a) Difference in health and medical needs:

As people age, their health and well-being need to change. People in their 30s may not have any chronic disease, so they do not have to frequently see a doctor or be on long-term medication. In contrast, many people who are 60 – 80 years old are frail, wheelchair-bound, on long-term medications and may have chronic heart or lung disease and memory impairment. They may face difficulties in their day-to-day activities like bathing, going to the toilet, and dressing.

b) Homeostasis:

The human body is designed to maintain a constant healthy state. This is known as homeostasis. Due to this, our body can maintain its body temperature, blood glucose levels, water levels, etc. As we grow old, our ability to maintain homeostasis reduces. This condition is known as homeostasis. Due to this, our body becomes increasingly susceptible to infection, trauma, etc.

A common cold may cause fever, body aches, and appetite loss in a younger individual. It can be easily treated with simple medication. However, the same illness in an elderly person may cause havoc. Similarly, poor appetite may cause significant dehydration and lead to dizziness and falls, especially if the person is on blood pressure medications. Being bedridden even for a day or two will make an elderly person noticeably weaker. Therefore, older people need to be treated by a specialist who understands their body’s state.

c) Multimorbidity:

Multiple ailments or medical conditions present at the same time. Older people typically do not visit a doctor with one single condition. Instead, they have a variety of concerns and illnesses, such as hypertension, diabetes, obesity, arthritis, etc. Sometimes, treatment for one condition may interfere with another or worsen it. So, a speciality that combines the treatments safely and effectively is essential.

d) Atypical disease presentations:

Like how diseases have different presentations in the paediatric (child) age group, diseases have different presentations in older people. To give a few examples, classic symptoms of a heart attack, such as chest pain and a sense of impending doom, are rarely present in the elderly. Instead, they may complain of stomachache, nausea, or simply feeling tired. Cough, breathlessness, and fever—the hallmarks of pneumonia—may not be presenting features in the elderly. They may manifest as poor appetite, fatigability, and confusion.

e) Polypharmacy:

As we grow old, the number of diseases keeps adding up. Due to this, people have to take multiple medicines. At the same time, the efficiency of their liver and kidneys reduces, decreasing their ability to metabolize the medicines. Also, multiple drugs, when taken together, may cause many side effects. A Geriatric Medicine specialist doctor ensures that the medicines are optimally consumed and have minimal side effects.

f) Attitude of the relatives and caregivers:

Even for a minor health problem, a kid gets immediate attention. However, family members often ignore an older person’s complaint of physical discomfort, considering it to be an inevitable part of the aging process. A geriatric medicine specialist doctor supports or counsels the patient, family members, and caregivers.

g) Social problems:

Many senior citizens suffer from socioeconomic problems like isolation, dependence on others for their daily activities, poverty, and so on. These problems may aggravate or precipitate the already existing medical problems.

h) Geriatric giants:

Traditionally, older people have been suffering from immobility, instability, incontinence (lack of control of urine and stool), and impaired intellect/memory. More recently, four new syndromes – frailty (weakness), sarcopenia (loss of muscles), anorexia (lack of appetite), and cognitive impairment (loss of memory and mental functions) are called modern geriatric issues. Impaired vision and hearing impairment are other common chronic problems in senior citizens. A Geriatrician who is exclusively trained in elderly care can adequately assess all these issues and advise appropriate management to improve the functionality and quality of life in older adults.