Geriatric syndromes are clinical conditions commonly seen in older adults that do not fit into discrete disease categories. They are typically multifactorial and associated with substantial morbidity and poor health outcomes. Some of the most common geriatric syndromes include:

1. Falls
2. Cognitive impairment and delirium
3. Frailty
4. Urinary incontinence
5. Polypharmacy

Common signs and symptoms of geriatric syndromes include:

• Falls: History of falls, gait and balance impairment, muscle weakness
• Cognitive impairment: Memory loss, confusion, impaired judgment
• Frailty: Unintentional weight loss, exhaustion, weakness, slow gait speed, low physical activity
• Urinary incontinence: Involuntary urine leakage
• Polypharmacy: Taking multiple medications, often 5 or more

While specific lab tests are not diagnostic for geriatric syndromes, some relevant lab results may include:

• Vitamin D and B12 deficiency in those at risk for falls
• Abnormal thyroid function tests in cognitive impairment
• Anemia or malnutrition markers in frailty
• Urinalysis to rule out infection in incontinence

Preventative treatments and interventions include:

• Falls: Exercise programs, home safety modifications, vitamin D supplementation
• Cognitive impairment: Cognitive stimulation, treatment of reversible causes
• Frailty: Exercise, nutritional support, treatment of underlying conditions
• Incontinence: Pelvic floor exercises, bladder training
• Polypharmacy: Medication review and deprescribing

geriatric syndromes have a significant impact on the quality of life (QoL) in older adults:

Geriatric syndromes affect certain domains of quality of life in adults over 60 with varying intensity. The physical health and psychological domains were most affected. Geriatric syndromes like pressure ulcers, incontinence, falls, functional decline, and delirium can substantially diminish quality of life in older adults. They lead to increased mortality, disability, decreased resources, and longer hospitalizations. Common geriatric syndromes like frailty, sarcopenia, loss of body mass, and mild cognitive disorder are significant problems that can affect quality of life in the older population. A study on older adults receiving home-based healthcare found that frailty and geriatric syndromes, including comorbidities, are important risk factors for “poor” quality of life. Geriatric syndromes have substantial implications for functioning and life satisfaction in older persons. They pose distinctive challenges for clinicians caring for this population.

The multifactorial nature of geriatric syndromes, with shared risk factors like cognitive impairment, functional impairment, and impaired mobility, contributes to their impact on various aspects of an older adult’s life and wellbeing. Even with progress in understanding and treating some geriatric syndromes (like delirium and falls), translating this knowledge into clinical practice to improve quality of life remains challenging due to barriers at patient, provider, and organizational levels. Early identification and multifactorial interventions are key in managing geriatric syndromes. A comprehensive geriatric assessment is recommended to evaluate for these syndromes and guide treatment.

References:

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