As the baby boomer generation ages, the number of Americans age 65 and older is increasing dramatically.
According to U.S. Census figures, the nation’s 65-and-older population grew from 44 million in 2013 to 46 million in 2014. By 2030, that number will explode to more than 75 million, according to census estimates.
And as the population ages, so does the need for geriatricians. Geriatricians are doctors who specialize in treating older patients. They get training and certification beyond basic family practice.
The field of geriatrics is a relatively new one, says Dr. William J. Hall, a Paul Fine Professor of Medicine at the University of Rochester School of Medicine’s Center for Healthy Aging.
“It’s the youngest of specialties, even though we take care of the oldest of patients,” Hall says.
Even for geriatricians, caring for older people with multiple health problems can be tricky, the society says.
“An 85-year-old is not the same person they were at 45,” Hall says.
As people age, their bodies change. They go through metabolic changes, changes in kidney function, and changes in body fat that can affect metabolism, among other things, says Dr. Amy M. Westcott, a geriatrician who works in the palliative care department of the Penn State Milton S. Hershey Medical Center in Hershey, Pa.
In fact, more than half of adults age 65 and older have three or more medical problems, such as heart disease, diabetes, arthritis, Alzheimer’s disease or high blood pressure, according to the American Geriatrics Society.
Many patients with multiple medical problems are on multiple medications, and changes in people’s bodies as they age also affect the way the medicines affect them. One of a geriatrician’s key roles is to manage the many medications a person takes.
“A lot of time is spent figuring out, ‘Do they really need all these medications or are they better off without them?’” Westcott says.
For example, Hall says, there was one point when the philosophy on high blood pressure was to leave it untreated. But with all the advancements in medications, more people are taking them to lower their blood pressure. But lowering a patient’s blood pressure can sometimes lead to lightheadedness and even falls, something every older person wants to avoid, Hall says.
“It’s a fine balance between treating high blood pressure and not treating high blood pressure,” he says.
Along with high blood pressure, diabetes is among the top medical problems facing older patients. But regulation of blood sugar is a “very complicated thing,” Hall says. “In some patients, it’s incredibly easy to over-treat.”
Older patients might have different liver function or eating habits that could affect treatments, as well. So geriatricians work to ensure the care for one condition isn’t actually causing more harm than good, with the ultimate goal of helping people live independently longer.
“We will ‘undertreat’ one chronic illness because treating it will make another illness worse,” Hall says.
So when is it time for an aging patient to see a geriatrician?
“There’s no age really,” Westcott says. “What aging is in our society you cannot put a number on.”
Some patients are as young as 65, often already with multiple medical conditions. Others are into their 80s before they need specialized care.
Yet there are more patients who are younger and healthier who are opting to see a geriatrician.
“They say, ‘I’m aging and I want to age well,’” Westcott says. “It might help them feel better and live independently longer.”
