatric_pharmacology" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Geriatric_pharmacology"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.4</span> <span>Geriatric pharmacology</span> </div> </a> <ul id="toc-Geriatric_pharmacology-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Geriatric_syndromes" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Geriatric_syndromes"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.5</span> <span>Geriatric syndromes</span> </div> </a> <ul id="toc-Geriatric_syndromes-sublist" class="vector-toc-list"> <li id="toc-Frailty" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Frailty"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.5.1</span> <span>Frailty</span> </div> </a> <ul id="toc-Frailty-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Functional_decline" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Functional_decline"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.5.2</span> <span>Functional decline</span> </div> </a> <ul id="toc-Functional_decline-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Falls" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Falls"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.5.3</span> <span>Falls</span> </div> </a> <ul id="toc-Falls-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Urinary_incontinence" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Urinary_incontinence"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.5.4</span> <span>Urinary incontinence</span> </div> </a> <ul id="toc-Urinary_incontinence-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Malnutrition" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Malnutrition"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.5.5</span> <span>Malnutrition</span> </div> </a> <ul id="toc-Malnutrition-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Practical_concerns" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Practical_concerns"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.6</span> <span>Practical concerns</span> </div> </a> <ul id="toc-Practical_concerns-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Subspecialties_and_related_services" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Subspecialties_and_related_services"> <div class="vector-toc-text"> <span class="vector-toc-numb">2</span> <span>Subspecialties and related services</span> </div> </a> <button aria-controls="toc-Subspecialties_and_related_services-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Subspecialties and related services subsection</span> </button> <ul id="toc-Subspecialties_and_related_services-sublist" class="vector-toc-list"> <li id="toc-Medical" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Medical"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.1</span> <span>Medical</span> </div> </a> <ul id="toc-Medical-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Surgical" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Surgical"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.2</span> <span>Surgical</span> </div> </a> <ul id="toc-Surgical-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Other_geriatrics_subspecialties" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Other_geriatrics_subspecialties"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.3</span> <span>Other geriatrics subspecialties</span> </div> </a> <ul id="toc-Other_geriatrics_subspecialties-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-History" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#History"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>History</span> </div> </a> <ul id="toc-History-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Geriatrician_training" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Geriatrician_training"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>Geriatrician training</span> </div> </a> <button aria-controls="toc-Geriatrician_training-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Geriatrician training subsection</span> </button> <ul id="toc-Geriatrician_training-sublist" class="vector-toc-list"> <li id="toc-United_States" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#United_States"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.1</span> <span>United States</span> </div> </a> <ul id="toc-United_States-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-United_Kingdom" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#United_Kingdom"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.2</span> <span>United Kingdom</span> </div> </a> <ul id="toc-United_Kingdom-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Canada" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Canada"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.3</span> <span>Canada</span> </div> </a> <ul id="toc-Canada-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-India" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#India"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.4</span> <span>India</span> </div> </a> <ul id="toc-India-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Minimum_geriatric_competencies" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Minimum_geriatric_competencies"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>Minimum geriatric competencies</span> </div> </a> <ul id="toc-Minimum_geriatric_competencies-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Research" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Research"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>Research</span> </div> </a> <ul id="toc-Research-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Ethical_and_medico-legal_issues" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Ethical_and_medico-legal_issues"> <div class="vector-toc-text"> <span class="vector-toc-numb">7</span> <span>Ethical and medico-legal issues</span> </div> </a> <ul id="toc-Ethical_and_medico-legal_issues-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-See_also" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#See_also"> <div class="vector-toc-text"> <span class="vector-toc-numb">8</span> <span>See also</span> </div> </a> <ul id="toc-See_also-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">9</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Further_reading" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Further_reading"> <div class="vector-toc-text"> <span class="vector-toc-numb">10</span> <span>Further reading</span> </div> </a> <ul id="toc-Further_reading-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> <span class="vector-toc-numb">11</span> <span>External links</span> </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" title="Table of Contents" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" ><span class="vector-icon mw-ui-icon-listBullet mw-ui-icon-wikimedia-listBullet"></span> <span class="vector-dropdown-label-text">Toggle the table of contents</span> </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading"><span class="mw-page-title-main">Geriatrics</span></h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 55 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-55" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">55 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D8%B7%D8%A8_%D8%A7%D9%84%D9%85%D8%B3%D9%86%D9%8A%D9%86" title="طب المسنين – Arabic" lang="ar" hreflang="ar" data-title="طب المسنين" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-ast mw-list-item"><a href="https://ast.wikipedia.org/wiki/Xeriatr%C3%ADa" title="Xeriatría – Asturian" lang="ast" hreflang="ast" data-title="Xeriatría" data-language-autonym="Asturianu" data-language-local-name="Asturian" class="interlanguage-link-target"><span>Asturianu</span></a></li><li class="interlanguage-link interwiki-be mw-list-item"><a href="https://be.wikipedia.org/wiki/%D0%93%D0%B5%D1%80%D1%8B%D1%8F%D1%82%D1%80%D1%8B%D1%8F" title="Герыятрыя – Belarusian" lang="be" hreflang="be" data-title="Герыятрыя" data-language-autonym="Беларуская" data-language-local-name="Belarusian" class="interlanguage-link-target"><span>Беларуская</span></a></li><li class="interlanguage-link interwiki-be-x-old mw-list-item"><a href="https://be-tarask.wikipedia.org/wiki/%D0%93%D0%B5%D1%80%D1%8B%D1%8F%D1%82%D1%80%D1%8B%D1%8F" title="Герыятрыя – Belarusian (Taraškievica orthography)" lang="be-tarask" hreflang="be-tarask" data-title="Герыятрыя" data-language-autonym="Беларуская (тарашкевіца)" data-language-local-name="Belarusian (Taraškievica orthography)" class="interlanguage-link-target"><span>Беларуская (тарашкевіца)</span></a></li><li class="interlanguage-link interwiki-bg mw-list-item"><a href="https://bg.wikipedia.org/wiki/%D0%93%D0%B5%D1%80%D0%B8%D0%B0%D1%82%D1%80%D0%B8%D1%8F" title="Гериатрия – Bulgarian" lang="bg" hreflang="bg" data-title="Гериатрия" data-language-autonym="Български" data-language-local-name="Bulgarian" class="interlanguage-link-target"><span>Български</span></a></li><li class="interlanguage-link interwiki-bs mw-list-item"><a href="https://bs.wikipedia.org/wiki/Gerijatrija" title="Gerijatrija – Bosnian" lang="bs" hreflang="bs" data-title="Gerijatrija" data-language-autonym="Bosanski" data-language-local-name="Bosnian" class="interlanguage-link-target"><span>Bosanski</span></a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Geriatria" title="Geriatria – Catalan" lang="ca" hreflang="ca" data-title="Geriatria" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target"><span>Català</span></a></li><li class="interlanguage-link interwiki-cs mw-list-item"><a href="https://cs.wikipedia.org/wiki/Geriatrie" title="Geriatrie – Czech" lang="cs" hreflang="cs" data-title="Geriatrie" data-language-autonym="Čeština" data-language-local-name="Czech" class="interlanguage-link-target"><span>Čeština</span></a></li><li class="interlanguage-link interwiki-da mw-list-item"><a href="https://da.wikipedia.org/wiki/Geriatri" title="Geriatri – Danish" lang="da" hreflang="da" data-title="Geriatri" data-language-autonym="Dansk" data-language-local-name="Danish" class="interlanguage-link-target"><span>Dansk</span></a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Geriatrie" title="Geriatrie – German" lang="de" hreflang="de" data-title="Geriatrie" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-et mw-list-item"><a href="https://et.wikipedia.org/wiki/Geriaatria" title="Geriaatria – Estonian" lang="et" hreflang="et" data-title="Geriaatria" data-language-autonym="Eesti" data-language-local-name="Estonian" class="interlanguage-link-target"><span>Eesti</span></a></li><li class="interlanguage-link interwiki-el mw-list-item"><a href="https://el.wikipedia.org/wiki/%CE%93%CE%B7%CF%81%CE%B9%CE%B1%CF%84%CF%81%CE%B9%CE%BA%CE%AE" title="Γηριατρική – Greek" lang="el" hreflang="el" data-title="Γηριατρική" data-language-autonym="Ελληνικά" data-language-local-name="Greek" class="interlanguage-link-target"><span>Ελληνικά</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Geriatr%C3%ADa" title="Geriatría – Spanish" lang="es" hreflang="es" data-title="Geriatría" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-eu mw-list-item"><a href="https://eu.wikipedia.org/wiki/Geriatria" title="Geriatria – Basque" lang="eu" hreflang="eu" data-title="Geriatria" data-language-autonym="Euskara" data-language-local-name="Basque" class="interlanguage-link-target"><span>Euskara</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D9%BE%DB%8C%D8%B1%D9%BE%D8%B2%D8%B4%DA%A9%DB%8C" title="پیرپزشکی – Persian" lang="fa" hreflang="fa" data-title="پیرپزشکی" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/G%C3%A9riatrie" title="Gériatrie – French" lang="fr" hreflang="fr" data-title="Gériatrie" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-ga mw-list-item"><a href="https://ga.wikipedia.org/wiki/Leigheas_seanaoise" title="Leigheas seanaoise – Irish" lang="ga" hreflang="ga" data-title="Leigheas seanaoise" data-language-autonym="Gaeilge" data-language-local-name="Irish" class="interlanguage-link-target"><span>Gaeilge</span></a></li><li class="interlanguage-link interwiki-gl mw-list-item"><a href="https://gl.wikipedia.org/wiki/Xeriatr%C3%ADa" title="Xeriatría – Galician" lang="gl" hreflang="gl" data-title="Xeriatría" data-language-autonym="Galego" data-language-local-name="Galician" class="interlanguage-link-target"><span>Galego</span></a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%EB%85%B8%EC%9D%B8%EC%9D%98%ED%95%99" title="노인의학 – Korean" lang="ko" hreflang="ko" data-title="노인의학" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target"><span>한국어</span></a></li><li class="interlanguage-link interwiki-hi mw-list-item"><a href="https://hi.wikipedia.org/wiki/%E0%A4%9C%E0%A4%B0%E0%A4%BE%E0%A4%B0%E0%A5%8B%E0%A4%97%E0%A4%B5%E0%A4%BF%E0%A4%A6%E0%A5%8D%E0%A4%AF%E0%A4%BE" title="जरारोगविद्या – Hindi" lang="hi" hreflang="hi" data-title="जरारोगविद्या" data-language-autonym="हिन्दी" data-language-local-name="Hindi" class="interlanguage-link-target"><span>हिन्दी</span></a></li><li class="interlanguage-link interwiki-hr mw-list-item"><a href="https://hr.wikipedia.org/wiki/Gerijatrija" title="Gerijatrija – Croatian" lang="hr" hreflang="hr" data-title="Gerijatrija" data-language-autonym="Hrvatski" data-language-local-name="Croatian" class="interlanguage-link-target"><span>Hrvatski</span></a></li><li class="interlanguage-link interwiki-id mw-list-item"><a href="https://id.wikipedia.org/wiki/Geriatri" title="Geriatri – Indonesian" lang="id" hreflang="id" data-title="Geriatri" data-language-autonym="Bahasa Indonesia" data-language-local-name="Indonesian" class="interlanguage-link-target"><span>Bahasa Indonesia</span></a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Geriatria" title="Geriatria – Italian" lang="it" hreflang="it" data-title="Geriatria" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%92%D7%A8%D7%99%D7%90%D7%98%D7%A8%D7%99%D7%94" title="גריאטריה – Hebrew" lang="he" hreflang="he" data-title="גריאטריה" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target"><span>עברית</span></a></li><li class="interlanguage-link interwiki-ka mw-list-item"><a href="https://ka.wikipedia.org/wiki/%E1%83%92%E1%83%94%E1%83%A0%E1%83%98%E1%83%90%E1%83%A2%E1%83%A0%E1%83%98%E1%83%90" title="გერიატრია – Georgian" lang="ka" hreflang="ka" data-title="გერიატრია" data-language-autonym="ქართული" data-language-local-name="Georgian" class="interlanguage-link-target"><span>ქართული</span></a></li><li class="interlanguage-link interwiki-kk mw-list-item"><a href="https://kk.wikipedia.org/wiki/%D0%93%D0%B5%D1%80%D0%B8%D0%B0%D1%82%D1%80%D0%B8%D1%8F" title="Гериатрия – Kazakh" lang="kk" hreflang="kk" data-title="Гериатрия" data-language-autonym="Қазақша" data-language-local-name="Kazakh" class="interlanguage-link-target"><span>Қазақша</span></a></li><li class="interlanguage-link interwiki-ku mw-list-item"><a href="https://ku.wikipedia.org/wiki/P%C3%AEr%C3%AEnas%C3%AE" title="Pîrînasî – Kurdish" lang="ku" hreflang="ku" data-title="Pîrînasî" data-language-autonym="Kurdî" data-language-local-name="Kurdish" class="interlanguage-link-target"><span>Kurdî</span></a></li><li class="interlanguage-link interwiki-hu mw-list-item"><a href="https://hu.wikipedia.org/wiki/Geri%C3%A1tria" title="Geriátria – Hungarian" lang="hu" hreflang="hu" data-title="Geriátria" data-language-autonym="Magyar" data-language-local-name="Hungarian" class="interlanguage-link-target"><span>Magyar</span></a></li><li class="interlanguage-link interwiki-ml mw-list-item"><a href="https://ml.wikipedia.org/wiki/%E0%B4%9C%E0%B5%86%E0%B4%B1%E0%B4%BF%E0%B4%AF%E0%B4%BE%E0%B4%9F%E0%B5%8D%E0%B4%B0%E0%B4%BF%E0%B4%95%E0%B5%8D%E0%B4%B8%E0%B5%8D" title="ജെറിയാട്രിക്സ് – Malayalam" lang="ml" hreflang="ml" data-title="ജെറിയാട്രിക്സ്" data-language-autonym="മലയാളം" data-language-local-name="Malayalam" class="interlanguage-link-target"><span>മലയാളം</span></a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Geriatrie" title="Geriatrie – Dutch" lang="nl" hreflang="nl" data-title="Geriatrie" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target"><span>Nederlands</span></a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E8%80%81%E5%B9%B4%E5%8C%BB%E5%AD%A6" title="老年医学 – Japanese" lang="ja" hreflang="ja" data-title="老年医学" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target"><span>日本語</span></a></li><li class="interlanguage-link interwiki-no mw-list-item"><a href="https://no.wikipedia.org/wiki/Geriatri" title="Geriatri – Norwegian Bokmål" lang="nb" hreflang="nb" data-title="Geriatri" data-language-autonym="Norsk bokmål" data-language-local-name="Norwegian Bokmål" class="interlanguage-link-target"><span>Norsk bokmål</span></a></li><li class="interlanguage-link interwiki-uz mw-list-item"><a href="https://uz.wikipedia.org/wiki/Geriatriya" title="Geriatriya – Uzbek" lang="uz" hreflang="uz" data-title="Geriatriya" data-language-autonym="Oʻzbekcha / ўзбекча" data-language-local-name="Uzbek" class="interlanguage-link-target"><span>Oʻzbekcha / ўзбекча</span></a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Geriatria" title="Geriatria – Polish" lang="pl" hreflang="pl" data-title="Geriatria" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target"><span>Polski</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Geriatria" title="Geriatria – Portuguese" lang="pt" hreflang="pt" data-title="Geriatria" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-ro mw-list-item"><a href="https://ro.wikipedia.org/wiki/Geriatrie_%C8%99i_gerontologie" title="Geriatrie și gerontologie – Romanian" lang="ro" hreflang="ro" data-title="Geriatrie și gerontologie" data-language-autonym="Română" data-language-local-name="Romanian" class="interlanguage-link-target"><span>Română</span></a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%93%D0%B5%D1%80%D0%B8%D0%B0%D1%82%D1%80%D0%B8%D1%8F" title="Гериатрия – Russian" lang="ru" hreflang="ru" data-title="Гериатрия" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target"><span>Русский</span></a></li><li class="interlanguage-link interwiki-simple mw-list-item"><a href="https://simple.wikipedia.org/wiki/Geriatrics" title="Geriatrics – Simple English" lang="en-simple" hreflang="en-simple" data-title="Geriatrics" data-language-autonym="Simple English" data-language-local-name="Simple English" class="interlanguage-link-target"><span>Simple English</span></a></li><li class="interlanguage-link interwiki-sk mw-list-item"><a href="https://sk.wikipedia.org/wiki/Geriatria" title="Geriatria – Slovak" lang="sk" hreflang="sk" data-title="Geriatria" data-language-autonym="Slovenčina" data-language-local-name="Slovak" class="interlanguage-link-target"><span>Slovenčina</span></a></li><li class="interlanguage-link interwiki-sl mw-list-item"><a href="https://sl.wikipedia.org/wiki/Geriatrija" title="Geriatrija – Slovenian" lang="sl" hreflang="sl" data-title="Geriatrija" data-language-autonym="Slovenščina" data-language-local-name="Slovenian" class="interlanguage-link-target"><span>Slovenščina</span></a></li><li class="interlanguage-link interwiki-ckb mw-list-item"><a href="https://ckb.wikipedia.org/wiki/%D9%BE%D8%B2%DB%8C%D8%B4%DA%A9%DB%8C%DB%8C_%D9%BE%DB%8C%D8%B1%D8%A7%D9%86" title="پزیشکیی پیران – Central Kurdish" lang="ckb" hreflang="ckb" data-title="پزیشکیی پیران" data-language-autonym="کوردی" data-language-local-name="Central Kurdish" class="interlanguage-link-target"><span>کوردی</span></a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/%D0%93%D0%B5%D1%80%D0%B8%D1%98%D0%B0%D1%82%D1%80%D0%B8%D1%98%D0%B0" title="Геријатрија – Serbian" lang="sr" hreflang="sr" data-title="Геријатрија" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target"><span>Српски / srpski</span></a></li><li class="interlanguage-link interwiki-sh mw-list-item"><a href="https://sh.wikipedia.org/wiki/Gerijatrija" title="Gerijatrija – Serbo-Croatian" lang="sh" hreflang="sh" data-title="Gerijatrija" data-language-autonym="Srpskohrvatski / српскохрватски" data-language-local-name="Serbo-Croatian" class="interlanguage-link-target"><span>Srpskohrvatski / српскохрватски</span></a></li><li class="interlanguage-link interwiki-fi mw-list-item"><a href="https://fi.wikipedia.org/wiki/Geriatria" title="Geriatria – Finnish" lang="fi" hreflang="fi" data-title="Geriatria" data-language-autonym="Suomi" data-language-local-name="Finnish" class="interlanguage-link-target"><span>Suomi</span></a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/Geriatrik" title="Geriatrik – Swedish" lang="sv" hreflang="sv" data-title="Geriatrik" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target"><span>Svenska</span></a></li><li class="interlanguage-link interwiki-tl mw-list-item"><a href="https://tl.wikipedia.org/wiki/Heriyatriko" title="Heriyatriko – Tagalog" lang="tl" hreflang="tl" data-title="Heriyatriko" data-language-autonym="Tagalog" data-language-local-name="Tagalog" class="interlanguage-link-target"><span>Tagalog</span></a></li><li class="interlanguage-link interwiki-ta mw-list-item"><a href="https://ta.wikipedia.org/wiki/%E0%AE%AE%E0%AF%81%E0%AE%A4%E0%AE%BF%E0%AE%AF%E0%AF%8B%E0%AE%B0%E0%AF%8D_%E0%AE%AE%E0%AE%B0%E0%AF%81%E0%AE%A4%E0%AF%8D%E0%AE%A4%E0%AF%81%E0%AE%B5%E0%AE%AE%E0%AF%8D" title="முதியோர் மருத்துவம் – Tamil" lang="ta" hreflang="ta" data-title="முதியோர் மருத்துவம்" data-language-autonym="தமிழ்" data-language-local-name="Tamil" class="interlanguage-link-target"><span>தமிழ்</span></a></li><li class="interlanguage-link interwiki-te mw-list-item"><a href="https://te.wikipedia.org/wiki/%E0%B0%9C%E0%B0%BF%E0%B0%B0%E0%B0%BF%E0%B0%AF%E0%B0%BE%E0%B0%9F%E0%B1%8D%E0%B0%B0%E0%B0%BF%E0%B0%95%E0%B1%8D%E0%B0%B8%E0%B1%8D" title="జిరియాట్రిక్స్ – Telugu" lang="te" hreflang="te" data-title="జిరియాట్రిక్స్" data-language-autonym="తెలుగు" data-language-local-name="Telugu" class="interlanguage-link-target"><span>తెలుగు</span></a></li><li class="interlanguage-link interwiki-tg mw-list-item"><a href="https://tg.wikipedia.org/wiki/%D0%9F%D0%B8%D1%80%D0%BF%D0%B8%D0%B7%D0%B8%D1%88%D0%BA%D3%A3" title="Пирпизишкӣ – Tajik" lang="tg" hreflang="tg" data-title="Пирпизишкӣ" data-language-autonym="Тоҷикӣ" data-language-local-name="Tajik" class="interlanguage-link-target"><span>Тоҷикӣ</span></a></li><li class="interlanguage-link interwiki-tr mw-list-item"><a href="https://tr.wikipedia.org/wiki/Ya%C5%9Fl%C4%B1l%C4%B1k_hekimli%C4%9Fi" title="Yaşlılık hekimliği – Turkish" lang="tr" hreflang="tr" data-title="Yaşlılık hekimliği" data-language-autonym="Türkçe" data-language-local-name="Turkish" class="interlanguage-link-target"><span>Türkçe</span></a></li><li class="interlanguage-link interwiki-uk mw-list-item"><a href="https://uk.wikipedia.org/wiki/%D0%93%D0%B5%D1%80%D1%96%D0%B0%D1%82%D1%80%D1%96%D1%8F" title="Геріатрія – Ukrainian" lang="uk" hreflang="uk" data-title="Геріатрія" data-language-autonym="Українська" data-language-local-name="Ukrainian" class="interlanguage-link-target"><span>Українська</span></a></li><li class="interlanguage-link interwiki-vi mw-list-item"><a href="https://vi.wikipedia.org/wiki/L%C3%A3o_khoa" title="Lão khoa – Vietnamese" lang="vi" hreflang="vi" data-title="Lão khoa" data-language-autonym="Tiếng Việt" data-language-local-name="Vietnamese" class="interlanguage-link-target"><span>Tiếng 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searchaux" style="display:none">Specialty that focuses on health care of elderly people</div> <p class="mw-empty-elt"> </p> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">For other uses, see <a href="/wiki/Geriatrics_(disambiguation)" class="mw-disambig" title="Geriatrics (disambiguation)">Geriatrics (disambiguation)</a>.