Definition:
- The giants of geriatrics are immobility, instability (falls), incontinence, intellectual impairment (dementia) and iatrogenic disease.
- They have in common multiple causation, chronic course and no simple cure.
Components of Geriatric giants
- Immobility:
- Impairment of the ability to move independently.
- Immobility often multifactorial; eg. Arthritis, heart disease, stroke etc
- Instability (falls): Unintentionally coming to rest on the ground, not as a result of a major intrinsic event (e.g.stroke, syncope) or overwhelming hazard.
- Incontinence: May occur as
- stress incontinence,
- urge incontinence,
- overflow incontinence,
- functional incontinence
- Intellectual impairment (Dementia): Dementia is a syndrome in which progressive deterioration in intellectual abilities is so severe that it interferes with the person’s usual social and occupational functioning.
- latrogenic:
- latrogenic disease more frequently occur due to polypharmacy
Common geriatric illness:
- Arthritis.
- Cancer
- CKD, COPD
- Dementia/Alzheimer’s Disease, Parkinson’s Disease
- Diabetes, Osteoporosis, Stroke.
Prevention/precaution in geriatric giants:
Immobility: Early intervention and multifactorial treatment focused on the factors which will improve the quality of life
Instabilty(falls): optimal fall prevention strategy is the identification amongst the elderly who have modifiable risk factors
Incontinence: causes should be identified and treat the contributing factors early
Intellectual impairment (dementia): dementia, delirium or depression detect early
Iatrogenic: Avoid polypharmacy and ADR in elderly by careful prescription of drugs