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  1. 1. 1
  2. 2. Geriatrics DR RAHIM IQBAL MBBS(Pb).MPH(H.S.A) Senior DemonstratorRawalpindi Medical college Rawalpindi 2
  3. 3. Geriatrics • Geriatrics is the branch ofinternal medicine that focuses on health care of the elderly. It aims to promotehealth and to prevent and treat diseases and disabilities in older adults. 3
  4. 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. 4
  5. 5. Geriatrics• The branch of medicine that is concerned with clinical study and treatment of old age and its manifestation 5
  6. 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 6
  7. 7. Geriatrics(Facts about old age)• Old age is an incurable disease.• We can not cure old age. 7
  8. 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. 8
  9. 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. 9
  10. 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. 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] 11
  12. 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] 12
  13. 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. 13
  14. 14. Geriatrics(Important subjects involved)• Pharmacology• Psychology• Polypharmacy• Orthogeriatrics• Cardio geriatrics• psychogeriatrics 14
  15. 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. 15
  16. 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. 16
  17. 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). 17
  18. 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 18
  19. 19. Geriatrics Health problems of the aged• Problems associated with long term- illness • Genitourinary system • Respiratory illness • Diabetes • Cancer • accidents 19
  20. 20. Geriatrics Health problems of the aged• Psychological Problems; 3 corners1. Mental changes2. Sexual adjustments3. Emotional disorders• irritability• Jealousy• Bitterness• Depression• Dementia• suicide 20
  21. 21. GeriatricsMost 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 21
  22. 22. Primary prevention• Health habitats• Smoking• Alcohol abuse• Obesity• Nutrition• sleep• Coronary heart disease• Immunization• Influenza• Pneumovax• tetanus• Injury prevention• Osteoporosis prevention 22
  23. 23. Secondary prevention• (A) Searching for• Hypertension• Diabetes• Dental diseases• Colorectal cancer• breast cancer• Prostatic cancer• anemia• Depression• Incontinence• Fall risk• TB• Syphilis• (B) Stroke prevention• (C) Myocardial infarction 23
  24. 24. Tertiary prevention• Rehabilitation• Physical deficits• Cognitive defects• Functional defects• Care taker support 24
  25. 25. ISLAM and Geriatrics• Holy Quarn• Hadees shreef• Great people sayings 25
  26. 26. GeriatricsReferences• 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. 26
  27. 27. Success or Failure Failure of Success 27
  28. 28. Chinese lok dastan 28
  29. 29. Thank you Very Much 29