Geriatrics

Geriatrics is that specialty of medicine that deals with the care, prevention and support of the elderly person during the aging process.
Clinical attention to the onset of disability and frailty aims to halt/slow the functional decline of the elderly person in the face of chronic/acute illness.

Through a geriatric multidimensional assessment, the goal is to recognize and identify typical geriatric syndromes at the origin of the patient's loss of autonomy.

• Cognitive deficits: problems related to cognitive impairment (including various types of dementia, such as Alzheimer's disease).
• Delirium: management of the acute confusional state that typically arises in individuals with cognitive frailty who have an intercurrent health problem.
• Gait and balance disorders, as well as the consequences of them (falls, fractures, psychological consequences).
• Affective sphere disorders: diagnosis and treatment (e.g., depressive syndromes; loneliness, etc.).
• Malnutrition: causes (e.g., lack of appetite) and consequences, (e.g., sarcopenia, understood as loss of muscle mass).
• Chronic pain: assessment/care of pain syndromes and their impact on quality of life.
• Incontinence problems: treatment of problems of involuntary loss of urine and feces.
• Polypharmacotherapy and drug iatrogenics: taking charge of the negative effects of too many drugs and adverse effects on the elderly.
• Frailty: multidimensional assessment of health issues and bio-psycho-social consequences on the elderly person; analysis of the impact of geriatric syndromes on the physical and mental state of the elderly person and the fallout in the social sphere.

Diagnosis

The diagnostic picture is outlined through the activation of geriatric multidimensional assessment techniques with the aim of performing an overall assessment of the elderly person's health status.

• Comprehensive history: initial collection of information aimed at clarifying the patient's clinical situation and medical history, also involving any support network (family members, Spitex, etc.).
• Clinical examination of the patient: thorough examination of physical and psycho-behavioral status.
• Paraclinical examinations: use of neuroimaging (MRI/ CT brain scan, etc.) and laboratory examinations in search of pathologies at the origin of the disorders.
• Analysis of the issues that required the specialist's intervention.

Treatments

The results of the assessment are aimed at the implementation of personalized therapies that take into account the psychophysical state. They are carried out by a multidisciplinary team, with the goal of rehabilitation and maintaining the person's self-sufficiency as long as possible. Among the treatments, coordinated by the geriatric physician, are for example:

• physiotherapy for recovery of mobility, safety and prevention of falls;
• occupational therapy for recovery of autonomy in AVQ (activities of daily living);
• reactivation nursing approach, aimed at recovery of maximum autonomy;
• rehabilitative neuropsychology;
• psychological support and emotional support.