Geriatric psychiatry

Geriatric psychiatry, also known as geropsychiatry, psychogeriatrics or psychiatry of old age, is a branch of medicine and a subspecialty of psychiatry dealing with the study, prevention, and treatment of neurodegenerative, cognitive impairment, and mental disorders in people of old age.[1][2][3] Geriatric psychiatry as a subspecialty has significant overlap with the specialties of geriatric medicine, behavioural neurology, neuropsychiatry, neurology, and general psychiatry. Geriatric psychiatry has become an official subspecialty of psychiatry with a defined curriculum of study and core competencies.[4]

Geriatric psychiatry
SystemNervous system, Mental health
Significant diseasesAlzheimer's disease, Vascular dementia, Dementia with Lewy bodies, Parkinson's disease, Depression, Bipolar disorder, Schizophrenia, Delirium, Behavioral and psychological symptoms of dementia, Substance use disorder
Significant testsMental status examination, Cognitive testing, Neuroimaging
SpecialistGeriatric psychiatrist

History

Origins
Alois Alzheimer (1915), a German psychiatrist who identified the pathology involved in Alzheimer's disease.

The origins of geriatric psychiatry began with Alois Alzheimer, a German psychiatrist and neuropathologist who first identified amyloid plaques and neurofibrillary tangles in a fifty-year-old woman he called Auguste D. These plaques and tangles were later identified as being responsible for her behavioural symptoms, short-term memory loss, and psychiatric symptoms.[5] These brain anomalies would become identifiers of what later became known as Alzheimer's disease.[6]

Subspecialty

The subspecialty of geriatric psychiatry originated in the United Kingdom in the 1950s.[7]

Naming

The geropsychiatric unit, the term for a hospital-based geriatric psychiatry program, was first introduced in 1984 by Norman White MD, when he opened New England's first specialized program at a community hospital in Rochester, New Hampshire. White is a pioneer in geriatric psychiatry, being among the first psychiatrists nationally to achieve board certification in the field. The prefix psycho- had been proposed for the geriatric program, but White, knowing New Englanders' aversion to anything psycho- lobbied successfully for the name geropsychiatric rather than psychogeriatrics.

Diseases

Diseases and disorders diagnosed or managed by geriatric psychiatrists include:[8][9][10]

Geriatric Psychiatrist
Geriatric psychiatrist
Occupation
NamesDoctor, Medical Specialist
Occupation type
Specialty
Activity sectors
Medicine
Description
Education required
Fields of
employment
Hospitals, Clinics

A geriatric psychiatrist is a physician who specializes in the field of medical sub-specialty called geriatric psychiatrist. A geriatric psychiatrist holds a board certification after specialized training after attaining a medical degree, residency, and an additional geriatric psychiatry fellowship training program. The requirements may vary by countries. Geriatric psychiatrist are also psychiatrists who are qualified in the general diagnosis and treatment of psychiatric disorders. Some geriatric psychiatrists also conduct research to determine the cause and better treatments for neurodegenerative disorders and late-life mental health disorders.[11]

Geriatric psychiatrists may perform neurological examinations, mental status examination, laboratory investigations, neuroimaging, cognitive assessments to investigate the causes of psychiatric or neurologic symptoms in old age.[12]

International

The International Psychogeriatric Association is an international community of scientists and healthcare geriatric professionals working for mental health in aging.[13] International Psychogeriatrics is the official journal of the International Psychogeriatric Association.[14]

Canada

The Royal College of Physicians and Surgeons of Canada is responsible for training and certifying geriatric psychiatrists in Canada. Geriatric psychiatry requires an additional year of subspecialty fellowship training in addition to general psychiatry training.[8]

United Kingdom

The Royal College of Psychiatrists is responsible for training and certifying psychiatrists in the United Kingdom. Within the Royal College of Psychiatrists, the Faculty of Old Age Psychiatry is responsible for training in Old Age Psychiatry. Doctors who have membership of the Royal College of Psychiatrists can undertake a three or four-year training programme to become a specialist in Old Age Psychiatry. There is currently a shortage of old age psychiatrists in the United Kingdom.[15]

United States

The American Association for Geriatric Psychiatry (AAGP) is the national organization representing health care providers specializing in late life mental disorders. The American Journal of Geriatric Psychiatry[16] is the official journal of the AAGP.[17] The American Board of Psychiatry and Neurology and the American Osteopathic Board of Neurology and Psychiatry both issue a board certification in geriatric psychiatry.[18][19]

After a 4-year residency in psychiatry, a psychiatrist can complete a one-year fellowship in geriatric psychiatry. Many fellowships in geriatric psychiatry exist.[20]

See also

References
  1. Barraclough, J.; Gill, D. (1996). Hughes' outline of modern psychiatry. (4th ed.) New York: John Wiley & Sons. ISBN 978-0-471-96358-5
  2. Bowden, V.M.; Long, M.J. (1995). Geriatric psychiatry. Journal of the American Medical Association, 273, 1395.
  3. Harkins, S. (16 April 2003). "Glossary of Terms". Retrieved 17 October 2007.
  4. Fischer, Corinne E.; Ismail, Zahinoor; Rapoport, Mark J. (January 17, 2013). "Geriatric Psychiatry or Psychogeriatrics? Partnership at the CAGP/CCSMH 2012 Scientific Meeting". Canadian Geriatrics Journal. 16 (1): 3–5. doi:10.5770/cgj.16.66. PMC 3578771. PMID 23441142 – via cgjonline.ca.
  5. Berrios, G. E. (1990). "Alzheimer's disease: A conceptual history". International Journal of Geriatric Psychiatry. 5 (6): 355–365. doi:10.1002/gps.930050603. S2CID 145155424.
  6. "Alois Alzheimer". Biography.com. 2 April 2014. Archived from the original on 23 March 2018. Retrieved 19 February 2019.
  7. Clare Hilton; Tom Arle (December 2010). The Development of Old Age Psychiatry in the UK. pp. 7–11. doi:10.1002/9780470669600.ch2. ISBN 9780470747230 – via www.researchgate.net.
  8. "Canadian Academy of Geriatric Psychiatry - Definition of Geriatric Psychiatry". www.cagp.ca.
  9. "Alzheimer's or depression: Could it be both? - Mayo Clinic". www.mayoclinic.org. Retrieved 2019-11-20.
  10. "Depression in older adults: MedlinePlus Medical Encyclopedia". medlineplus.gov. Retrieved 2019-11-20.
  11. "Federally Funded Programs–Geriatric Mental Health Research And Services Fact Sheet". www.aagponline.org.
  12. "Careers in Geriatric Psychiatry". www.aagponline.org.
  13. "International Psychogeriatric Association". www.ipa-online.org.
  14. "Psychogeriatrics journal". www.blackwellpublishing.com.
  15. Blewett, Charlotte; Milward, Kate; Bailey, Alex; McAlpine, Lynsey (June 2019). "Recruitment into old age psychiatry". BJPsych Bulletin. 43 (3): 131–135. doi:10.1192/bjb.2018.112. ISSN 2056-4694.
  16. http://ajgponline.org/ The American Journal of Geriatric Psychiatry
  17. "American Association for Geriatric Psychiatry". www.aagponline.org.
  18. "Geriatric Psychiatry". American Board of Psychiatry and Neurology.
  19. "Specialties & Subspecialties". American Osteopathic Association. Retrieved 23 September 2012.
  20. "Geriatric psychiatry fellowship". Archived from the original on 2008-12-30. Retrieved 2008-10-24.
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