Geriatrics as seen by the physiatrist.

An important part of geriatric medicine is rehabilitation, ranging from the prevention and early detection of disease or injury to restoration of the patient to his highest possible functional level. The basic step toward this objective is a thorough evaluation of all the factors involved, so that realistic goals may be set. Evaluation is discussed under the headings of psychological status and physical status (including the cardiac, peripheral vascular, nervous and musculoskeletal systems). Special attention is given to certain disorders affecting ambulation—hemiplegia, hip fracture, and arthritis of the lower extremities. The syndrome of musculoskeletal failure consists of joint deformities and disabilities that have developed because of several mild pathological states acting in combination. Since it is one of the most common forms of disability, it should always be considered in any program of rehabilitative therapy.