Geriatric Psychiatry

The subspecialty of Geriatric Psychiatry is focused on older adults, usually starting around the age of 65 years old. As the body ages, its capacities change: there are tissue losses, fewer cells, and therefore lost functioning. The older adult responds differently to the usual psychiatric medications, and the diseases of geriatric psychiatry have their own medications. Additionally, older adults often have multiple other medical problems and are often on a long list of other medications. This complex situation requires significant consideration and coordination, especially when any new medication is added.

Many of the disorders common to this age group are ultimately due to loss of neurons, in some way or another. Of course, each disorder is highly complex and much more complicated than my overarching generalizations here. However, the bottom line is the loss of functioning in the brain, which means loss of functioning in the command center of life. Some common examples are Alzheimer’s dementia, Frontotemporal dementia, Parkinson’s, and stroke. There is an incredibly large and complex world of knowledge just about these disorders and the older adults who struggle with them. Usually, an expert in Geriatric Psychiatry is the best physician to treat such problems. Even common problems like depression are not so simple in the geriatric world!! A stroke can lead to depression, or depression can be the first sign of dementia. I could give more examples, but the bottom line is that if you are age 65 or older and you have new-onset mental problems, you probably need to see an expert in your age group, i.e. the Geriatric Psychiatrist.

I am not a geriatric psychiatrist and I rarely see adults over 65 years old because my basic medical training was in pediatrics and not internal medicine, meaning that I am very familiar with the physical diseases of children, but not very familiar with the physical diseases of the elderly.