CM12.1-5 | Geriatric Services — Glossary

Six basic self-care activities (bathing, dressing, toileting, transferring, continence, feeding) assessed by the Katz Index; measures the most basic functional independence.

Systematic devaluation, stereotyping, or discrimination against individuals on the basis of age; affects how elderly people access and receive care and is now recognised as a determinant of health.

The practice of actively offering screening to high-risk individuals who present to health services for any reason — distinguished from mass population screening. The recommended approach for most elderly health needs in primary care.

A multidimensional, interdisciplinary diagnostic process assessing medical, cognitive, mood, functional, nutritional, and social domains to produce an integrated care plan; the cornerstone of geriatric service delivery.

A facility where elderly patients attend for monitoring, physiotherapy, social interaction, and medication review during daytime hours and return home in the evening; reduces hospitalisation, provides caregiver respite, and maintains social engagement.

An acute, fluctuating disturbance in attention and cognition, caused by an underlying medical condition; distinct from dementia by its acute onset and fluctuating course; a medical emergency in the elderly.

The process by which the proportion of older persons in a population increases, driven by falling fertility rates and declining mortality at older ages; measured by the old-age dependency ratio and age-pyramid shape.

A state of increased vulnerability to stressors resulting from the cumulative decline of multiple physiological systems; operationalised by the Fried phenotype (≥3 of: weight loss, exhaustion, low activity, slow gait, weak grip). Best predictor of adverse outcomes in elderly care.

A 15-item validated yes/no self-report questionnaire for depression screening in the elderly; ≥6 suggests possible depression. Preferred over general depression tools in elderly because it avoids somatic items that overlap with medical illness.

Bernard Isaacs' 1965 classification of the four most common geriatric syndromes: Instability/falls, Immobility, Incontinence, and Intellectual impairment (the '4 Is').

Organised systems of health-care delivery — including assessment, rehabilitation, long-term care, and palliation — designed to meet the specific needs of elderly populations through multidisciplinary teams.

The branch of medicine dealing with clinical, preventive, rehabilitative, and social aspects of illness in old age; distinct from general medicine in emphasising multi-morbidity, functional endpoints, and team-based care.

The age-related reduction in physiological reserve across multiple organ systems, reducing the ability to respond to stressors and explaining why minor insults cause major decompensation in older adults.

Eight higher-order daily activities (shopping, cooking, finances, telephone, transportation, housekeeping, laundry, medications) assessed by the Lawton-Brody scale; more sensitive to early functional decline than ADL.

An 8-item scale assessing complex daily activities (shopping, cooking, finances, telephone, transport, housekeeping, laundry, medications); more sensitive to early functional decline than ADL; any impairment in a previously independent elderly person warrants investigation.

A 30-item clinician-administered cognitive screening tool; <24/30 is the standard cut-off for possible cognitive impairment. Scores must be interpreted with education level — illiteracy artificially lowers scores without reflecting true cognitive impairment.

A 6-item nutritional screening tool for the elderly; score <11 indicates at risk of malnutrition. Takes under 3 minutes; validated for community and clinical settings.

The simultaneous presence of two or more chronic conditions in the same individual; the dominant clinical presentation in elderly patients and the primary driver of complexity, polypharmacy, and care coordination challenges.

National Programme for Health Care of the Elderly; launched 2010-11 by the Ministry of Health and Family Welfare, India, to provide dedicated, multi-tier health services to persons aged ≥60 years through a four-level structure from community to regional geriatric centre.

The number of elderly persons (≥60 years) per 100 working-age adults (15–64 years); tracks the economic and caregiving burden of population ageing.

Concurrent use of ≥5 regular medications; associated with adverse drug reactions, drug interactions, falls, cognitive impairment, and hospitalisation in the elderly.

The systematic review and reduction of a medication list to the minimum safe and necessary set; recommended for all elderly on ≥5 medications (polypharmacy). Reduces adverse drug reactions, falls, and cognitive impairment.

Actions before disease onset in the elderly: physical activity, nutrition supplementation, tobacco cessation, vaccination (influenza, pneumococcal), and social engagement to reduce risk of NCDs, falls, and cognitive decline.

Progressive, generalised loss of skeletal muscle mass and strength with ageing; a major contributor to frailty, falls, immobility, and metabolic vulnerability.

Screening and case-finding to identify disease or risk before symptoms cause harm: blood pressure, blood glucose, vision, hearing, depression (GDS-15), cognitive function (MMSE), and fall risk (TUG test) in all elderly contacts.

Limiting disability and preventing avoidable decline after disease is established: rehabilitation (physiotherapy, occupational therapy), assistive devices, caregiver training, and palliative care.

A validated fall risk screening test: rise from a chair, walk 3 metres, return, sit. Time ≥12 seconds = elevated fall risk; ≥20 seconds = high fall risk. Requires no equipment; takes 2 minutes; validated for PHC use.