Geriatric Syndromes by Organ System
Geriatric syndromes are clinical conditions in older adults that do not fit into discrete disease categories and are characterized by the body's inability to compensate for cumulative declines across multiple systems. These syndromes significantly impact morbidity, mortality, and quality of life in the elderly population 1.
Neurological System
- Cognitive Impairment and Dementia
- Alzheimer's disease, vascular dementia, Lewy body dementia
- Mild cognitive impairment
- Delirium (acute confusional state)
- Depression and Mood Disorders
- Late-life depression
- Anxiety disorders
- Sleep Disorders
- Insomnia
- Sleep apnea
- Circadian rhythm disorders
Cardiovascular System
- Orthostatic Hypotension
- Syncope
- Heart Failure with Preserved Ejection Fraction
- Atrial Fibrillation
- Vascular Stiffness
- Contributes to systolic hypertension and diastolic dysfunction 2
Musculoskeletal System
- Falls and Gait Disorders
- Balance impairment
- Sarcopenia (age-related loss of muscle mass and strength)
- Frailty
- Characterized by decreased physiologic reserve and resistance to stressors 3
- Osteoporosis and Fractures
- Osteoarthritis
Genitourinary System
- Urinary Incontinence
- Stress, urge, overflow, and functional types
- Nocturia
- Urinary Tract Infections
- Sexual Dysfunction
- Benign Prostatic Hyperplasia (in men)
Gastrointestinal System
- Malnutrition
- Weight loss patterns (>5% in six months or >10% beyond six months) 4
- Dysphagia
- Constipation
- Fecal Incontinence
- Anorexia of Aging
Sensory Systems
- Vision Impairment
- Cataracts, glaucoma, macular degeneration
- Hearing Loss
- Presbycusis
- Vestibular Disorders
- Dizziness and vertigo
Endocrine System
- Diabetes with Geriatric Complications
- Higher prevalence of geriatric syndromes in diabetic elderly 4
- Thyroid Dysfunction
- Vitamin D Deficiency
Hematologic/Immunologic System
- Anemia of Chronic Disease
- Immune Senescence
- Increased susceptibility to infections
- Decreased vaccine response
Integumentary System
- Pressure Ulcers
- Skin Tears
- Xerosis (Dry Skin)
- Pruritus
Multisystem Syndromes
- Polypharmacy
- Use of multiple medications with increased risk of adverse drug reactions 4
- Iatrogenic Complications
- Medication-related adverse events
- Hospital-acquired deconditioning
- Failure to Thrive
- Progressive functional decline with malnutrition
- Pain Syndromes
- Persistent pain affecting multiple systems
Psychosocial Aspects
- Social Isolation
- Elder Abuse and Neglect
- Caregiver Burden
Unique Features of Geriatric Syndromes
Multifactorial Etiology: Geriatric syndromes result from accumulated impairments in multiple systems rather than a single disease process 3.
Shared Risk Factors: Four key risk factors are common across multiple geriatric syndromes: older age, baseline cognitive impairment, baseline functional impairment, and impaired mobility 3.
Synergistic Interactions: These syndromes often interact and potentiate each other in a feedback loop, leading to progressive decline 5.
Impact on Quality of Life: Geriatric syndromes have been shown to significantly reduce health-related quality of life, often more than traditional medical conditions 6.
Complexity and Loss of Resilience: The aging process weakens coordination among body systems, undermining complexity and making older adults more vulnerable to stressors 5.
Understanding these geriatric syndromes by organ system provides a framework for comprehensive assessment and targeted interventions to improve outcomes in older adults. Early identification and management of these syndromes are essential to prevent functional decline and preserve quality of life.