</div> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical specialty</div><style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output 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.mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox"><caption class="infobox-title" style="padding-bottom:0.25em;">Geriatrics</caption><tbody><tr><td colspan="2" class="infobox-image"><span typeof="mw:File"><a href="/wiki/File:Nurse_in_geriatry.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/b/b9/Nurse_in_geriatry.jpg/330px-Nurse_in_geriatry.jpg" decoding="async" width="300" height="225" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/b/b9/Nurse_in_geriatry.jpg/500px-Nurse_in_geriatry.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/b/b9/Nurse_in_geriatry.jpg/600px-Nurse_in_geriatry.jpg 2x" data-file-width="640" data-file-height="480" /></a></span><div class="infobox-caption" style="padding-top:0.25em;padding-bottom:0.4em;">An elderly woman in a residential care home receiving a birthday cake</div></td></tr><tr><th scope="row" class="infobox-label" style="padding-top:0.185em;line-height:1.15em; padding-right:0.5em;">Significant <span style="padding-left:1px;">diseases</span></th><td class="infobox-data" style="line-height:1.3em;"><a href="/wiki/Dementia" title="Dementia">Dementia</a>, <a href="/wiki/Arthritis" title="Arthritis">arthritis</a>, <a href="/wiki/Osteoporosis" title="Osteoporosis">osteoporosis</a>, <a href="/wiki/Osteoarthritis" title="Osteoarthritis">osteoarthritis</a>, <a href="/wiki/Rheumatoid_arthritis" title="Rheumatoid arthritis">rheumatoid arthritis</a>, <a href="/wiki/Parkinson%27s_disease" title="Parkinson's disease">Parkinson's disease</a>, <a href="/wiki/Atherosclerosis" title="Atherosclerosis">atherosclerosis</a>, <a href="/wiki/Heart_disease" class="mw-redirect" title="Heart disease">heart disease</a>, <a href="/wiki/High_blood_pressure" class="mw-redirect" title="High blood pressure">high blood pressure</a></td></tr><tr><th scope="row" class="infobox-label" style="padding-top:0.185em;line-height:1.15em; padding-right:0.5em;">Specialist</th><td class="infobox-data" style="line-height:1.3em;">Geriatrician</td></tr></tbody></table> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1257001546" /><table class="infobox"><caption class="infobox-title">Geriatrician</caption><tbody><tr><th colspan="2" class="infobox-header">Occupation</th></tr><tr><th scope="row" class="infobox-label">Names</th><td class="infobox-data"> <ul><li>Physician</li></ul> </td></tr><tr><th scope="row" class="infobox-label"><div style="display: inline-block; line-height: 1.2em; padding: .1em 0;">Occupation type</div></th><td class="infobox-data"><a href="/wiki/Specialty_(medicine)" class="mw-redirect" title="Specialty (medicine)">Specialty</a></td></tr><tr><th scope="row" class="infobox-label"><div style="display: inline-block; line-height: 1.2em; padding: .1em 0;">Activity sectors</div></th><td class="infobox-data"><a href="/wiki/Medicine" title="Medicine">Medicine</a></td></tr><tr><th colspan="2" class="infobox-header">Description</th></tr><tr><th scope="row" class="infobox-label"><div style="display: inline-block; line-height: 1.2em; padding: .1em 0;">Education required</div></th><td class="infobox-data"> <ul><li><a href="/wiki/Doctor_of_Medicine" title="Doctor of Medicine">Doctor of Medicine</a> (M.D.)</li> <li><a href="/wiki/Doctor_of_Osteopathic_medicine" class="mw-redirect" title="Doctor of Osteopathic medicine">Doctor of Osteopathic medicine</a> (D.O.)</li> <li><a href="/wiki/Bachelor_of_Medicine,_Bachelor_of_Surgery" title="Bachelor of Medicine, Bachelor of Surgery">Bachelor of Medicine, Bachelor of Surgery</a> (M.B.B.S.)</li> <li><a href="/wiki/Bachelor_of_Medicine,_Bachelor_of_Surgery" title="Bachelor of Medicine, Bachelor of Surgery">Bachelor of Medicine, Bachelor of Surgery</a> (MBChB)</li></ul> </td></tr><tr><th scope="row" class="infobox-label"><div style="display: inline-block; line-height: 1.2em; padding: .1em 0;">Fields of<br />employment</div></th><td class="infobox-data"><a href="/wiki/Hospital" title="Hospital">Hospitals</a>, <a href="/wiki/Clinic" title="Clinic">Clinics</a></td></tr></tbody></table> <p><b>Geriatrics</b>, or <b>geriatric medicine</b>,<sup id="cite_ref-1" class="reference"><a href="#cite_note-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> is a medical specialty focused on addressing the unique health needs of older adults.<sup id="cite_ref-2" class="reference"><a href="#cite_note-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> The term <i>geriatrics</i> originates from the <a href="/wiki/Greek_language" title="Greek language">Greek</a> γέρων <i>geron</i> meaning "old man", and ιατρός <i>iatros</i> meaning "healer". It aims to promote <a href="/wiki/Health" title="Health">health</a> by <a href="/wiki/Prevention_(medical)" class="mw-redirect" title="Prevention (medical)">preventing</a>, diagnosing and treating <a href="/wiki/Disease" title="Disease">disease</a> in <a href="/wiki/Older_adults" class="mw-redirect" title="Older adults">older adults</a>.<sup id="cite_ref-3" class="reference"><a href="#cite_note-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> Older adults may be healthy, but they're more likely to have chronic health concerns and require more medical care. <sup id="cite_ref-4" class="reference"><a href="#cite_note-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup>There is not a defined <a href="/wiki/Ageing" title="Ageing">age</a> at which <a href="/wiki/Patient" title="Patient">patients</a> may be under the care of a <b>geriatrician</b>, or <b>geriatric physician</b>, a physician who specializes in the care of older people. Rather, this decision is guided by individual patient needs and the caregiving structures available to them. This care may benefit those who are managing <a href="/wiki/Multimorbidity" title="Multimorbidity">multiple chronic conditions</a> or experiencing significant age-related complications that threaten quality of daily life. Geriatric care may be indicated if caregiving responsibilities become increasingly stressful or medically complex for family and caregivers to manage independently.<sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p><p>There is a distinction between geriatrics and <a href="/wiki/Gerontology" title="Gerontology">gerontology</a>. Gerontology is the multidisciplinary study of the <a href="/wiki/Aging" class="mw-redirect" title="Aging">aging</a> process, defined as the decline in organ function over time in the absence of injury, illness, environmental risks or behavioral risk factors.<sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> However, geriatrics is sometimes called <b>medical gerontology</b>. </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Scope">Scope</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Geriatrics&action=edit&section=1" title="Edit section: Scope"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure typeof="mw:File/Thumb"><a href="/wiki/File:Nursing_home.JPG" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/8/87/Nursing_home.JPG/300px-Nursing_home.JPG" decoding="async" width="300" height="200" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/8/87/Nursing_home.JPG/450px-Nursing_home.JPG 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/8/87/Nursing_home.JPG/600px-Nursing_home.JPG 2x" data-file-width="3504" data-file-height="2336" /></a><figcaption>Elderly man at a <a href="/wiki/Nursing_home" title="Nursing home">nursing home</a> in <a href="/wiki/Norway" title="Norway">Norway</a></figcaption></figure> <div class="mw-heading mw-heading3"><h3 id="Differences_between_adult_and_geriatric_medicine">Differences between adult and geriatric medicine</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Geriatrics&action=edit&section=2" title="Edit section: Differences between adult and geriatric medicine"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Geriatric providers receive specialized training in caring for elderly patients and promoting healthy aging. The care provided is largely based on shared-decision making and is driven by patient goals and preferences, which can vary from preserving function, improving quality of life, or prolonging years of life. A guiding <a href="/wiki/Mnemonic" title="Mnemonic">mnemonic</a> commonly used by geriatricians in the United States and Canada is the 5 M's of Geriatrics which describes mind, mobility, multicomplexity, <a href="/wiki/Medication" title="Medication">medications</a> and matters most to elicit patient values.<sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> </p><p>It is common for <a href="/wiki/Old_age" title="Old age">elderly</a> adults to be managing multiple long-term conditions (multimorbidity). Age-associated changes in physiology drive a compounded increase in susceptibility to illness, disease-associated morbidity, and death. Moreover, common diseases may present atypically in elderly patients, adding further <a href="/wiki/Diagnosis" title="Diagnosis">diagnostic</a> and therapeutic complexity to patient care. </p><p>Geriatrics is highly interdisciplinary consisting of specialty providers from the fields of medicine, nursing, pharmacy, social work, and physical and occupational therapy. Elderly patients can receive care related to medication management, pain management, psychiatric and memory care, rehabilitation, long-term nursing care, nutrition, and different forms of therapy including physical, occupational, and speech. Non-medical considerations include social services, transitional care, advanced directives, power of attorney, and other legal considerations. </p> <div class="mw-heading mw-heading3"><h3 id="Increased_complexity">Increased complexity</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Geriatrics&action=edit&section=3" title="Edit section: Increased complexity"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The decline in physiological reserve in organs makes the elderly develop some kinds of diseases and have more complications from mild problems (such as <a href="/wiki/Dehydration" title="Dehydration">dehydration</a> from a mild <a href="/wiki/Gastroenteritis" title="Gastroenteritis">gastroenteritis</a>). Multiple problems may compound: A mild <a href="/wiki/Fever" title="Fever">fever</a> in elderly persons may cause <a href="/wiki/Confusion" title="Confusion">confusion</a>, which can advance to a fall and to a fracture of the <a href="/wiki/Femur_neck" class="mw-redirect" title="Femur neck">neck of the femur</a> ("broken hip").The presentation of disease in elderly persons may be vague and non-specific, or it may include <a href="/wiki/Delirium" title="Delirium">delirium</a> or falls. (<a href="/wiki/Pneumonia" title="Pneumonia">Pneumonia</a>, for example, may present with low-grade <a href="/wiki/Fever" title="Fever">fever</a> and <a href="/wiki/Confusion" title="Confusion">confusion</a>, rather than the high fever and cough seen in younger people.) Some elderly people may find it hard to describe their <a href="/wiki/Symptoms" class="mw-redirect" title="Symptoms">symptoms</a> in words, especially if the disease is causing confusion, or if they have <a href="/wiki/Cognitive_impairment" title="Cognitive