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INTEGRATIVE GERIATRICS

General Principles

Forty percent of older adults regularly use integrative medicine, and growing numbers are turning to strategies variably known as healthy aging, restorative aging, functional medicine, antiaging medicine, lifestyle medicine, and age management medicine. Usage rates by older adults in particular are expected to increase in coming decades since baby boomers are more likely to question convention, seek alternative care, and use multiple modalities than earlier generations.

The popularity of alternative and wellness approaches to health care reveals significant gaps in mainstream medicine’s ability to adequately address patient concerns and belief systems. The most common reasons older adults go beyond conventional medicine include symptom management, disease prevention, wellness, forestalling aging, and treatment of chronic conditions. Clinicians who can discuss complementary modalities with patients in educated, collaborative, evidence-based ways may find that they not only are better able to identify their patients’ unmet care needs and health goals but also have a larger toolbox with which to address them. Equally important, they will have the knowledge to direct patients toward useful modalities and counsel them away from the people and organizations profiting from sales of unproven and potentially harmful therapies.

Background, Definitions, and Usage Patterns

Integrative medicine is defined as care and research that attends to social, psychological, spiritual, behavioral, environmental, and biological determinants of health; emphasizes the clinician-patient relationship and patient empowerment; and brings together conventional and nonmainstream therapies in a coordinated, evidence-informed way to foster healing. Nonmainstream therapies are called “alternative” when used instead of conventional medicine and “complementary” when used with conventional medicine. Integrative medicine takes an evidence-based approach to these diverse practices and treatments, drawing from all traditions and considering the patient’s mind-body-spirit needs and sociocultural contexts to optimize health, wellness, and disease management (Table 71–1).

Table 71–1.Classifications of diagnostic and treatment approaches in integrative geriatrics.

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