Appropriate Terminology for Referring to Geriatric Patients
Use precise, clinically-defined terminology based on functional status and age rather than generic terms—specifically: "elderly" for those over 65, "geriatric patient" for those with functional decline and disease burden, "frail elderly" for those with ADL limitations, and "very elderly" for those over 85. 1
Standardized Terminology Framework
Age-Based Definitions
"Elderly" refers specifically to the age group over 65 years and is the appropriate general term for chronological age designation 1
"Very old" or "very elderly" describes those over 85 years of age, recognizing this population's distinct care needs 1
Some trauma and emergency protocols use age 55 as the threshold for geriatric-focused management due to significantly elevated mortality risk at this age 2
Functional Status-Based Definitions
"Geriatric patient" is the precise term for a biologically elderly patient who is at acute risk of loss of independence due to acute and/or chronic diseases (multiple pathology) with related limitations in physical, psychological, mental and/or social functions 1
This designation applies when abilities to perform basic activities of independent daily living are jeopardized, diminished, or lost, and the person requires rehabilitative, physical, psychological and/or social care 1
"Frail elderly" specifically describes patients limited in activities of daily living due to physical, mental, psychological and/or social impairments as well as recurrent disease, who suffer from multiple pathologies that seriously impair independence and require particular help and/or care 1
Clinical Application Algorithm
When to Use "Elderly" vs "Geriatric Patient"
Use "elderly" when referring to chronological age alone (>65 years) without functional impairment 1
Use "geriatric patient" when the individual demonstrates functional decline, multiple comorbidities, or geriatric syndromes regardless of whether they meet the age 65 threshold 1, 2
The American Geriatrics Society's "Geriatric 5Ms" framework (Mind, Mobility, Medications, What Matters Most, Multicomplexity) should guide identification of patients requiring geriatric-specific terminology and care 2, 3
Context-Specific Considerations
In emergency and trauma settings, use geriatric terminology for patients ≥55 years due to significantly elevated mortality risk even when adjusted for injury severity 2
In oncology settings, the National Comprehensive Cancer Network uses age 65 as the cutoff for geriatric treatment algorithms, though functional status may warrant geriatric designation earlier 2
In diabetes care, the American Diabetes Association recommends geriatric-specific screening (cognitive impairment, falls, polypharmacy) for all adults ≥65 years 2, 3
Important Caveats
Never rely on chronological age alone—biological age, frailty status, and comorbidities are more important determinants than numerical age for appropriate terminology 2
The term "geriatric patient" implies specific care needs including reduced capacity for rehabilitation, meaning restoration of muscle mass and other functions requires greater effort compared to younger patients 1
Functional status assessment should include global function (ability to perform activities of daily living) and specific functions (muscle strength, immune function, cognitive status) to determine appropriate terminology 1
Frailty prevalence in dementia patients ranges from 24.3% to 98.9% depending on setting, making functional assessment critical for accurate terminology 4
Terminology to Avoid
Avoid vague or non-specific terms that don't convey clinical meaning or care requirements 1
The term "oldest old" was historically used for those ≥85 but "very elderly" is the current preferred terminology 1
Generic age references without functional context miss the opportunity to communicate specific care needs and risk stratification 1, 2