impairment">cognitive impairment</a>. <a href="/wiki/Delirium" title="Delirium">Delirium</a> in the elderly may be caused by a minor problem such as <a href="/wiki/Constipation" title="Constipation">constipation</a> or by something as serious and life-threatening as a <a href="/wiki/Myocardial_infarction" title="Myocardial infarction">heart attack</a>. Many of these problems are treatable, if the root cause can be discovered. </p> <div class="mw-heading mw-heading3"><h3 id="Cognition">Cognition</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Geriatrics&action=edit&section=4" title="Edit section: Cognition"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Cognitive aging is characterized by declines in fluid abilities like processing speed, working memory, and executive function, while crystallized abilities such as knowledge remain stable (Anstey & Low, 2004; Murman, 2015). Age-related changes in brain structure and function correlate with these cognitive declines (Murman, 2015). Older adults show weaker occipital activity and stronger prefrontal and parietal activity during cognitive tasks, possibly reflecting compensation (Cabeza et al., 2004). Subjective cognitive complaints are common among older adults, particularly regarding working memory (Newson & Kemps, 2006). Various factors influence cognitive aging, including genetics, lifestyle, and health (Bäckman et al., 2004). Cognitive impairments can progress to <a href="/wiki/Mild_cognitive_impairment" title="Mild cognitive impairment">mild cognitive impairment (MCI)</a> or <a href="/wiki/Dementia" title="Dementia">dementia</a> (Mendoza-Ruvalcaba et al., 2018). </p><p>MCI is a transitional state between normal aging and Dementia, affecting 10-20% of adults over 65 (Schwarz, 2015). Geriatricians encounter MCI patients in various care settings, with <b>diagnoses</b> relying on clinical assessment and mental status examinations (Tangalos & Petersen, 2018). MCI is highly prevalent among older adults with depression and may persist after depression remits (Lee et al., 2006). While MCI is considered a high-risk condition for developing <a href="/wiki/Alzheimer%27s_disease" title="Alzheimer's disease">Alzheimer's disease</a>, there is heterogeneity in its presentation and outcomes (Petersen et al., 2001). </p><p>Dementia is a prevalent condition in geriatric populations, affecting cognitive function and daily activities (Talawar, 2018; Mirzapure et al., 2022). Alzheimer's disease is the most common cause, accounting for 40-80% of cases (Mirzapure et al., 2022; Chulakadabba et al., 2020). Geriatric patients with dementia often have comorbidities and other geriatric syndromes, requiring holistic and integrated care (Chulakadabba et al., 2020; Nguyen et al., 2023). Geriatricians play a crucial role in dementia care, but many feel current training is inadequate and seek more structured experiences (Mayne et al., 2014). Improving access to geriatricians and enhancing general practitioners' diagnostic skills could improve timely and accurate dementia diagnosis (Mansfield et al., 2022). However, there are significant shortages of dementia specialists, particularly in rural areas (Liu et al., 2024; Christley et al., 2022). Geriatricians support comprehensive post-diagnosis information provision, including sensitive topics like advance care planning (Mansfield et al., 2022). Collaboration between specialists and family physicians is essential, with specialists often handling contentious issues like driving competency (Hum et al., 2014). Geriatric training may influence end-of-life care patterns for dementia patients (Gotanda et al., 2023). A geriatrics perspective emphasizes prevention, considering lifestyle factors that promote healthy cognitive aging (Steffens, 2018). </p> <div class="mw-heading mw-heading3"><h3 id="Geriatric_pharmacology">Geriatric pharmacology</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Geriatrics&action=edit&section=5" title="Edit section: Geriatric pharmacology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Elderly people require specific attention to <a href="/wiki/Medications" class="mw-redirect" title="Medications">medications</a>. Elderly people particularly are subjected to <a href="/wiki/Polypharmacy" title="Polypharmacy">polypharmacy</a> (taking multiple medications) given their accumulation of multiple chronic diseases. Many of these individuals have also self-prescribed <a href="/wiki/Herbal_medication" class="mw-redirect" title="Herbal medication">herbal medications</a> and <a href="/wiki/Over-the-counter_drug" title="Over-the-counter drug">over-the-counter drugs</a>. This polypharmacy, in combination with geriatric status, may increase the risk of <a href="/wiki/Drug_interaction" title="Drug interaction">drug interactions</a> or <a href="/wiki/Adverse_drug_reaction" title="Adverse drug reaction">adverse drug reactions</a>.<sup id="cite_ref-8" class="reference"><a href="#cite_note-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Pharmacokinetics" title="Pharmacokinetics">Pharmacokinetic</a> and <a href="/wiki/Pharmacodynamics" title="Pharmacodynamics">pharmacodynamic</a> changes arise with older age, impairing their ability to metabolize and respond to drugs. Each of the four pharmacokinetic mechanisms (absorption, distribution, metabolism, excretion) is disrupted by age-related physiologic changes. For example, overall decreased hepatic function can interfere with clearance or metabolism of drugs and reductions in kidney function can affect renal elimination.<sup id="cite_ref-9" class="reference"><a href="#cite_note-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> Pharmacodynamic changes lead to altered sensitivity to drugs in geriatric patients, such as increased pain relief with <a href="/wiki/Morphine" title="Morphine">morphine</a> use.<sup id="cite_ref-10" class="reference"><a href="#cite_note-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> Therefore, geriatric individuals require specialized pharmacological care that is informed by these age-related changes. </p> <div class="mw-heading mw-heading3"><h3 id="Geriatric_syndromes">Geriatric syndromes</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Geriatrics&action=edit&section=6" title="Edit section: Geriatric syndromes"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Geriatric syndromes is a term used to describe a group of clinical conditions that are highly prevalent in elderly people.<sup id="cite_ref-11" class="reference"><a href="#cite_note-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-12" class="reference"><a href="#cite_note-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-13" class="reference"><a href="#cite_note-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> These syndromes are not caused by specific pathology or disease, rather, are a manifestation of multifactorial conditions affecting several organ systems. Common conditions include frailty, functional decline, falls, loss of continence, and malnutrition, amongst others.<sup id="cite_ref-14" class="reference"><a href="#cite_note-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Frailty">Frailty</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Geriatrics&action=edit&section=7" title="Edit section: Frailty"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Frailty is marked by a decline in physiological reserve, increased vulnerability to physiological and emotional stressors, and loss of function. This may present as progressive and unintentional weight loss, fatigue, muscular weakness, and decreased mobility.<sup id="cite_ref-15" class="reference"><a href="#cite_note-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> It is associated with increased injuries, hospitalization, and adverse clinical outcomes. </p> <div class="mw-heading mw-heading4"><h4 id="Functional_decline">Functional decline</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Geriatrics&action=edit&section=8" title="Edit section: Functional decline"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Functional disability can arise from a decline in physical function and/or cognitive function. It is associated with an acquired difficulty in performing basic everyday tasks resulting in an increased dependence of other individuals and/or medical devices.<sup id="cite_ref-Edemekong_2022_16-0" class="reference"><a href="#cite_note-Edemekong_2022-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-17" class="reference"><a href="#cite_note-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> These tasks are sub-divided into basic activities of daily living (ADL) and instrumental activities of daily living (IADL) and are commonly used as an indicator of a person's functional status. </p><p><a href="/wiki/Activities_of_daily_living" title="Activities of daily living">Activities of daily living (ADL)</a> are fundamental skills needed to care for oneself, including feeding, personal hygiene, toileting, transferring and ambulating. Instrumental activities of daily living (IADL) describe more complex skills needed to allow oneself to live independently in a community, including cooking, housekeeping, managing one's finances and medications. Routine monitoring of ADL and IADL is an important functional assessment used by clinicians to determine the extent of support and care to provide to elderly adults and their caregivers. It serves as a qualitative measurement of function over time and predicts the need for alternative living arrangements or models of care, including senior housing apartments, skilled nursing facilities, palliative, hospice or home-based care.<sup id="cite_ref-Edemekong_2022_16-1" class="reference"><a href="#cite_note-Edemekong_2022-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Falls">Falls</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Geriatrics&action=edit&section=9" title="Edit section: Falls"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951" /><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Falls_in_older_adults" title="Falls in older adults">Falls in older adults</a></div> <p>Falls are the leading cause of emergency department admissions and hospitalizations in adults age 65 and older, many of which result in significant injury and permanent disability.<sup id="cite_ref-18" class="reference"><a href="#cite_note-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> As certain risk factors can be modifiable for the purpose of reducing falls, this highlights an opportunity for intervention and risk reduction. Modifiable factors include: </p> <ul><li>Improving balance and muscle strength.</li> <li>Removing environmental hazards.</li> <li>Encouraging use of assistive devices.</li> <li>Treating chronic conditions.</li> <li>Adjusting medication.</li></ul> <div class="mw-heading mw-heading4"><h4 id="Urinary_incontinence">Urinary incontinence</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Geriatrics&action=edit&section=10" title="Edit section: Urinary incontinence"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Urinary_incontinence" title="Urinary incontinence">Urinary incontinence</a> or <a href="/wiki/Overactive_bladder" title="Overactive bladder">overactive bladder</a> symptoms is defined as unintentionally urinating oneself. These symptoms can be caused by medications that increase urine output and frequency (e.g. anti-hypertensives and diuretics), urinary tract infections, pelvic organ prolapse, pelvic floor dysfunction, and diseases that damage the nerves that regulate <a href="/wiki/Urinary_bladder" class="mw-redirect" title="Urinary bladder">bladder</a> emptying.