GERIATRIC

Edu S. Tehupeiory

BAGIAN GERIATRI FAKULTAS KEDOKTERAN UNIVERSITAS

HASANUDDIN
RUMAH SAKIT DR. WAHIDIN SUDIROHUSODO
MAKASSAR

INTRODUCTION

Definition :

GERONTOLOGY

Scientific study of the phenomena of old

age. The study of the biological,
psychological, and sosiological phenomena
associated with old age and aging.

GERIATRICS
That branch of medical science which is
concerned with old age and its disease.
This branch that deals with the diagnosis
and treatment of diseases and problems
specific to the aged.

GERIATRICIAN

A physician who specializes in geriatrics.

Geritrician have had 3 senses.

Sense of love, sense of belonging and

sense of responsibility.

ASPECT OF GERONTOLOGY AND

INTRODUCTION TO GERIATRIC
THEORY FOR GETTING OLD
1. Genetic Clock

Getting old is programmed by genetic process for each

species.
For each species, the genetic clock is in the nuclei of
cells and replicated by special mechanism.
According to this concept if the clock stop, the species
die.

2. Somatic mutation

Progressive mutation of DNA.

Hypothesis : Error Catastrophe
# Transcription abnormality
# Translation abnormality
As a result of being formed the abnormal enzyme.
As a result of the reaction of abnormal metabolism.

3. Senescence of the immune system.

The immune system changes with age
Cell-mediated and humoral immune response
to foreign Ag are decreased, while the
response to autologous Ag is increased
The changes in the immune system that
accompany aging have been defined and
related to the involution of the thymus gland.

4. Free radicals

The free radical could be formed in the wild free, as

the side product in chain of breathing inside
mitokondria (Oen LH 1993).
The free radical can damage because of being reactive
as well as to be able to react with DNA, protein, the
fatty acid in the cell membrane.

Getting old but still health

(HEALTHY AGING)

Gerontology is concerned primarily with of

healthy aging rather than the prevention of
aging (Takemi 1977).

Healthy aging is influenced by :

- Endogenic Aging
- Exogenic Factors
(Boedhi Darmojo 1994)

Endogenic Aging

Cellullar

Tissue
Anatomical

organ

Healthy aging

Environment

Life-Style

Exogenic Aging

Fig 1. The Factors who influenced Healthy aging

(Boedhi-Darmojo, 1994)

COMPREHENSIVE GERIATRIC ASSESSMENT

( CGA)

Disease manifestation in the eldery are frequently

atypical.
Multiple chronic disease and/or health problems there
is less consistent relationship between pasthology and
diseases, between disease and clinical manifestation,
resulting in difficulties in assesssing elderly or geriatric
patients conditions.
The standard of taking history and physical
examination are not sufficient when dealing with
geriatric patients : their problem may go unnoticed
because they fail to report their problems in the right
way.

GERIATRIC ASSESSMENT
Geriatric assessment is a good standard to
elaborate every problem suffered by the elderly.
It extends beyond the traditional medical
evaluation of geriatric patients including
assessment of of cognitive, affective, funtional,
social, economic, environmental and spirutual
status.
Geriatric assessment can be used to refer either
to eveluation by the individual clinician or
intensive interdisciplinary process known
Comprehensive Geriatric Assessment (
CGA ).

Comprehensive geriatric assessment is based on the

premise that a systematic evaluation of frail older
persons by a team of health professionals may uncover
treatable health problems and lead to better health
outcomes.

Comprehensive geriatric assessment consists of 3 steps

process : screening or targeting of appropriate patients,
assessment and development of recommendations, and
implementation of recommendations, including physician
and patient adherence with recommendations.