Recent Advances in Geriatric Medicine

The study of aging and geriatrics is a relatively recent area of study and specialization. Much of the increase in focus on geriatrics has been a result of the explosion of the aging population. It therefore has become essential for the modern clinician to have an understanding of the different disciplines involved in administering to the aging population. Keeping track of recent advances can be a daunting undertaking. This chapter will prepare the reader to appreciate the multidisciplinary approach to geriatric medicine. This growing demographic has a dramatic impact on the future of scientific research.

The retirement of baby boomers and the rising share of elderly population are creating health and economic crises in the U.S. The U.S. Census Bureau projects that by 2030 there will be about 71 million Americans aged 65 and older and by 2040, one of every five Americans will be over 65 [1]. These demographics transitions have far-reaching implications for meeting healthcare needs and ensuring economic security for the elderly. As the Baby Boom generation ages, a large number of frail elderly will need health and personal care and progressively use more long-term care services which will have major implications for healthcare costs and public policies.

There are a number of physical, psychological and social changes that occur with the passage of time. Aging, then, can be understood as the impact of time on our bodies. This happens on multiple levels, such as cellular and hormonal aging, accumulated damage, and metabolic aging. Well-being in late life depends on a tightknit balance of physical, psychological, and social health [1]. If one of these three key components of a balanced life style is disrupted, it throws off the other two. For example, if an elderly individual suffers from flu, that in turn, will affect other aspects of their life. This individual may find it hard to be active when ill, which may lead to negative changes in their mood. In addition, other people may avoid him or her due to fear of catching their illness. This could lead to feelings of depression and social isolation, which may further impair immune system functioning.

As people get older, they begin to worry that any type of memory lapse may be the onset of dementia. In fact, the American Psychology Association agrees that dementia is one of the most feared aspects of getting older. It may be important, therefore, for both aging individuals and potential caretakers to have a better understanding of what would be considered to be normal age-related cognitive changes and what would be considered to be changes that might indicate a condition that would need to be evaluated by a medical professional.

Osteoporosis is a silent destructor of bone. King, Clarke and Sandhu (2014) reported that as many as 10 million Americans have osteoporosis and this number will increase by 50% by 2025. This disease is not gender selective; however, women are the prevalent gender affected. Many do not consider this a problem; because one cannot observe the bone destruction until this disease progresses into advanced stages. Bringing forward information to both genders is an important preventer of this silent, but painful condition. Imagine presenting with a bone or spinal fracture that is not associated with any trauma or injury. This is a typical presentation for a person who has osteoporosis. Pain then becomes the driver of stopping the progression of this disease. As many times after a fracture, a person must deal with the acute pain of the fracture and then has the potential to become chronic pain for many individuals. Knowledge and prevention are the key factors to this devastating disease.

Among the sensory changes that negatively impact older adults, changes in vision are the most salient. Problems with vision are associated with trouble reading and driving. The impact on activities of daily living is apparent and pervasive. Many older adults find that their lifestyles are most significantly impacted by visual changes and visual ailments.

The National Sleep Foundation (NSF) recommends that the average adult accrue between 7 and 9 hours of quality sleep per night for optimal health and performance outcomes; for older adults the recommendation becomes 7 to 8 hours per night [1]. The Centers for Disease Control and Prevention refer to insufficient sleep as a public health problem and, subsequently, recommend adequate sleep be considered as a vital sign of health. Lifestyle choices and personal habits often prohibit individuals from achieving this recommendation for healthy sleep duration, however, many adults fail to adhere to sleep guidelines because of an existing acute or chronic sleep disorder.

In this chapter, we will discuss the scope of practice in Speech Language Pathology (SLPs) specifically with the aging population, implications of the areas of communication, cognition, and swallowing due to abnormal aspects of the aging process, optimal services, and various therapeutic approaches to address those areas of communication, cognition, swallowing.

Older adulthood is considered to be the last phase of life in the human lifespan. According to the Centers for Disease Control and Prevention [1], the average age of death in the United States is 78 years. It is a well-known part of the human experience that death most commonly occurs during older adulthood and is more widely accepted by society than when death occurs in a child or young adult. Old age is characterized by the developmental stage of life known as integrity versus despair [2]. In this last developmental stage of life, an individual is left challenged to accept and find meaning in the life that he/she has lived.