<sup id="cite_ref-19" class="reference"><a href="#cite_note-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> Other <a href="/wiki/Human_musculoskeletal_system" title="Human musculoskeletal system">musculoskeletal</a> conditions affecting mobility should be considered, as these can make accessing bathrooms difficult. </p> <div class="mw-heading mw-heading4"><h4 id="Malnutrition">Malnutrition</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Geriatrics&action=edit&section=11" title="Edit section: Malnutrition"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Malnutrition" title="Malnutrition">Malnutrition</a> and poor nutritional status is an area of concern, affecting 12% to 50% of hospitalized elderly patients and 23% to 50% of institutionalized elderly patients living in long-term care facilities such as assisted living communities and skilled nursing facilities.<sup id="cite_ref-Evans_2005_38–41_20-0" class="reference"><a href="#cite_note-Evans_2005_38–41-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup> As malnutrition can occur due to a combination of physiologic, pathologic, psychologic and socioeconomic factors, it can be difficult to identify effective interventions.<sup id="cite_ref-21" class="reference"><a href="#cite_note-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup> Physiologic factors include reduced smell and taste, and a decreased metabolic rate affecting nutritional food intake. Unintentional weight loss can result from pathologic factors, including a wide range of chronic diseases that affect cognitive function, directly impact digestion (e.g. poor dentition, <a href="/wiki/Gastrointestinal_cancer" title="Gastrointestinal cancer">gastrointestinal cancers</a>, <a href="/wiki/Gastroesophageal_reflux_disease" title="Gastroesophageal reflux disease">gastroesophageal</a> reflux disease) or may be managed with dietary restrictions (e.g. congestive heart failure, diabetes mellitus, <a href="/wiki/Hypertension" title="Hypertension">hypertension</a>). Psychologic factors include conditions including depression, anorexia, and grief.<sup id="cite_ref-Evans_2005_38–41_20-1" class="reference"><a href="#cite_note-Evans_2005_38–41-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Practical_concerns">Practical concerns</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Geriatrics&action=edit&section=12" title="Edit section: Practical concerns"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Functional abilities, independence, and <a href="/wiki/Quality_of_life" title="Quality of life">quality of life</a> issues are central concerns to geriatricians and their patients. Elderly people generally want to live independently as long as possible, which requires them to be able to engage in <a href="/wiki/Self-care" title="Self-care">self-care</a> and other <a href="/wiki/Activities_of_daily_living" title="Activities of daily living">activities of daily living</a>. A geriatrician may be able to provide information about <a href="/wiki/Elder_care" class="mw-redirect" title="Elder care">elder care</a> options, and refer people to <a href="/wiki/Home_care" title="Home care">home care</a> services, <a href="/wiki/Skilled_nursing_facilities" class="mw-redirect" title="Skilled nursing facilities">skilled nursing facilities</a>, <a href="/wiki/Assisted_living_facilities" class="mw-redirect" title="Assisted living facilities">assisted living facilities</a>, and <a href="/wiki/Hospice" title="Hospice">hospice</a> as appropriate. </p><p><a href="/wiki/Frailty_syndrome" title="Frailty syndrome">Frail elderly</a> individuals may choose to decline some kinds of medical care, because the risk-benefit ratio is different. For example, frail elderly women routinely stop <a href="/wiki/Screening_mammogram" class="mw-redirect" title="Screening mammogram">screening mammograms</a>, because <a href="/wiki/Breast_cancer" title="Breast cancer">breast cancer</a> is typically a slowly growing disease that would cause them no pain, impairment, or loss of life before they would die of other causes. Frail people are also at significant risk of complications following surgery and the need for extended care, and an accurate prediction—based on validated measures, rather than how old the patient's face looks—can help older patients make fully informed choices about their options. Assessment of older patients before elective surgeries can accurately predict the patients' recovery trajectories.<sup id="cite_ref-Frailty_22-0" class="reference"><a href="#cite_note-Frailty-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup> One frailty scale uses five items: unintentional weight loss, <a href="/wiki/Muscle_weakness" title="Muscle weakness">muscle weakness</a>, exhaustion, low physical activity, and slowed walking speed. A healthy person scores 0; a very frail person scores 5. Compared to non-frail elderly people, people with moderate frailty scores (2 or 3) are twice as likely to have post-surgical complications, spend 50% more time in the hospital, and are three times as likely to be discharged to a skilled nursing facility instead of to their own homes.<sup id="cite_ref-Frailty_22-1" class="reference"><a href="#cite_note-Frailty-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup> Frail elderly patients (score of 4 or 5) who were living at home before the surgery have even worse outcomes, with the risk of being discharged to a nursing home rising to twenty times the rate for non-frail elderly people. </p> <div class="mw-heading mw-heading2"><h2 id="Subspecialties_and_related_services">Subspecialties and related services</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Geriatrics&action=edit&section=13" title="Edit section: Subspecialties and related services"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Some diseases commonly seen in elderly are rare in adults, e.g., dementia, delirium, falls. As societies aged, many specialized geriatric- and geriatrics-related services emerged<sup id="cite_ref-23" class="reference"><a href="#cite_note-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-pmid10855612_24-0" class="reference"><a href="#cite_note-pmid10855612-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup> including: </p> <div class="mw-heading mw-heading3"><h3 id="Medical">Medical</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Geriatrics&action=edit&section=14" title="Edit section: Medical"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a href="/wiki/Geriatric_cardiology" class="mw-redirect" title="Geriatric cardiology">Geriatric cardiology</a> or <a href="/wiki/Cardiogeriatrics" title="Cardiogeriatrics">cardiogeriatrics</a>.</li> <li><a href="/wiki/Geriatric_dentistry" title="Geriatric dentistry">Geriatric dentistry</a>.</li> <li><a href="/wiki/Geriatric_dermatology" class="mw-redirect" title="Geriatric dermatology">Geriatric dermatology</a>.</li> <li>Geriatric diagnostic imaging.</li> <li>Geriatric emergency medicine.</li> <li><a href="/wiki/Geriatric_nephrology" title="Geriatric nephrology">Geriatric nephrology</a>.</li> <li><a href="/wiki/Geriatric_neurology" title="Geriatric neurology">Geriatric neurology</a>.</li> <li><a href="/wiki/Geriatric_oncology" title="Geriatric oncology">Geriatric oncology</a>.</li> <li>Geriatric physical examination of interest especially to physicians & physician assistants.</li> <li><a href="/wiki/Geriatric_psychiatry" title="Geriatric psychiatry">Geriatric psychiatry</a> or <a href="/wiki/Geriatric_psychiatry" title="Geriatric psychiatry">psychogeriatrics</a> (focus on <a href="/wiki/Dementia" title="Dementia">dementia</a>, <a href="/wiki/Delirium" title="Delirium">delirium</a>, <a href="/wiki/Clinical_depression" class="mw-redirect" title="Clinical depression">depression</a> and other psychiatric disorders).</li> <li>Geriatric public health or preventive geriatrics</li> <li><a href="/wiki/Geriatric_rehabilitation" title="Geriatric rehabilitation">Geriatric rehabilitation</a>.</li> <li><a href="/wiki/Geriatric_rheumatology" title="Geriatric rheumatology">Geriatric rheumatology</a> (focus on joints and soft tissue disorders in elderly).</li> <li><a href="/wiki/Geriatric_sexology" class="mw-redirect" title="Geriatric sexology">Geriatric sexology</a> (focus on sexuality in aged people).</li> <li>Geriatric subspeciality medical clinics (such as geriatric anticoagulation clinic, geriatric assessment clinic, falls and balance clinic, continence clinic, palliative care clinic, elderly pain clinic, cognition and memory disorders clinic).</li></ul> <div class="mw-heading mw-heading3"><h3 id="Surgical">Surgical</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Geriatrics&action=edit&section=15" title="Edit section: Surgical"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li>Geriatric orthopaedics or orthogeriatrics (close cooperation with <a href="/wiki/Orthopedic_surgery" title="Orthopedic surgery">orthopedic surgery</a> and a focus on <a href="/wiki/Osteoporosis" title="Osteoporosis">osteoporosis</a> and rehabilitation).</li> <li>Geriatric cardiothoracic surgery.</li> <li>Geriatric urology.</li> <li>Geriatric otolaryngology.</li> <li>Geriatric general surgery.</li> <li><a href="/wiki/Geriatric_trauma" title="Geriatric trauma">Geriatric trauma</a>.</li> <li>Geriatric gynecology.</li> <li>Geriatric ophthalmology.</li> <li>Perioperative medicine for Older People having Surgery (POPS)</li></ul> <div class="mw-heading mw-heading3"><h3 id="Other_geriatrics_subspecialties">Other geriatrics subspecialties</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Geriatrics&action=edit&section=16" title="Edit section: Other geriatrics subspecialties"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a href="/wiki/Geriatric_anesthesia" title="Geriatric anesthesia">Geriatric anesthesia</a> (focuses on <a href="/wiki/Anesthesia" title="Anesthesia">anesthesia</a> & perioperative care of elderly).</li> <li><a href="/wiki/Geriatric_intensive-care_unit" title="Geriatric intensive-care unit">Geriatric intensive-care unit</a>: (a special type of <a href="/wiki/Intensive_care_unit" title="Intensive care unit">intensive care unit</a> dedicated to critically ill elderly).</li> <li><a href="/wiki/Geriatric_nursing" class="mw-redirect" title="Geriatric nursing">Geriatric nursing</a> (focuses on nursing of elderly patients and the aged).</li> <li>Geriatric nutrition.</li> <li>Geriatric occupational therapy.</li> <li>Geriatric pain management.</li> <li>Geriatric pharmacy.</li> <li>Geriatric <a href="/wiki/Optometry" title="Optometry">optometry</a>.</li> <li>Geriatric physical therapy.</li> <li>Geriatric <a href="/wiki/Podiatry" title="Podiatry">podiatry</a>.</li> <li><a href="/wiki/Geriatric_psychology" title="Geriatric psychology">Geriatric psychology</a>.</li> <li>Geriatric speech-language <a href="/wiki/Pathology" title="Pathology">pathology</a> (focuses on neurological disorders such as dysphagia, stroke, aphasia, and traumatic brain injury).</li> <li>Geriatric mental health counselor/specialist (focuses on treatment more so than assessment).</li> <li>Geriatric audiology.