ABIM Geriatric Medicine study guide
ABIM Geriatric Medicine · Work through your exam, one topic at a time.
The Geriatric Medicine Certification Examination is a subspecialty examination offered by the American Board of Internal Medicine for internists seeking board certification in the care of older adults. This page is an independent study resource: it is not affiliated with, endorsed by, or sponsored by ABIM, and candidates must confirm eligibility and complete registration through ABIM's Physician Portal. The ABIM Geriatric Medicine study guide has 10 sections and about 2,554 words.
01Normal Aging and Age-Related Physiology
Aging changes are predictable, gradual, and usually asymptomatic; disease is not. Key physiologic shifts include declining renal blood flow and GFR (roughly 8 mL/min/1.73 m² per decade after age 40), reduced hepatic phase I metabolism, decreased total body water with increased fat, lower lean mass, arterial stiffening with rising systolic and widened pulse pressure, blunted baroreflex and beta-adrenergic responsiveness, reduced maximal heart rate, decreased vital capacity and cough strength, immunosenescence, reduced thirst and thermoregulation, presbyopia and high-frequency hearing loss, slowed nerve conduction, and altered sleep architecture.
281 words, about 1 min02Geriatric Assessment, Function, and Disability
Comprehensive geriatric assessment (CGA) is multidimensional: medical, functional, cognitive, psychological, social, environmental, nutritional, and advance care planning. Function is measured by ADLs (Katz: bathing, dressing, toileting, transferring, continence, feeding) and IADLs (Lawton: telephone, shopping, food preparation, housekeeping, laundry, transportation, medications, finances).
262 words, about 1 min03Falls, Gait Disorders, and Immobility
Falls result from interacting intrinsic and extrinsic factors: prior fall, gait and balance impairment, lower-extremity weakness, cognitive impairment, vision loss, neuropathy, orthostatic hypotension, arrhythmia, and medications (sedative-hypnotics, antipsychotics, antidepressants, antihypertensives, anticholinergics, hypoglycemics). Environmental hazards, footwear, and fear of falling contribute.
274 words, about 1 min04Cognitive Impairment and Dementia
Major neurocognitive disorder requires acquired, progressive cognitive decline in one or more domains that interferes with independence. Mild cognitive impairment (MCI) shows decline without functional loss.
256 words, about 1 min05Delirium and Psychiatric Disorders in Older Adults
Delirium is an acute, fluctuating disturbance of attention and awareness, often with disorientation, hallucinations, or altered sleep-wake cycle. Use the Confusion Assessment Method (CAM): acute onset/fluctuation plus inattention, with disorganized thinking or altered consciousness.
265 words, about 1 min06Medication Management and Polypharmacy
Polypharmacy (often ≥5 medications) increases falls, delirium, bleeding, hypoglycemia, and hospitalization. Use the Beers criteria and STOPP/START to identify potentially inappropriate medications and prescribing omissions.
229 words, about 1 min07Other Geriatric Syndromes: Incontinence, Pressure Injury, Sensory Impairment, Sleep, and Elder Mistreatment
Transient causes follow DIAPPERS: Delirium, Infection, Atrophic vaginitis, Pharmaceuticals, Psychological, Excess fluids, Restricted mobility, Stool impaction. Persistent types: urge (overactive bladder), stress (pelvic floor weakness), overflow (retention, obstruction, neuropathy), and functional.
249 words, about 1 min08Common Medical Disorders in Older Adults Across Organ Systems
Older adults often present with nonspecific symptoms: confusion, falls, functional decline, weakness, or anorexia rather than classic pain or fever. Myocardial infarction may present with dyspnea or delirium; pneumonia may lack fever or cough; urinary tract infection may cause confusion without dysuria; hypothyroidism and depression may mimic dementia.
227 words, about 1 min09Prevention, Health Maintenance, and Care Across Settings
Immunizations: influenza annually, COVID-19 per current schedule, pneumococcal vaccination, Tdap, shingles, and RSV for eligible older adults. Cancer screening should reflect life expectancy, goals, and risk: mammography, colorectal cancer screening, cervical screening, lung cancer screening for eligible smokers, and osteoporosis screening with DXA.
229 words, about 1 min10Palliative Care, End-of-Life Care, Ethics, and Goals of Care
Palliative care addresses symptoms and goals at any stage of serious illness; hospice is a model for patients with a prognosis of about 6 months or less who forego curative treatment. Advance care planning includes health care proxies, living wills, and POLST/MOLST for seriously ill patients.
282 words, about 1 min