84493 - Geriatric Medicine

Learning outcomes

Discriminate between normal aging and diseases of aging. Identify common geriatric syndromes and conditions, including risk factors, causes, signs, symptoms, differential diagnoses, treatments and preventive strategies. Evaluate the effect of patient age on prescribing practices. Evaluate common problems encountered in geriatric medicine, including co-morbidity, polytherapy, frailty and the need for physical/social assistance. Summarize the organization of health care services and social assistance for the elderly.

Course contents

Learning outcomes

At the end of the module the student:

- knows the demographic data of the Italian population and the general international indications in the geriatric field, with an ethical and assistance value;

- knows the methodological bases of clinical reasoning to diagnose major geriatric syndromes and comorbidities;

- can apply to the geriatric patient the principles of differential diagnosis and prognosis for diseases and syndromes of greater severity and prevalence in the elderly of our country;

- knows how to frame the health status of the old, understood as a person, as a patient and as a subject inserted in specific contexts (home, hospital, nursing home, RSA);

- knows how to integrate the management strategies of the elderly patients based on available territorial and hospital resoruces;

- Knows how to communicate with the elderly patient, with his relatives and with the professional health figures, in particular on the subject of death, suffering and decay;

- knows indications and contraindications of the main diagnostic and therapeutic measures, including invasive, in adults, in the elderly and in the ultra-octogenarian;

- knows how to set up therapeutic programs, also oriented towards prevention and rehabilitation, for the most frequent geriatric syndromes according to international guidelines;

Course contents

1. The aging of organs and apparatuses. Demography of aging and society. Frailty

2. Changes in body composition in aging. Malnutrition and swallowing disorders. Obesity and sarcopenia.
3. Geriatric multidimensional evaluation as a basic methodology for dealing with the problems of the elderly. Most common tools for evaluating the elderly patient (MMSE, GDS, ADL, IADL). Polipathology. Atypical manifestation of common diseases.
4. Functional consequences of aging. Relations between functions, health and disability: their social impact; more frequent causes of disability and their classification. Osteoporosis and fractures. Rehabilitation in the elderly
5. Services for the elderly and care settings; integration with social assistance.
6. Drug prescriptions in the elderly. Iatrogenesis. Pain.
7. Cerebrovascular and cardiovascular diseases in the elderly
8. Difficulty in motility, disequilibrium, falls. Causes, prevention and treatment of bedsores
9. Dementia

10. Delirium and depression
11. Communication deficits (sight, hearing). Urinary and fecal incontinence. Dehydration.
12. Diabetes mellitus and metabolic syndrome. Palliative care. Medical-legal problems.

Readings/Bibliography

Brocklehurst’s Textbook of Geriatric Medicine and Gerontology, Elsevier

Oxford Textbook of Geriatric Medicin, Oxford University Press

Merck Manual of Geriatrics (www.merckmanuals.com/professional/geriatrics)

Teaching methods

Public oral lectures

Assessment methods

At the end of the Course, an exam will verify the level of knowledge of the arguments of the Course content. The exam consist in an oral individual test. The final grade of the Course is defined by the average of the votes reported in two questions about specific topics relevant to the educational objectives of the Course. The student will be asked to answer to a third question (and the grade reported will be part of the final evaluation) if it will be necessary to verify the complete achievement of the educational objective of the Course.

Grading procedure:

- knowledge of a very limited number of topics and limited analytical capacity → 18-19 out of 30;

- knowledge of a limited number of topics and basic analytical capacity → 20-24 out of 30;

- knowledge of a consistent number of topics and good analytical capacity → 25-29 out of 30;

- knowledge of all topics and very good analytical capacity → 30-30L out of 30.

Teaching tools

Oral lectures with slides

Office hours

See the website of Paola Forti