</li></ul> <div class="mw-heading mw-heading2"><h2 id="History">History</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Geriatrics&action=edit&section=17" title="Edit section: History"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1251242444">.mw-parser-output .ambox{border:1px solid #a2a9b1;border-left:10px solid #36c;background-color:#fbfbfb;box-sizing:border-box}.mw-parser-output .ambox+link+.ambox,.mw-parser-output .ambox+link+style+.ambox,.mw-parser-output .ambox+link+link+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+style+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+link+.ambox{margin-top:-1px}html body.mediawiki .mw-parser-output .ambox.mbox-small-left{margin:4px 1em 4px 0;overflow:hidden;width:238px;border-collapse:collapse;font-size:88%;line-height:1.25em}.mw-parser-output .ambox-speedy{border-left:10px solid #b32424;background-color:#fee7e6}.mw-parser-output .ambox-delete{border-left:10px solid #b32424}.mw-parser-output .ambox-content{border-left:10px solid #f28500}.mw-parser-output .ambox-style{border-left:10px solid #fc3}.mw-parser-output .ambox-move{border-left:10px solid #9932cc}.mw-parser-output .ambox-protection{border-left:10px solid #a2a9b1}.mw-parser-output .ambox .mbox-text{border:none;padding:0.25em 0.5em;width:100%}.mw-parser-output .ambox .mbox-image{border:none;padding:2px 0 2px 0.5em;text-align:center}.mw-parser-output .ambox .mbox-imageright{border:none;padding:2px 0.5em 2px 0;text-align:center}.mw-parser-output .ambox .mbox-empty-cell{border:none;padding:0;width:1px}.mw-parser-output .ambox .mbox-image-div{width:52px}@media(min-width:720px){.mw-parser-output .ambox{margin:0 10%}}@media print{body.ns-0 .mw-parser-output .ambox{display:none!important}}</style><table class="box-Cite_check plainlinks metadata ambox ambox-content" role="presentation"><tbody><tr><td class="mbox-image"><div class="mbox-image-div"><span typeof="mw:File"><span><img src="//upload.wikimedia.org/wikipedia/commons/thumb/a/a4/Text_document_with_red_question_mark.svg/40px-Text_document_with_red_question_mark.svg.png" decoding="async" width="40" height="40" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/a/a4/Text_document_with_red_question_mark.svg/60px-Text_document_with_red_question_mark.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/a/a4/Text_document_with_red_question_mark.svg/80px-Text_document_with_red_question_mark.svg.png 2x" data-file-width="48" data-file-height="48" /></span></span></div></td><td class="mbox-text"><div class="mbox-text-span">This section <b>may contain <a href="/wiki/Wikipedia:CITE" class="mw-redirect" title="Wikipedia:CITE">citations</a> that do not <a href="/wiki/Wikipedia:V" class="mw-redirect" title="Wikipedia:V">verify</a> the text</b>.<span class="hide-when-compact"> Please <a class="external text" href="https://en.wikipedia.org/w/index.php?title=Geriatrics&action=edit">check for citation inaccuracies</a>.</span> <span class="date-container"><i>(<span class="date">September 2010</span>)</i></span><span class="hide-when-compact"><i> (<small><a href="/wiki/Help:Maintenance_template_removal" title="Help:Maintenance template removal">Learn how and when to remove this message</a></small>)</i></span></div></td></tr></tbody></table> <p>A number of physicians in the <a href="/wiki/Byzantine_Empire" title="Byzantine Empire">Byzantine Empire</a> studied geriatrics, with doctors like <a href="/wiki/A%C3%ABtius_of_Amida" title="Aëtius of Amida">Aëtius of Amida</a> evidently specializing in the field. <a href="/wiki/Alexander_of_Tralles" title="Alexander of Tralles">Alexander of Tralles</a> viewed the process of aging as a natural and inevitable form of <a href="/wiki/Marasmus" title="Marasmus">marasmus</a>, caused by the loss of moisture in body tissue.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (August 2022)">citation needed</span></a></i>]</sup><sup id="cite_ref-25" class="reference"><a href="#cite_note-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup> The works of Aëtius describe the mental and physical symptoms of aging. <a href="/wiki/Theophilus_Protospatharius" title="Theophilus Protospatharius">Theophilus Protospatharius</a> and <a href="/wiki/Joannes_Actuarius" title="Joannes Actuarius">Joannes Actuarius</a> also discussed the topic in their medical works. Byzantine physicians typically drew on the works of <a href="/wiki/Oribasius" title="Oribasius">Oribasius</a> and recommended that elderly patients consume a diet rich in foods that provide "heat and moisture". They also recommended frequent bathing, massaging, rest, and low-intensity exercise regimens.<sup id="cite_ref-26" class="reference"><a href="#cite_note-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup> </p><p>In <i><a href="/wiki/The_Canon_of_Medicine" title="The Canon of Medicine">The Canon of Medicine</a></i>, written by <a href="/wiki/Avicenna" title="Avicenna">Avicenna</a> in 1025, the author was concerned with how "old folk need plenty of sleep" and how their bodies should be <a href="/wiki/Anointing" title="Anointing">anointed</a> with <a href="/wiki/Oil" title="Oil">oil</a>, and recommended <a href="/wiki/Exercise" title="Exercise">exercises</a> such as <a href="/wiki/Walking" title="Walking">walking</a> or <a href="/wiki/Equestrianism" title="Equestrianism">horse-riding</a>. Thesis III of the <i>Canon</i> discussed the <a href="/wiki/Diet_(nutrition)" title="Diet (nutrition)">diet</a> suitable for <a href="/wiki/Old_age" title="Old age">old people</a>, and dedicated several sections to elderly patients who become <a href="/wiki/Constipation" title="Constipation">constipated</a>.<sup id="cite_ref-27" class="reference"><a href="#cite_note-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-28" class="reference"><a href="#cite_note-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-29" class="reference"><a href="#cite_note-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup> </p><p>The <a href="/wiki/Islamic_medicine" class="mw-redirect" title="Islamic medicine">Arab</a> physician <a href="/wiki/Ibn_Al-Jazzar" class="mw-redirect" title="Ibn Al-Jazzar">Algizar</a> (<abbr title="circa">c.</abbr><span style="white-space:nowrap;"> 898</span>–980) wrote a book on the medicine and health of the elderly.<sup id="cite_ref-Al_Jazzar_30-0" class="reference"><a href="#cite_note-Al_Jazzar-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-pmid11620335_31-0" class="reference"><a href="#cite_note-pmid11620335-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup> He also wrote a book on <a href="/wiki/Sleep_disorder" title="Sleep disorder">sleep disorders</a> and another one on <a href="/wiki/Forgetting" title="Forgetting">forgetfulness</a> and how to strengthen <a href="/wiki/Memory" title="Memory">memory</a>,<sup id="cite_ref-32" class="reference"><a href="#cite_note-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-33" class="reference"><a href="#cite_note-33"><span class="cite-bracket">[</span>33<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-34" class="reference"><a href="#cite_note-34"><span class="cite-bracket">[</span>34<span class="cite-bracket">]</span></a></sup> and a treatise on causes of <a href="/wiki/Death" title="Death">mortality</a>.<sup id="cite_ref-Al_Jazzar_30-1" class="reference"><a href="#cite_note-Al_Jazzar-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup> Another Arab physician in the 9th century, <a href="/wiki/Ishaq_ibn_Hunayn" title="Ishaq ibn Hunayn">Ishaq ibn Hunayn</a> (died 910), the son of Nestorian Christian scholar <a href="/wiki/Hunayn_Ibn_Ishaq" class="mw-redirect" title="Hunayn Ibn Ishaq">Hunayn Ibn Ishaq</a>, wrote a <i>Treatise on Drugs for Forgetfulness</i>.<sup id="cite_ref-35" class="reference"><a href="#cite_note-35"><span class="cite-bracket">[</span>35<span class="cite-bracket">]</span></a></sup> </p><p>George Day published the <i>Diseases of Advanced Life</i> in 1849, one of the first publications on the subject of geriatric medicine.<sup id="cite_ref-History_36-0" class="reference"><a href="#cite_note-History-36"><span class="cite-bracket">[</span>36<span class="cite-bracket">]</span></a></sup> The first modern geriatric hospital was founded in Belgrade, Serbia, in 1881 by doctor <a href="/wiki/Laza_Lazarevi%C4%87" title="Laza Lazarević">Laza Lazarević</a>.<sup id="cite_ref-37" class="reference"><a href="#cite_note-37"><span class="cite-bracket">[</span>37<span class="cite-bracket">]</span></a></sup> </p><p>The term <i>geriatrics</i> was proposed in <a href="/wiki/%C3%89lie_Metchnikoff" title="Élie Metchnikoff">1908 by Ilya Ilyich Mechnikov</a>, Laurate of the Nobel Prize for Medicine and later by 1909 by <a href="/wiki/Ignatz_Leo_Nascher" title="Ignatz Leo Nascher">Ignatz Leo Nascher</a>,<sup id="cite_ref-38" class="reference"><a href="#cite_note-38"><span class="cite-bracket">[</span>38<span class="cite-bracket">]</span></a></sup> former Chief of Clinic in the <a href="/wiki/Mount_Sinai_Hospital,_New_York" class="mw-redirect" title="Mount Sinai Hospital, New York">Mount Sinai Hospital</a> Outpatient Department (New York City) and a "father" of geriatrics in the United States.<sup id="cite_ref-39" class="reference"><a href="#cite_note-39"><span class="cite-bracket">[</span>39<span class="cite-bracket">]</span></a></sup> </p><p>Modern geriatrics in the United Kingdom began with the "mother"<sup id="cite_ref-mother_40-0" class="reference"><a href="#cite_note-mother-40"><span class="cite-bracket">[</span>40<span class="cite-bracket">]</span></a></sup> of geriatrics, <a href="/wiki/Marjory_Warren" title="Marjory Warren">Marjory Warren</a>.<sup id="cite_ref-History_36-1" class="reference"><a href="#cite_note-History-36"><span class="cite-bracket">[</span>36<span class="cite-bracket">]</span></a></sup> Warren emphasized that rehabilitation was essential to the care of older people. Using her experiences as a physician in a London Workhouse infirmary, she believed that merely keeping older people fed until they died was not enough; they needed diagnosis, treatment, care, and support. She found that patients, some of whom had previously been bedridden, were able to gain some degree of independence with the correct assessment and treatment.<sup id="cite_ref-41" class="reference"><a href="#cite_note-41"><span class="cite-bracket">[</span>41<span class="cite-bracket">]</span></a></sup> </p><p>The practice of geriatrics in the UK is also one with a rich multidisciplinary history. It values all the professions, not just medicine, for their contributions in optimizing the well-being and independence of older people. </p><p>Another innovator of British geriatrics is Bernard Isaacs, who described the "giants" of geriatrics mentioned above: immobility and instability, <a href="/wiki/Urinary_incontinence" title="Urinary incontinence">incontinence</a>, and <a href="/wiki/Dementia" title="Dementia">impaired intellect</a>.<sup id="cite_ref-42" class="reference"><a href="#cite_note-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-43" class="reference"><a href="#cite_note-43"><span class="cite-bracket">[</span>43<span class="cite-bracket">]</span></a></sup> Isaacs asserted that, if examined closely enough, all common problems with older people relate to one or more of these giants. </p><p>The care of older people in the UK has been advanced by the implementation of the National Service Frameworks for Older People, which outlines key areas for attention.<sup id="cite_ref-44" class="reference"><a href="#cite_note-44"><span class="cite-bracket">[</span>44<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Geriatrician_training">Geriatrician training</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Geriatrics&action=edit&section=18" title="Edit section: Geriatrician training"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="United_States">United States</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Geriatrics&action=edit&section=19" title="Edit section: United States"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In the <a href="/wiki/United_States" title="United States">United States</a>, geriatricians are <a href="/wiki/Primary-care_physician" class="mw-redirect" title="Primary-care physician">primary-care physicians</a> (<a href="/wiki/Doctor_of_Osteopathic_Medicine" title="Doctor of Osteopathic Medicine">D.O</a>. or <a href="/wiki/Doctor_of_Medicine" title="Doctor of Medicine">M.D.