Some Considerations regarding Geriatric Syndromes
Authors: Elizabeth A. Phelan, Elizabeth K. Vig, Itamar B. Abrass
Journal: Annals of Internal Medicine (2001)

Letters18 December 2001Some Considerations regarding Geriatric SyndromesElizabeth A. Phelan, MD, MS, Elizabeth K. Vig, MD, MPH, and Itamar B. Abrass, MDElizabeth A. Phelan, MD, MSUniversity of Washington; Seattle, WA 98104-2499Search for more papers by this author, Elizabeth K. Vig, MD, MPHUniversity of Washington; Seattle, WA 98104-2499Search for more papers by this author, and Itamar B. Abrass, MDUniversity of Washington; Seattle, WA 98104-2499Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-135-12-200112180-00029 SectionsAboutVisual AbstractPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We read Dr. Drachman's editorial, “Occam's Razor, Geriatric Syndromes, and the Dizzy Patient” (1), with interest. Dr. Drachman asks, “What would change in the physician's approach to … dizziness if it is labeled a ‘geriatric syndrome’?” He believes that such a label would “underscore the likelihood that more than one problem contributes to the symptom,” but he expresses concern that dizziness might be written off as a “usual concomitant of aging” and that the dizzy patient would not receive the diagnostic evaluation deserved.To geriatricians, terming a condition a geriatric syndrome implies the application of an approach alternative to the “diagnose and treat approach,” one that we term a risk factor assessment and reduction approach. Diagnoses are still sought and, if identified, treated. In addition, a risk factor assessment is performed, followed by the application of targeted interventions to reduce or eliminate any risk factor or risk factors identified. The goal is to reduce the severity of the symptom and any associated disability (Table). What should in fact change in the physician's approach if dizziness is labeled a geriatric syndrome? In our opinion, the approach to the evaluation. It should be understood that this symptom, because it is probably produced by “a multiplicity of factors,” may not be curable but may be ameliorated by risk factor reduction.Table. Comparison of Two Approaches to Geriatric Syndromes Using Falls as an Example Dr. Drachman's editorial and the subsequent letters to the editor (2-4) alerted us to a misunderstanding of the term geriatric syndrome. As geriatricians, we must work to dispel misunderstandings associated with this label, particularly the idea that there is no need to diagnose and treat any identifiable cause or perform any risk factor assessment or reduction for such conditions. If our efforts are not successful, we may need to come up with a new strategy to indicate that medical attention to geriatric syndromes is required.References1. Drachman DA. Occam's razor, geriatric syndromes, and the dizzy patient [Editorial]. Ann Intern Med. 2000;132:403-4. [PMID: 10691591] LinkGoogle Scholar2. Katsarkas A. Chronic dizziness in older adults [Letter]. Ann Intern Med. 2000;133:236. [PMID: 10906843] LinkGoogle Scholar3. Cheng JS. Chronic dizziness in older adults [Letter]. Ann Intern Med. 2000;133:236. [PMID: 10906844] LinkGoogle Scholar4. Weintraub MI. Chronic dizziness among older adults [Letter]. Ann Intern Med. 2000;132:1009-10. [PMID: 10858170] LinkGoogle Scholar Comments0 CommentsSign In to Submit A Comment Author, Article, and Disclosure InformationAffiliations: University of Washington; Seattle, WA 98104-2499 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoOccam's Razor, Geriatric Syndromes, and the Dizzy Patient David A. Drachman Chronic Dizziness among Older Adults Michael I. Weintraub Chronic Dizziness in Older Adults Athanasios Katsarkas Chronic Dizziness in Older Adults Jose S. Cheng Metrics Cited byChronic multisite pain: evaluation of a new geriatric syndromeFall Prevention in Community-Dwelling Older AdultsElizabeth A. Phelan, MD, MS and Katherine Ritchey, DO, MPHClinical implications of geriatric syndromesTen ways to improve the care of elderly patients in the hospitalSELF-NEGLECT AS A GERIATRIC SYNDROME 18 December 2001Volume 135, Issue 12Page: 1095KeywordsAgingDisabilitiesGeriatricsMedical risk factors ePublished: 18 December 2001 Issue Published: 18 December 2001 Copyright & PermissionsCopyright © 2001 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...