Geriatric Gastroenterology: The Geriatrician’s Perspective

  • T. S. Dharmarajan
  • T. S. Dharmarajan
  • T. S. Dharmarajan
  • T. S. Dharmarajan


Aging trends confirm a population with longer life expectancy, many living to be octogenarians and centenarians. This group differs in that it has a greater likelihood for functional and cognitive disorders and additional comorbidity. With this background, the specialist including the gastroenterologist must adopt an approach that differs from that to the young patient; one can anticipate difficulties in preparing for a diagnostic procedure and comprehending the purpose for diagnostic testing or management. Physiological age must be given importance over chronological age; the ultimate goal should be restoration of functional status where possible, understanding risks involved, adherence to the patient’s wishes and keeping quality of life foremost in mind.


Palliative Care Fecal Occult Blood Test Geriatric Patient Successful Aging Impaired Cognition 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
  2. 2.
    Dharmarajan TS, Sohagia A. Urgent surgery in a near supercentenarian nursing home resident: possible with favorable outcome! J Am Med Dir Assoc. 2007;8:543–4.PubMedCrossRefGoogle Scholar
  3. 3.
    Dharmarajan TS, Ugalino JT. The physiology of aging. In: Dharmarajan TS, Norman RA, editors. Clinical geriatrics. 1st ed. Boca Raton: CRC Press/Parthenon; 2003. p. 9–22.Google Scholar
  4. 4.
    Hall KE, Proctor DD, Fisher L, et al. American gastroenterological association future trends committee report: effect of aging of the population on gastroenterology practice, education and research. Gastroenterology. 2005;129:1305–38.PubMedCrossRefGoogle Scholar
  5. 5.
    Coll PP. Determination of life expectancy: implications for the practice of medicine. Ann Longterm care. 2010;18(4):21–4.Google Scholar
  6. 6.
    Perls TT. The oldest old. Sci Am. 1995;14(3):6–11.Google Scholar
  7. 7.
    Rowe JW, Kahn RI. Human aging: usual and successful. Science. 1987;237:143–9.PubMedCrossRefGoogle Scholar
  8. 8.
    Morley JE. Successful aging or aging successfully. J Am Med Dir Assoc. 2009;10:85–6.PubMedCrossRefGoogle Scholar
  9. 9.
    Rueben DB. Medical care for the final years of life. “When you’re 83, it’s not going to be 20 years”. JAMA. 2009;302:2686–94.CrossRefGoogle Scholar
  10. 10.
    Gibson R. Resource use in the last 6 months of life. What does it mean for patients? Arch Intern Med. 2011;171(3):194–5.PubMedCrossRefGoogle Scholar
  11. 11.
    Nusbaum NJ. What should geriatricians be doing? Ann Longterm Care. 2009;17:38–9.Google Scholar
  12. 12.
    Kuehn BM. Effort under way to prepare physicians to care for growing elderly population. JAMA. 2009;302:727–8.PubMedCrossRefGoogle Scholar
  13. 13.
    O’Malley AS, Reschovsky JD. Referral and consultation communication between primary care and specialist physicians. Arch Intern Med. 2011;171(1):56–65.PubMedCrossRefGoogle Scholar
  14. 14.
    Chen AH, Yee Jr HF. Improving primary care-specialty care communication. Lessons from the San Francisco safety net. Arch Intern Med. 2011;171(1):65–7.PubMedCrossRefGoogle Scholar
  15. 15.
    Carlson CM, Kirby KA, Casadei MA, et al. Lack of follow-up after fecal occult blood testing in older adults. Inappropriate screening or failure to follow up? Arch Intern Med. 2011;171(3):249–56.PubMedCrossRefGoogle Scholar
  16. 16.
    Gambert SR. Capacity to make an informed decision: an essential component of every initial patient encounter. Clin Geriatr. Accessed 21 Feb 2011;19(2):9–11.Google Scholar
  17. 17.
  18. 18.
    Leipzig RM, Hall WJ, Fried LP. Treating our societal scotoma: the case for investing in geriatrics, our nation’s future, and our patients. Ann Intern Med. 2012;156:657–9.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • T. S. Dharmarajan
    • 1
  • T. S. Dharmarajan
    • 2
  • T. S. Dharmarajan
    • 3
  • T. S. Dharmarajan
    • 4
  1. 1.New York Medical CollegeValhallaUSA
  2. 2.Department of MedicineMontefiore Medical Center (North Division)BronxUSA
  3. 3.Division of GeriatricsMontefiore Medical Center (North Division)BronxUSA
  4. 4.Geriatric Medicine Fellowship ProgramMontefiore Medical Center (North Division)BronxUSA

Personalised recommendations