</a>) who are board-certified in either <a href="/wiki/Family_medicine" title="Family medicine">family medicine</a> or <a href="/wiki/Internal_medicine" title="Internal medicine">internal medicine</a> and who have also acquired the additional training necessary to obtain the Certificate of Added Qualifications (CAQ) in geriatric medicine. Geriatricians have developed an expanded expertise in the aging process, the impact of aging on illness patterns, drug therapy in seniors, health maintenance, and <a href="/wiki/Rehabilitation_(penology)" title="Rehabilitation (penology)">rehabilitation</a>. They serve in a variety of roles including hospital care, long-term care, home care, and terminal care. They are frequently involved in ethics consultations to represent the unique health and diseases patterns seen in seniors. The model of care practiced by geriatricians is heavily focused on addressing working closely with other disciplines such as nurses, <a href="/wiki/Clinical_pharmacy" title="Clinical pharmacy">pharmacists</a>, therapists, and social workers. </p> <div class="mw-heading mw-heading3"><h3 id="United_Kingdom">United Kingdom</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Geriatrics&action=edit&section=20" title="Edit section: United Kingdom"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In the United Kingdom, most geriatricians are hospital physicians, whereas others focus on community geriatrics in particular. Although originally a distinct clinical specialty, it has been integrated as a specialization of general medicine since the late 1970s.<sup id="cite_ref-45" class="reference"><a href="#cite_note-45"><span class="cite-bracket">[</span>45<span class="cite-bracket">]</span></a></sup> Most geriatricians are, therefore, accredited for both. Unlike in the United States, geriatric medicine is a major specialty in the United Kingdom and are the single most numerous internal medicine specialists. </p> <div class="mw-heading mw-heading3"><h3 id="Canada">Canada</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Geriatrics&action=edit&section=21" title="Edit section: Canada"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In <a href="/wiki/Canada" title="Canada">Canada</a>, there are two pathways that can be followed in order to work as a physician in a geriatric setting. </p> <ol><li>Doctors of Medicine (M.D.) can complete a three-year core internal medicine residency program, followed by two years of specialized geriatrics residency training. This pathway leads to certification, and possibly fellowship after several years of supplementary academic training, by the <a href="/wiki/Royal_College_of_Physicians_and_Surgeons_of_Canada" title="Royal College of Physicians and Surgeons of Canada">Royal College of Physicians and Surgeons of Canada</a>.</li> <li>Doctors of Medicine (M.D.) can opt for a two-year residency program in family medicine and complete a one-year enhanced skills program in <a href="/wiki/Care_of_the_elderly" class="mw-redirect" title="Care of the elderly">care of the elderly</a>. This post-doctoral pathway is accredited by the <a href="/wiki/College_of_Family_Physicians_of_Canada" title="College of Family Physicians of Canada">College of Family Physicians of Canada</a>.</li></ol> <p>Many universities across Canada also offer gerontology training programs for the general public, such that <a href="/wiki/Nurses" class="mw-redirect" title="Nurses">nurses</a> and other health care professionals can pursue further education in the discipline in order to better understand the process of aging and their role in the presence of older patients and residents. </p> <div class="mw-heading mw-heading3"><h3 id="India">India</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Geriatrics&action=edit&section=22" title="Edit section: India"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In India, Geriatrics is a relatively new speciality offering. A three-year post graduate residency (M.D) training can be joined for after completing the 5.5-year undergraduate training of <a href="/wiki/MBBS" class="mw-redirect" title="MBBS">MBBS</a> (Bachelor of Medicine and Bachelor of Surgery). Unfortunately, only eight major institutes provide M.D in Geriatric Medicine and subsequent training. Training in some institutes are exclusive in the Department of Geriatric Medicine, with rotations in Internal medicine, medical subspecialties etc. but in certain institutions, are limited to 2-year training in Internal medicine and subspecialities followed by one year of exclusive training in Geriatric Medicine. </p> <div class="mw-heading mw-heading2"><h2 id="Minimum_geriatric_competencies">Minimum geriatric competencies</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Geriatrics&action=edit&section=23" title="Edit section: Minimum geriatric competencies"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In July 2007, the <a href="/wiki/Association_of_American_Medical_Colleges" title="Association of American Medical Colleges">Association of American Medical Colleges</a> (AAMC) and the <a href="/wiki/John_A._Hartford_Foundation" title="John A. Hartford Foundation">John A. Hartford Foundation</a><sup id="cite_ref-46" class="reference"><a href="#cite_note-46"><span class="cite-bracket">[</span>46<span class="cite-bracket">]</span></a></sup> hosted a National Consensus Conference on Competencies in Geriatric Education where a consensus was reached on minimum competencies (learning outcomes) that graduating medical students needed to assure competent care by new interns to older patients. Twenty-six (26) Minimum Geriatric Competencies in eight content domains were endorsed by the <a href="/wiki/American_Geriatrics_Society" title="American Geriatrics Society">American Geriatrics Society</a> (AGS), the <a href="/wiki/American_Medical_Association" title="American Medical Association">American Medical Association</a> (AMA), and the Association of Directors of Geriatric Academic Programs (ADGAP). The domains are: cognitive and behavioral disorders; medication management; self-care capacity; falls, balance, gait disorders; atypical presentation of disease; palliative care; hospital care for elders, and health care planning and promotion. Each content domain specifies three or more observable, measurable competencies. </p> <div class="mw-heading mw-heading2"><h2 id="Research">Research</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Geriatrics&action=edit&section=24" title="Edit section: Research"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Changes in physiology with aging may alter the absorption, the effectiveness and the side effect profile of many drugs. These changes may occur in oral protective reflexes (dryness of the mouth caused by diminished salivary glands), in the gastrointestinal system (such as with delayed emptying of solids and liquids possibly restricting speed of absorption), and in the distribution of drugs with changes in <a href="/wiki/Body_fat" class="mw-redirect" title="Body fat">body fat</a> and muscle and drug elimination.<sup id="cite_ref-47" class="reference"><a href="#cite_note-47"><span class="cite-bracket">[</span>47<span class="cite-bracket">]</span></a></sup> </p><p>Psychological considerations include the fact that elderly persons (in particular, those experiencing substantial memory loss or other types of cognitive impairment) are unlikely to be able to adequately monitor and adhere to their own scheduled <a href="/wiki/Pharmacological" class="mw-redirect" title="Pharmacological">pharmacological</a> administration. One study (Hutchinson et al., 2006) found that 25% of participants studied admitted to skipping doses or cutting them in half. Self-reported noncompliance with adherence to a medication schedule was reported by a striking one-third of the participants. Further development of methods that might possibly help monitor and regulate dosage administration and scheduling is an area that deserves attention.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (October 2022)">citation needed</span></a></i>]</sup> </p><p>Another important area is the potential for improper administration and use of potentially inappropriate medications, and the possibility of errors that could result in dangerous drug interactions. Polypharmacy is often a predictive factor.<sup id="cite_ref-48" class="reference"><a href="#cite_note-48"><span class="cite-bracket">[</span>48<span class="cite-bracket">]</span></a></sup> Research done on home/community health care found that "nearly 1 of 3 medical regimens contain a potential medication error".<sup id="cite_ref-49" class="reference"><a href="#cite_note-49"><span class="cite-bracket">[</span>49<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Ethical_and_medico-legal_issues">Ethical and medico-legal issues</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Geriatrics&action=edit&section=25" title="Edit section: Ethical and medico-legal issues"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Elderly persons sometimes cannot make decisions for themselves. They may have previously prepared a <a href="/wiki/Power_of_attorney" title="Power of attorney">power of attorney</a> and <a href="/wiki/Advance_directives" class="mw-redirect" title="Advance directives">advance directives</a> to provide guidance if they are unable to understand what is happening to them, whether this is due to long-term dementia or to a short-term, correctable problem, such as <a href="/wiki/Delirium" title="Delirium">delirium</a> from a fever. </p><p><a href="/wiki/Geriatricians" class="mw-redirect" title="Geriatricians">Geriatricians</a> must respect the patients' privacy while seeing that they receive appropriate and necessary services. More than most specialties, they must consider whether the patient has the legal <a href="/wiki/Moral_responsibility" title="Moral responsibility">responsibility</a> and <a href="/wiki/Competence_(law)" title="Competence (law)">competence</a> to understand the facts and make decisions. They must support <a href="/wiki/Informed_consent" title="Informed consent">informed consent</a> and resist the temptation to manipulate the patient by withholding information, such as the dismal <a href="/wiki/Prognosis" title="Prognosis">prognosis</a> for a condition or the likelihood of recovering from surgery at home. </p><p><a href="/wiki/Elder_abuse" title="Elder abuse">Elder abuse</a> is the physical, financial, emotional, sexual, or other type of abuse of an older dependent. Adequate training, services, and support can reduce the likelihood of elder abuse, and proper attention can often identify it. For elderly people who are unable to care for themselves, geriatricians may recommend <a href="/wiki/Legal_guardianship" class="mw-redirect" title="Legal guardianship">legal guardianship</a> or <a href="/wiki/Conservatorship" title="Conservatorship">conservatorship</a> to care for the person or the estate. </p><p>Elder abuse occurs increasingly when caregivers of elderly relatives have a mental illness. These instances of abuse can be prevented by engaging these individuals with mental illness in mental health treatment. Additionally, interventions aimed at decreasing elder reliance on relatives may help decrease conflict and abuse. Family education and support programs conducted by mental health professionals may also be beneficial for elderly patients to learn how to set limits with relatives with psychiatric disorders without causing conflict that leads to abuse.