Prevalence of Common Geriatric Giants among Patients attending Geriatric Clinic of a Tertiary Care Hospital

Objectives: To study the prevalence of Geriatric giants among elderly attending Geriatric clinic of YMCH and to study the various factors (like Age, gender, co-morbidity, etc.) associated with these Geriatric giants. Method: This retrospective study was conducted in a tertiary care referral centre, from the year 2018 to 2019, Ethics committee approval was taken wide letter no. YEC-1/29/2020 (Protocol YEC2/162). Two hundred two geriatric patients, presenting to the geriatric clinic with geriatric giants, with various co-morbidities, their data was recorded. Falls in the previous year and urinary incontinence were recorded. Polypharmacy is considered as concurrent use of more than four drugs. Diagnosis of dementia and depression was conducted according to the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition diagnostic criteria. All the proportions were expressed as percentages; mean ± SD were used for Numerical Data. Factors such as age group, gender, morbidity index (number of morbidity present) which are related to geriatric giants were assessed using the Chi-square test. Results: The frequency of urinary incontinence was 75.7%, depression was 69.3%, falls were 67.3%, dementia was 47.5%, and polypharmacy was 33.6%. When all the participants were divided into four groups age-wise, respectively (60-69, 70-79, 80-89, 90-99 years), all syndromes were significantly increased with age. While a significant number of cases in the 60-69 years age group did not have any syndromes, more than 50% of cases in ≥80 years had more than three geriatric syndromes simultaneously. Conclusion: The frequency and coincidence of geriatric giants, except for polypharmacy, increases with age. Therefore, clinicians other than the geriatricians taking care of older people should be aware of these syndromes as well as their treatment mechanisms

Treating complexity in the older adult - the role of the geriatric giants

As people age, they accumulate medical conditions. Geriatric giants comprise a group of conditions that lead to significant mortality and morbidity and contribute to the complexity in treating geriatric patients. They are common and rarely occur in isolation. The 5 Is of geriatric giants are: iatrogenesis, immobility, instability, incontinence and impaired cognition. Consequences for the patient and their caregivers include loss of functional independence, institutionalisation and caregiver burnout. Primary care practitioners are often the first port of call for geriatric patients in South Africa and by asking a few key questions and performing a thorough examination; these conditions can be recognised early. Whilst there are often limitations to cure, the main aim is to maintain the older adult’s functional independence as much as possible, and by following an organised management approach to each of these conditions, the quality of life of patients can be improved.