Skip to main content

Geriatric Gastroenterology: A Geriatrician’s Perspective

  • Reference work entry
  • First Online:
Geriatric Gastroenterology

Abstract

Aging trends in the United States and worldwide suggest an increasingly aging population, characterized by a longer life expectancy. Many live on to be nonagenarians, and some reach the stage of centenarians, with a few luckiest living to be supercentenarians. Older people are working longer, fulfilling societal demands. But alongside, they also manifest a significant decline in their functional status and cognitive function, along with a whole range of complex comorbid disorders. Frailty and care dependency are common in the old. Biological age poorly matches chronological age and deserves far more consideration. The ultimate goals while caring for older adults are to restore functional status where possible, understand risks and benefits of invasive and noninvasive management, adhere to the patient’s expressed wishes and advance directives, and keep quality of life foremost in mind. The chapter provides data on life expectancy and other demographics, comorbid disorders and functional limitations in aging people, lifestyles, and causes of mortality. Bearing in mind this background, specialists, including gastroenterologists, must adopt an approach that differs significantly from that used for younger individuals. Considerations must include life expectancy, comorbid and functional status, decision-making capacity, patient’s current wishes or prior expressed directives as part of advance care planning, and ethical aspects; some or all of them may factor in decision-making for a diagnostic procedure and medical and surgical management.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

References

  • AGS Health in Aging Foundation. Choosing wisely: 10 things physicians and patients should question. 2013–2014. HealthinAging.org. https://www.healthinaging.org/sites/default/files/pdf/Choosing.Wisely.Ten_Things.pdf

  • Arai H, Ouchi Y, Toba K, et al. Japan as the front-runner of super-aged societies: perspectives and medical care in Japan. Geriatr Gerontol Int. 2015;15(6):673–87.

    Article  Google Scholar 

  • Avers D, Brown M, Chi KK, et al. Editor’s message. Use of the term “elderly”. J Geriatr Phys Ther. 2011;34(4):153–4.

    Article  Google Scholar 

  • Burke C. It is time to stop using the term “senior citizen”. AARP. 2019. https://www.aarp.org. 10 July 2019.

  • Centenarian. Wikipedia. 2020. https://en.wikipedia.org/wiki/Centenarian. Accessed 3 Nov 2020.

  • Coll PP. Determination of life expectancy: implications for the practice of medicine. Ann Long Term Care. 2010;18(4):21–4.

    Google Scholar 

  • Dharmarajan TS, Sohagia A. Urgent surgery in a near super centenarian nursing home resident: possible with favorable outcome! J Am Med Dir Assoc. 2007;8:543–4.

    Article  CAS  Google Scholar 

  • Dharmarajan TS, Choi H, Hossain N, et al. Deprescribing as a clinical improvement focus. J Am Med Dir Assoc. 2020;21:355–60.

    Article  Google Scholar 

  • Dorling JL, Martin CK, Redman LM. Calorie restriction for enhanced longevity: the role of novel dietary strategies in the present obesogenic environment. Ageing Res Rev. 2020:101038. https://doi.org/10.1016/j.arr.2020.101038.

  • Dumic I, Nordin T, Jecmenica M, et al. Gastrointestinal tract disorders in older age. Can J Gastroenterol Hepatol. 2019;2019:6757524. https://doi.org/10.1155/2019/6757524.

    Article  PubMed  PubMed Central  Google Scholar 

  • Durazzo M, Campion D, Fagoonee S, Pellicano R. Gastrointestinal tract disorders in the elderly. Minerva Med. 2007;108(6):575–91.

    Google Scholar 

  • Evert J, Lawler E, Bogan H, et al. Morbidity profiles of centenarians: survivors, delayers, and escapers. J Gerontol A Biol Sci Med Sci. 2003;58A:M232–7.

    Article  Google Scholar 

  • Falconer M, O’Neill D. Out with “the old”, elderly and aged. BMJ. 2007;334:316.

    Article  Google Scholar 

  • Federal Interagency Forum on Aging-Related Statistics. Older Americans 2016: key indicators of Well-being. Washington, DC: US Government Printing Office; 2016.

    Google Scholar 

  • Forciea MA. Geriatric medicine: history of a young specialty. Virtual Mentor. 2014;16(5):385–9.