<sup id="cite_ref-50" class="reference"><a href="#cite_note-50"><span class="cite-bracket">[</span>50<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="See_also">See also</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Geriatrics&action=edit&section=26" title="Edit section: See also"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1184024115">.mw-parser-output .div-col{margin-top:0.3em;column-width:30em}.mw-parser-output .div-col-small{font-size:90%}.mw-parser-output .div-col-rules{column-rule:1px solid #aaa}.mw-parser-output .div-col dl,.mw-parser-output .div-col ol,.mw-parser-output .div-col ul{margin-top:0}.mw-parser-output .div-col li,.mw-parser-output .div-col dd{page-break-inside:avoid;break-inside:avoid-column}</style><div class="div-col" style="column-width: 20em;"> <ul><li><a href="/wiki/Aging_in_Place" class="mw-redirect" title="Aging in Place">Aging in Place</a></li> <li><a href="/wiki/Aging-associated_diseases" title="Aging-associated diseases">Aging-associated diseases</a></li> <li><a href="/wiki/Alliance_for_Aging_Research" title="Alliance for Aging Research">Alliance for Aging Research</a></li> <li>Commission for Certification in Geriatric Pharmacy</li> <li><a href="/wiki/Elderly_care" title="Elderly care">Elderly care</a></li> <li><a href="/wiki/Gero-Informatics" class="mw-redirect" title="Gero-Informatics">Gero-Informatics</a></li> <li><a href="/wiki/GERRI" title="GERRI">GERRI</a></li> <li><a href="/wiki/Nosokinetics" title="Nosokinetics">Nosokinetics</a></li> <li><a href="/wiki/Life_extension" title="Life extension">Life extension</a></li> <li><a href="/wiki/Geriatric_medicine_in_Egypt" title="Geriatric medicine in Egypt">Geriatric medicine in Egypt</a></li> <li><a href="/wiki/Transgenerational_design" title="Transgenerational design">Transgenerational design</a></li> <li><i><a href="/wiki/Physical_%26_Occupational_Therapy_in_Geriatrics" title="Physical & Occupational Therapy in Geriatrics">Physical & Occupational Therapy in Geriatrics</a></i> (journal)</li> <li><a href="/wiki/Gerontological_nursing" title="Gerontological nursing">Gerontological nursing</a></li> <li><a href="/wiki/Geriatric_Dentistry" class="mw-redirect" title="Geriatric Dentistry">Geriatric Dentistry</a></li> <li><a href="/wiki/Activist_Ageing" class="mw-redirect" title="Activist Ageing">Activist Ageing</a></li></ul></div> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Geriatrics&action=edit&section=27" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist reflist-columns references-column-width" style="column-width: 30em;"> <ol class="references"> <li id="cite_note-1"><span class="mw-cite-backlink"><b><a href="#cite_ref-1">^</a></b></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output 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"Potentially inappropriate medication use in elderly patients receiving home health care: a retrospective data analysis". <i>The American Journal of Geriatric Pharmacotherapy</i>. <b>4</b> (2): <span class="nowrap">134–</span>143. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.amjopharm.2006.06.010">10.1016/j.amjopharm.2006.06.010</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/16860260">16860260</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+American+Journal+of+Geriatric+Pharmacotherapy&rft.atitle=Potentially+inappropriate+medication+use+in+elderly+patients+receiving+home+health+care%3A+a+retrospective+data+analysis&rft.volume=4&rft.issue=2&rft.pages=%3Cspan+class%3D%22nowrap%22%3E134-%3C%2Fspan%3E143&rft.date=2006-06&rft_id=info%3Adoi%2F10.1016%2Fj.amjopharm.2006.06.010&rft_id=info%3Apmid%2F16860260&rft.aulast=Cannon&rft.aufirst=KT&rft.au=Choi%2C+MM&rft.au=Zuniga%2C+MA&rfr_id=info%3Asid%2Fen.wikipedia.org%3AGeriatrics" class="Z3988"></span></span> </li> <li id="cite_note-49"><span class="mw-cite-backlink"><b><a href="#cite_ref-49">^</a></b></span> <span class="reference-text">Choi et al., 2006.<sup class="noprint Inline-Template" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citing_sources#What_information_to_include" title="Wikipedia:Citing sources"><span title="A complete citation is needed. (January 2025)">full citation needed</span></a></i>]</sup></span> </li> <li id="cite_note-50"><span class="mw-cite-backlink"><b><a href="#cite_ref-50">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite id="CITEREFLabrum2017" class="citation journal cs1">Labrum T (2017). "Factors related to abuse of older persons by relatives with psychiatric disorders". <i>Archives of Gerontology and Geriatrics</i>. <b>68</b>: <span class="nowrap">126–</span>134. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.archger.2016.09.007">10.1016/j.archger.2016.09.007</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/27810660">27810660</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Archives+of+Gerontology+and+Geriatrics&rft.atitle=Factors+related+to+abuse+of+older+persons+by+relatives+with+psychiatric+disorders&rft.volume=68&rft.pages=%3Cspan+class%3D%22nowrap%22%3E126-%3C%2Fspan%3E134&rft.date=2017&rft_id=info%3Adoi%2F10.1016%2Fj.archger.2016.09.007&rft_id=info%3Apmid%2F27810660&rft.aulast=Labrum&rft.aufirst=T&rfr_id=info%3Asid%2Fen.wikipedia.org%3AGeriatrics" class="Z3988"></span></span> </li> </ol></div> <div class="mw-heading mw-heading2"><h2 id="Further_reading">Further reading</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Geriatrics&action=edit&section=28" title="Edit section: Further reading"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239549316">.mw-parser-output .refbegin{margin-bottom:0.5em}.mw-parser-output .refbegin-hanging-indents>ul{margin-left:0}.mw-parser-output .refbegin-hanging-indents>ul>li{margin-left:0;padding-left:3.2em;text-indent:-3.2em}.mw-parser-output .refbegin-hanging-indents ul,.mw-parser-output .refbegin-hanging-indents ul li{list-style:none}@media(max-width:720px){.mw-parser-output .refbegin-hanging-indents>ul>li{padding-left:1.6em;text-indent:-1.6em}}.mw-parser-output .refbegin-columns{margin-top:0.3em}.mw-parser-output .refbegin-columns ul{margin-top:0}.mw-parser-output .refbegin-columns li{page-break-inside:avoid;break-inside:avoid-column}@media screen{.mw-parser-output .refbegin{font-size:90%}}</style><div class="refbegin" style=""> <ul><li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite id="CITEREFAtchleyBaxterBlanchardBrady2009" class="citation book cs1">Atchley RC, Baxter SL, Blanchard J, Brady K, Comfort WE, Egbert AB (2009). <i>Working with seniors: Health, financial and social issues</i>. Denver, CO: Society of Certified Senior Advisors.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Working+with+seniors%3A+Health%2C+financial+and+social+issues.&rft.place=Denver%2C+CO&rft.pub=Society+of+Certified+Senior+Advisors&rft.date=2009&rft.aulast=Atchley&rft.aufirst=RC&rft.au=Baxter%2C+SL&rft.au=Blanchard%2C+J&rft.au=Brady%2C+K&rft.au=Comfort%2C+WE&rft.au=Egbert%2C+AB&rfr_id=info%3Asid%2Fen.wikipedia.org%3AGeriatrics" class="Z3988"></span></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite id="CITEREFGidal2006" class="citation journal cs1">Gidal BE (January 2006). "Drug absorption in the elderly: biopharmaceutical considerations for the antiepileptic drugs". <i>Epilepsy Research</i>. <b>68</b> (Suppl 1): <span class="nowrap">S65 –</span> <span class="nowrap">S69</span>. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.eplepsyres.2005.07.018">10.1016/j.eplepsyres.2005.07.018</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/16413756">16413756</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Epilepsy+Research&rft.atitle=Drug+absorption+in+the+elderly%3A+biopharmaceutical+considerations+for+the+antiepileptic+drugs&rft.volume=68&rft.issue=Suppl+1&rft.pages=%3Cspan+class%3D%22nowrap%22%3ES65+-%3C%2Fspan%3E+%3Cspan+class%3D%22nowrap%22%3ES69%3C%2Fspan%3E&rft.date=2006-01&rft_id=info%3Adoi%2F10.1016%2Fj.eplepsyres.2005.07.018&rft_id=info%3Apmid%2F16413756&rft.aulast=Gidal&rft.aufirst=BE&rfr_id=info%3Asid%2Fen.wikipedia.org%3AGeriatrics" class="Z3988"></span></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite id="CITEREFHutchisonJonesWestWei2006" class="citation journal cs1">Hutchison LC, Jones SK, West DS, Wei JY (June 2006). "Assessment of medication management by community-living elderly persons with two standardized assessment tools: a cross-sectional study". <i>The American Journal of Geriatric Pharmacotherapy</i>. <b>4</b> (2): <span class="nowrap">144–</span>153. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.amjopharm.2006.06.009">10.1016/j.amjopharm.2006.06.009</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/16860261">16860261</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+American+Journal+of+Geriatric+Pharmacotherapy&rft.atitle=Assessment+of+medication+management+by+community-living+elderly+persons+with+two+standardized+assessment+tools%3A+a+cross-sectional+study&rft.volume=4&rft.issue=2&rft.pages=%3Cspan+class%3D%22nowrap%22%3E144-%3C%2Fspan%3E153&rft.date=2006-06&rft_id=info%3Adoi%2F10.1016%2Fj.amjopharm.2006.06.009&rft_id=info%3Apmid%2F16860261&rft.aulast=Hutchison&rft.aufirst=LC&rft.au=Jones%2C+SK&rft.au=West%2C+DS&rft.au=Wei%2C+JY&rfr_id=info%3Asid%2Fen.wikipedia.org%3AGeriatrics" class="Z3988"></span></li></ul> </div> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Geriatrics&action=edit&section=29" title="Edit section: External links"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a rel="nofollow" class="external text" href="http://www.merck.com/mrkshared/mm_geriatrics/home.jsp">Merck Manual of Geriatrics</a></li> <li><a rel="nofollow" class="external text" href="http://ec.europa.eu/health-eu/my_health/elderly/index_en.htm">Health-EU Portal</a> – Care for the elderly in the EU</li> <li><a rel="nofollow" class="external text" href="http://www.americangeriatrics.org">American Geriatrics Society</a></li></ul> <div class="navbox-styles"><style data-mw-deduplicate="TemplateStyles:r1129693374">.mw-parser-output .hlist dl,.mw-parser-output .hlist ol,.mw-parser-output .hlist ul{margin:0;padding:0}.mw-parser-output .hlist dd,.mw-parser-output .hlist dt,.mw-parser-output .hlist li{margin:0;display:inline}.mw-parser-output .hlist.inline,.mw-parser-output .hlist.inline dl,.mw-parser-output .hlist.inline ol,.mw-parser-output .hlist.inline ul,.mw-parser-output .hlist dl dl,.mw-parser-output .hlist dl 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text" href="https://id.loc.gov/authorities/sh85054315">United States</a></span></span></li><li><span class="uid"><span class="rt-commentedText tooltip tooltip-dotted" title="Gériatrie"><a rel="nofollow" class="external text" href="https://catalogue.bnf.fr/ark:/12148/cb119315708">France</a></span></span></li><li><span class="uid"><span class="rt-commentedText tooltip tooltip-dotted" title="Gériatrie"><a rel="nofollow" class="external text" href="https://data.bnf.fr/ark:/12148/cb119315708">BnF data</a></span></span></li><li><span class="uid"><a rel="nofollow" class="external text" href="https://id.ndl.go.jp/auth/ndlna/00569782">Japan</a></span></li><li><span class="uid"><span class="rt-commentedText tooltip tooltip-dotted" title="geriatrie"><a rel="nofollow" class="external text" href="https://aleph.nkp.cz/F/?func=find-c&local_base=aut&ccl_term=ica=ph120550&CON_LNG=ENG">Czech Republic</a></span></span></li><li><span class="uid"><a rel="nofollow" class="external text" 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