Introductory Chapter: Geriatrics

Geriatrics has been identified as a subspecialty by virtue of a board certification since the mid-1980s by the American Board of Internal Medicine. The original core of knowledge was primarily the extension of the diagnoses and management of diseases of organ systems to the three age groups over the age of 60 years: youngold was 60–70, old was 70–80, and old-old was over 80 years of age. At that time I became interested in geriatrics by focusing on elders with renal and urology diseases [1]. At the beginning I researched the anatomic and physiologic changes of the kidney and urinary system, and then later each other major organ system of the body. My work in renal and urologic diseases led to editing my first book in the field [2]. As I delved into caring for the elderly, I became exposed to the knowledge of problems which are outside of the individual organ systems like “falls” or problems which affect every organ system like “geropharmacology.” Over the decades since then, the role of the geriatrician who is the primary care provider for the elderly requires knowledge in a multitude of other specialties beyond internal medicine such as ophthalmology, ENT, audiology, neurology, orthopedics, and physiatry. I will present the earliest skills needed for the care of the elderly followed by the newest skills now incorporated into the subject matter of geriatrics. The chapters in this book mostly represent a catalog of the newer skills.