    Article  Google Scholar 

  • Gonzalez-Freire M, Diaz-Ruiz A, Hauser D, et al. The road ahead for health and lifespan interventions. Ageing Res Rev. 2020;59:101037. https://doi.org/10.1016/j.arr.2020.101037.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Hall KE, Proctor DD, Fisher L, et al. American Gastroenterological Association future trends committee report: effect of aging of the population on gastroenterology practice. Educ Res Gastroenterol. 2005;129:1305–38.

    Google Scholar 

  • Hamczyk MR, Nevado RM, Barettino A, et al. Biological versus chronological aging: JACC Focus Seminar. J Am Coll Cardiol. 2020;75(8):919–30.

    Article  CAS  Google Scholar 

  • Hausman DB, Fischer JG, Johnson MA. Nutrition in centenarians. Maturitas. 2011;68(3):203–9.

    Article  Google Scholar 

  • Jean-Marie R, Cubaynes S. Worldwide demography of centenarians. Mech Aging Dev. 2017;165:59–67.

    Article  Google Scholar 

  • Kochanek KD, Murphy SL, Xu JQ, Arias E. Deaths: final data for 2017. Natl Vital Stat Rep. 2019;68(9):1–75.

    PubMed  Google Scholar 

  • Koh HK, Parekh AK. Towards a United States of health: implications of understanding the US burden of disease. JAMA. 2018;319:1438–40.

    Article  Google Scholar 

  • Lester PE, Dharmarajan TS, Weinstein E. The looming geriatrician shortage: ramifications and solutions. J Aging Health. 2019:898264319879325. https://doi.org/10.1177/0898264319879325.

  • Murphy SL, Xu JQ, Kochanek KD, Arias E. Mortality in the United States, 2017, NCHS data brief no. 328. Hyattsville: National Center for Health Statistics; 2018.

    Google Scholar 

  • Peery AF, Dellon ES, Lund J, et al. Burden of gastrointestinal disease in the United States: 2012 update. Gastroenterology. 2012;143(5):1179–87.

    Article  Google Scholar 

  • Perls TT. The oldest old. Sci Am. 1995;14(3):6–11.

    Google Scholar 

  • Rowe JW, Kahn RI. Human aging: usual and successful. Science. 1987;237:143–9.

    Article  CAS  Google Scholar 

  • Schoenhofen EA, Wyszynski DF, Andersen S, et al. Characteristics of 32 super centenarians. J Am Geriatr Soc. 2006;54(8):1237–40.

    Article  Google Scholar 

  • Takahashi R, Odera K. Multidisciplinary approach to aging. Yakugaku Zasshi. 2020;140(3):379–82.

    Article  CAS  Google Scholar 

  • Taleb NN. The Black Swan: the impact of the highly improbable. New York: Random House; 2007.

    Google Scholar 

  • Taylor A. Older adult, older person, senior, elderly or elder: a few thoughts on the language we use to reference aging. 2011. https://www.bcli.org/older-adult-older-person. Accessed 3 Oct 2020.

  • Vacante M, D’Agata V, Motta M, et al. Centenarians and super centenarians: a Black Swan. Emerging social, medical and surgical problems. BMC Surg. 2012;12(Suppl 1):S36.

    Article  Google Scholar 

  • Warshaw G, Lundebjerg NE. When it comes to older adults: language matters. Ann Long Term Care Aging. 2017;25(4):6–7.

    Google Scholar 

  • Weyh C, Kruger K, Strasser B. Physical activity and diet shape the immune system during aging. Nutrients. 2020;12(3):pii: E622. https://doi.org/10.3390/nu12030622.

    Article  CAS  Google Scholar 

  • Woolf SH, Schoomaker H. Life expectancy and mortality rates in the United States, 1959–2017. JAMA. 2019;322:1996–2016.

    Article  Google Scholar 

  • World Health Organization. Ageing and health. 2018a. https://www.who.int/news-room/fact-sheets/detail/ageing-and-health

  • World Health Organization. The top 10 causes of death. Global health estimates 2016: deaths by cause, age, sex, by country and by region, 2000–2016. Geneva: WHO; 2018b.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to T. S. Dharmarajan .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Dharmarajan, T.S. (2021). Geriatric Gastroenterology: A Geriatrician’s Perspective. In: Pitchumoni, C.S., Dharmarajan, T. (eds) Geriatric Gastroenterology. Springer, Cham. https://doi.org/10.1007/978-3-030-30192-7_1

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-30192-7_1

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-30191-0

  • Online ISBN: 978-3-030-30192-7

  • eBook Packages: MedicineReference Module Medicine

Publish with us

Policies and ethics