DR CHONG MEI SIAN 张美仙老年科高级顾问医生 Senior Consultant Geriatrician
Geriatric medicine is a specialty that focuses on health care of older adults. It aims to promote health by preventing and treating diseases & disabilities in older adults. High quality health services and medical advances have resulted in impressive improvement of the population’s life expectancy. However, the greater longevity conferred with healthcare advancement has lead to more years of disability of 10.7-13.3 years (locally). Geriatric medicine promotes the “compression of morbidity”. This is a term that means reducing the length of time a person who is close to the end of life spends sick or disabled so that people can have a longer healthy lifespan, through various preventive and health maintenance practices.
A geriatrician is a medical doctor who is specially trained to meet the unique healthcare needs of older adults. Illnesses, diseases and medications may affect older people differently than younger adults. Older patients often have multiple health problems and take multiple medications. Geriatricians prevent, manage and develop care plans that address the special health problems of the elderly. In Singapore, geriatricians are specialists who have undergone basic internal medicine training with further accreditation and specialization in the field of geriatric medicine.
Common geriatric syndromes
Many people have memory loss issues — this does not mean they have Alzheimer's disease or another dementia. There are many different causes of memory problems. If you or a loved one is experiencing troubling symptoms, visit a doctor to learn the reason. Some causes of dementia-like symptoms can be reversed.
Dementia is a general term for a decline in mental ability severe enough to interfere with daily life. Alzheimer's disease is the most common type of dementia. (go to useful links: 10 warning signs of dementia).
Functional decline, i.e., the loss of either complex or basic activities of daily living functioning is due to changes in one or more of six areas: physical, perceptual, cognitive, visual and hearing, falling and psychological. A detailed medical examination is required to elucidate the cause and potential reversibility of the functional decline.
Falls are the leading cause of both fatal and nonfatal injuries for people aged 65+.Falls can result in hip fractures, broken bones, and head injuries. And even falls without a major injury can cause an older adult to become fearful or depressed, making it difficult for them to stay active. It is important to seek medical attention to determine the reason for frequent falls in older adults and to potentially reverse the factors related to falls to prevent the negative consequences.
Incontinence (urinary or faecal) is a difficult and emotionally, fraught problem. Caregivers are often hesitant to address the subject, with their elderly loved one (especially if the loved one is a parent), but find themselves frustrated with trying to manage this situation. It is also important not to shy away from talking to the older adult’s doctor. Many treatments (some of them simple) are available that can improve, if not correct, incontinence. The first step is to understand what could be causing the incontinence.
Sleep disorders are fairly common in older adults. They tend to experience less deep sleep and wake up frequently in the night, which can lead to daytime fatigue. The older adult may also have trouble falling asleep and may also wake up early in the morning. Sleep disorders in the older adult can be caused by a number of factors, including medication, diseases, and poor sleeping habits. Depending on the cause, there are a number of different treatment options.