ABIM Geriatric Medicine key terms

The extra capacity an organ system keeps in reserve, which declines with age and leaves older adults less able to withstand illness, surgery, or other physiologic stress.

Age-related loss of skeletal muscle mass, strength, and performance that increases falls, disability, and frailty risk; diagnosis uses low muscle strength plus low muscle quantity or quality.

Progressive age-related hearing loss, usually high-frequency and bilateral, that impairs speech understanding, social participation, and safety; hearing aids and communication strategies can reduce disability.

A clinical state of increased vulnerability from cumulative declines in multiple systems, marked by low activity, weakness, exhaustion, slow gait, and weight loss; it predicts adverse outcomes.

Basic self-care tasks such as bathing, dressing, toileting, transferring, continence, and feeding; loss of ADL independence signals substantial disability and higher care needs.

Tasks needed to live independently in the community, such as managing finances, medications, transportation, shopping, cooking, housework, and using the telephone; impairment often precedes ADL loss.

A multidimensional, interdisciplinary process that assesses medical, functional, cognitive, psychological, social, and environmental needs, then creates and implements a coordinated care plan for older adults.

The time needed to walk a fixed distance, commonly 4 meters, expressed in meters per second; slow speed is a practical marker of frailty, disability, and mortality risk.

A timed test in which a person rises from a chair, walks 3 meters, turns, returns, and sits; longer times suggest mobility impairment and increased fall risk.

A drop in blood pressure on standing, usually at least 20 mm Hg systolic or 10 mm Hg diastolic within 3 minutes, causing dizziness, falls, and syncope; common with aging and medications.

A structured evaluation after falls or fall risk that reviews medications, orthostatic blood pressure, vision, gait and balance, cognition, continence, home hazards, and feet or footwear to guide targeted interventions.

An acute disturbance in attention and awareness with fluctuating course and altered cognition, often triggered by illness, medications, pain, or environment; it is a medical emergency in older adults.

A brief structured bedside tool that identifies delirium when there is acute onset or fluctuation plus inattention, and either disorganized thinking or altered level of consciousness.

Cognitive decline beyond normal aging that does not substantially impair daily function; it raises dementia risk and warrants monitoring, reversible-cause review, and advance planning.

A progressive or persistent cognitive decline affecting memory, language, executive function, or other domains enough to impair independence, caused by neurodegenerative, vascular, or other diseases.

The most common neurodegenerative dementia, typically beginning with episodic memory loss and progressing to broader cognitive and functional impairment; diagnosis integrates history, examination, and biomarker or imaging evidence when appropriate.

A dementia with fluctuating cognition, visual hallucinations, parkinsonism, and sensitivity to antipsychotics; rapid eye movement sleep behavior disorder and autonomic dysfunction are common supportive features.

Symptoms such as agitation, aggression, depression, apathy, psychosis, or sleep disturbance in dementia; first assess triggers and use nonpharmacologic strategies before cautious medication trials.

A treatable mood disorder that may present with sadness, anhedonia, insomnia, appetite change, pain, or cognitive complaints; screening and suicide risk assessment are essential.

Use of multiple medications, often defined as five or more, that raises risks of interactions, adverse effects, cost, and nonadherence; review should focus on indication, benefit, and burden.

A medication whose risks outweigh expected benefits for an older adult because of age-related pharmacokinetics, comorbidity, falls, cognition, or limited life expectancy; lists guide but do not replace clinical judgment.

An evidence-based list of medications that are potentially inappropriate for older adults, organized by drug class and clinical concern, with cautions about interactions and renal dosing.

The cumulative effect of medications with anticholinergic activity, which can cause confusion, dry mouth, constipation, urinary retention, falls, and worsened cognition in older adults.

A planned, supervised process of reducing or stopping medications when harms exceed benefits, using shared decision-making, tapering when needed, and monitoring for withdrawal or symptom recurrence.

An injury or harmful effect resulting from a medication, including falls, bleeding, confusion, renal injury, or hypoglycemia; older adults are especially vulnerable because of polypharmacy and altered drug handling.

Involuntary urine loss that is common in older adults and often multifactorial; types include stress, urgency, overflow, and functional incontinence, each needing different assessment and treatment.

Localized skin and tissue damage over a bony prominence from pressure or shear, often worsened by immobility, moisture, malnutrition, and poor perfusion; prevention requires repositioning and skin care.

Intentional or negligent acts by others that harm an older adult, including physical, sexual, psychological, financial abuse, neglect, and abandonment; screening requires private interview and reporting.

Persistent difficulty falling or staying asleep, or early awakening, with daytime consequences despite adequate opportunity to sleep; cognitive behavioral therapy is first-line treatment in older adults.

An ongoing process of discussing values, goals, and preferences for future medical care, documenting them, and appointing a surrogate decision-maker to guide care when the patient cannot speak.

A shared understanding of what matters most to a patient and which health outcomes are desired, used to choose treatments and align care with values across serious illness.

A patient's ability to understand relevant information, appreciate consequences, reason through options, and communicate a choice about a specific decision; it is task-specific and assessed clinically.

Interdisciplinary care focused on relieving suffering and improving quality of life for people with serious illness and their families, provided alongside curative or life-prolonging treatment.

Comprehensive comfort-focused care for people with terminal illness and limited life expectancy, usually when curative treatment is no longer chosen; it includes symptom management, family support, and bereavement care.

A portable medical order form, often called Physician Orders for Life-Sustaining Treatment, documenting preferences for resuscitation, intubation, antibiotics, and artificial nutrition in serious illness; it complements advance directives.

Coordinated actions that ensure continuity and safety when patients move between hospital, home, rehabilitation, or long-term care, including medication reconciliation, timely follow-up, and clear communication.

Vaccination to prevent infectious diseases and complications in older adults; schedules vary by age, comorbidity, prior vaccines, and setting, and counseling improves uptake.