2. Geriatrics
DR RAHIM IQBAL
MBBS(Pb).MPH(H.S.A)
Senior Demonstrator
Rawalpindi Medical college
Rawalpindi
2
3. Geriatrics
• Geriatrics is the branch of
internal medicine that focuses on health
care of the elderly. It aims to promote
health and to prevent and treat diseases
and disabilities in older adults.
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4. Geriatrics
• There is no set age at which patients may be
under the care of a geriatrician. Rather, this is
determined by a profile of the typical problems
that geriatrics focuses on. This includes the so-
called 'geriatric giants' of immobility, instability,
incontinence and impaired intellect/memory.
Health issues in older adults may also include
elderly care, delirium,
use of multiple medications, impaired vision and
hearing.
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5. Geriatrics
• The branch of medicine that is
concerned with clinical study and
treatment of old age and its
manifestation
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6. Gerontology
• This is the study of the aging process
itself. The term comes from the Greek
geron meaning "old man" and iatros
meaning "healer".
• The study of physical and psychological
changes which are incident to the old age
is call gerontology
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8. Geriatrics
Then what can be done for
the old age people
• You can protect their life.
• You can promote their health.
• You can extend their life.
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9. Geriatrics
(History)
• The term geriatrics was proposed in 1909
by Dr. Ignatz Leo Nascher, former Chief of
Clinic in the Mount Sinai Hospital
Outpatient Department (New York City)
and a "Father" of geriatrics in the United
States.
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10. Geriatrics
(History)
• The famous Arabic physician, Ibn Al-Jazzar Al-
Qayrawani (Algizar, circa 898-980), also wrote a
special book on the medicine and health of the
elderly, entitled Kitab Tibb al-Machayikh[6] or
Teb al-Mashaikh wa hefz sehatahom.[7] He also
wrote a book on sleep disorders and another
one on forgetfulness and how to strengthen
memory, entitled Kitab al-Nissian wa Toroq
Taqwiati Adhakira,[8][9][10] and a treatise on
causes of mortality entitled Rissala Fi Asbab al-
Wafah.[11] 10
11. Geriatrics
(History)
• Another Arabic physician in the 9th
century, Ishaq ibn Hunayn (died 910), the
son of Hunayn Ibn Ishaq, wrote a Treatise
on Drugs for Forgetfulness (Risalah al-
Shafiyah fi adwiyat al-nisyan).[12]
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12. Geriatrics
(History)
• The Canon of Medicine,[2] written by Abu Ali Ibn Sina
(Avicenna) in 1025, was the first book to offer instruction
for the care of the aged, foreshadowing modern
gerontology and geriatrics. In a chapter entitled
"Regimen of Old Age", Avicenna was concerned with
how "old folk need plenty of sleep", how their bodies
should be anointed with oil, and recommended exercises
such as walking or horse-riding. Thesis III of the Canon
discussed the diet suitable for old people, and dedicated
several sections to elderly patients who become
constipated.[3][4][5]
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13. Geriatrics
(History)
• Modern geriatrics in the United Kingdom really
began with the "Mother" of Geriatrics, Dr.
Marjorie Warren. Warren emphasized that
rehabilitation was essential to the care of older
people. She took her experiences as a
physician in a London Workhouse infirmary and
developed the concept 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.
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15. Geriatrics
(Important subjects involved)
• Pharmacology
• 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 body fat and
muscle and drug elimination.
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16. Geriatrics
(Important subjects involved)
• Psychology
• Psychological consideration is that of elderly persons
(particularly those experiencing substantial problems of
memory loss or other types of cognitive impairment)
being able to adequately monitor and adhere to their own
scheduled pharmacological 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
medication schedule was reported by a striking one-third
of the participants. Further development of methods
which might possibly help monitor and regulate dosage
administration and scheduling is an area that deserves
further attention.
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17. Geriatrics
(Important subjects involved)
• Polypharmacy
• It is often a predictive factor (Cannon et al,
2006). Research done on
home/community health care found that
"nearly 1 of 3 medical regimens contain a
potential medication error" (Choi et al,
2006).
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18. Geriatrics
Health problems of the aged
• Due to ageing process.
Senile cataract
Glaucoma
Bony changes affecting mobility
Nerve deafness
Emphysema
Failure of special senses
Changes in mental out look
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19. Geriatrics
Health problems of the aged
• Problems associated with long term-
illness
• Genitourinary system
• Respiratory illness
• Diabetes
• Cancer
• accidents
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20. Geriatrics
Health problems of the aged
• Psychological Problems; 3 corners
1. Mental changes
2. Sexual adjustments
3. Emotional disorders
• irritability
• Jealousy
• Bitterness
• Depression
• Dementia
• suicide
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21. Geriatrics
Most common diseases of old age
( A study result)
Men 45-64 years Men 45-64 years
High blood pressure arthritis
arthritis High blood pressure
Hearing impairment Chronic sinusitis
deafness Hearing impairment
Hay fever without Varicose veins
asthma
hemorrhoids Haemorroids
Visual impairment chronic bronchitis
diabetes diabetes
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26. Geriatrics
References
• Barton A, Mulley G. History of the development of geriatric medicine in the
UK. Postgrad Med J 2003;79:229-34. Fulltext. PMID 12743345.
• Cannon, K.T., Choi, M.M., Zuniga, M.M. (2006). Potentially inappropriate
medication use in elderly patients receiving home health care: a
retrospective data analysis. The American Journal of Geriatric
Pharmacotherapy, 4, 134-143.
• Gidal, B.E. (2006). Drug Absorption in the Elderly: Biopharmaceutical
Considerations for the Antiepileptic Drugs. Epilepsy Research, 68S, S65-
S69. Hutchison, L.C., Jones, S.K., West, D.S., Wei, J.Y. (2006).
Assessment of Medication Management by Community-Living Elderly
Persons with Two Standardized Assessment Tools: A Cross-Sectional
Study. The American Journal of Geriatric Pharmacotherapy, 4, 144-153.
• Isaacs B. An introduction to geriatrics. London: Balliere, Tindall and Cassell,
1965.
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