ABFM Geriatric Medicine study guide
ABFM Geriatric Medicine · Work through your exam, one topic at a time.
The Certificate of Added Qualification (CAQ) in Geriatric Medicine is an added qualification credential offered by the American Board of Family Medicine in conjunction with the American Board of Internal Medicine. It recognizes a family physician's training and knowledge in the care of older adults. The ABFM Geriatric Medicine study guide has 10 sections and about 3,266 words.
01Aging and Normal Physiologic Changes
Aging produces predictable loss of physiologic reserve across organ systems, but it does not by itself produce symptoms. The candidate must distinguish age-associated change from pathology: presbycusis and presbyopia are aging; a new focal deficit is not.
358 words, about 2 min02Geriatric Assessment and Functional Status
The comprehensive geriatric assessment (CGA) is a multidimensional, team-based process covering medical, functional, cognitive, psychological, social, and environmental domains, followed by an individualized care plan. Evidence supports CGA in improving survival and living circumstances for hospitalized older adults.
349 words, about 2 min03Falls, Gait, and Balance Disorders
About one-third of community-dwelling adults over 65 fall each year. Falls are multifactorial: intrinsic factors (gait and balance impairment, sarcopenia, neuropathy, parkinsonism, visual impairment, orthostatic hypotension, cognitive impairment, fear of falling) and extrinsic factors (medications, footwear, home hazards, lighting).
304 words, about 2 min04Cognitive Impairment and Dementia
Delirium is acute, fluctuating, and inattentive; dementia is chronic and progressive; depression can mimic dementia ("pseudodementia") with apathy and poor effort. Delirium frequently superimposes on dementia, and the single best question is whether cognition changed acutely.
297 words, about 1 min05Psychiatric and Behavioral Disorders in Older Adults
Depression is not normal aging and is underrecognized because elders present with somatic complaints, pain, insomnia, and appetite loss rather than sadness. Use the Geriatric Depression Scale.
323 words, about 2 min06Medication Management and Polypharmacy
Altered pharmacokinetics (reduced renal clearance, lower body water, higher fat fraction, reduced first-pass metabolism) combine with polypharmacy from multiple prescribers to produce adverse drug events, which often present atypically as falls, confusion, incontinence, or constipation rather than as a specific complaint. Use the Beers criteria to identify potentially inappropriate medications in older adults, and STOPP/START to identify both inappropriate prescribing and prescribing omissions (e.g., missing statin, ACE inhibitor, bisphosphonate, or vitamin D).
322 words, about 2 min07Common Geriatric Syndromes: Incontinence, Pressure Injuries, Sensory Impairment
Incontinence is never a normal consequence of aging and always deserves evaluation. Reversible causes follow the DIAPPERS mnemonic: delirium, infection, atrophic vaginitis/urethritis, pharmaceuticals, psychological causes, excess urine output (hyperglycemia, diuretics, congestive failure), restricted mobility, and stool impaction.
304 words, about 2 min08Chronic Illness, Multimorbidity, and Rehabilitation
Guideline-based targets derived from younger populations may not apply when a patient has limited life expectancy, frailty, or competing risks. Apply the concept of time to benefit: a preventive therapy should offer benefit within the patient's remaining lifespan.
335 words, about 2 min09Palliative Care, End-of-Life Care, and Ethics
Palliative care is symptom-focused care appropriate at any stage of serious illness alongside disease-directed treatment. Hospice is a benefit for patients with a prognosis of six months or less if the disease follows its usual course, with the "surprise question" ("Would I be surprised if this patient died within the year?") as a practical prompt.
331 words, about 2 min10Health Systems, Long-Term Care, and Care Coordination
Medicare Part A covers inpatient hospital, skilled nursing facility (up to 100 days per benefit period, typically requiring a qualifying hospital stay), hospice, and some home health. Part B covers outpatient and durable medical equipment.
343 words, about 2 min