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Geriatric Medicine
The Department of Geriatric Medicine specializes in the diagnosis and treatment of dementia, frailty, geriatric syndrome and polypharmacy in older adults. It provides Comprehensive Geriatric Assessment (CGA) and manages multiple diseases in order patients who have physical and/or mental disability.
Medical services
Older patients often suffer from a variety of diseases and clinical problems. To deal with them, the department forms multidisciplinary teams composed of geriatricians and related specialists such as psychologists and pharmacists to provide comprehensive medical care.
Diagnosis and treatment policy
To provide optimal care for each patient, the department collaborates with numerous specialists and employs Comprehensive Geriatric Assessment (CGA) to extensively evaluate dementia, frailty, geriatric syndromes, as well as the diverse and systemic diseases and living functions.
Specialties
The department provides general medical care for older people, but particularly focuses on dementia, frailty, geriatric syndrome and polypharmacy. It also excels at providing emergency care to the elderly.
Dementia
Various tests including imaging and spinal fluid tests are carried out to provide optimal diagnosis and treatment based on living functions and a differential diagnosis of dementia.
Osteoporosis
A condition that makes bones fragile and prone to fractures. Appropriate tests, treatments, and instructions for fall prevention are provided.
Frailty
The term frailty is used to describe the reversible decline in physical and mental functioning. A comprehensive assessment and examination for frailty is carried out to provide countermeasures and treatment.
Geriatric syndrome
Causes are determined, and treatment provided for characteristic symptoms of older adults such as cognitive impairment, muscle weakness (sarcopenia), falls and fractures, depression, malnutrition, and urinary incontinence.
Polypharmacy
A condition where the elevated number of medications leads to problems such as side effects and missed doses. Medications are adjusted based on a comprehensive determination of the appropriate prescriptions.
Sleep apnea
A polysomnography is performed and, if necessary, the patient is treated with nasal Continuous Positive Airway Pressure (nCPAP).
Gender sensitive medicine
Women’s general outpatient clinic (including traditional herbal medicine) for women by female physicians.
Target diseases
Frailty, sarcopenia, dementia, depression, stroke, heart failure, atrial fibrillation, aspiration pneumonia, urinary tract infections, malignancy, hypertension, diabetes, COPD, sleep apnea, osteoporosis, falls, malnutrition, dysuria, polypharmacy, poor appetite, weight loss, etc.
Advanced treatment/ Specialized treatments
- Comprehensive Geriatric Assessment (CGA)
Frequently performed tests and descriptions
Outpatients
[Comprehensive Geriatric Assessment (CGA)] Living functions are comprehensively assessed using the Barthel Index, Hasegawa’s Dementia Scale-revised, Geriatric Depression Scale (GDS), etc. [Dementia Examination] Psychological examination, brain CT scan, brain MRI, cerebral blood flow SPECT study [Frailty and sarcopenia] Bone density measurement, muscle mass measurement, gait speed measurement.
Inpatients
[Comprehensive Geriatric Assessment (CGA)] Used to support discharge from the hospital and to prepare the care environment
after discharge [Dementia screening] Spinal fluid collection in addition to outpatient examination [Drug adjustment hospitalization] Prescription drugs are adjusted based on CGA and other examinations [Poor appetite and weight loss] Identify causes such as malignancy and provide guidance on nutrition and exercise [Sleep apnea screening] Polysomnography.
Masahiro Akishita
Departments/Divisions
Geriatric Medicine
Titles
M.D. , Ph.D.
Expertise/Specialties
geriatric medicine, gerontology
Research Interests
Pharmacotherapy and its safety in the elderly. Gender difference in geriatric medicine.
Languages
Japanese, English
Procedure of forgetfulness assessment in the Department of Geriatric Medicine
| Initial outpatient consultation (when initially visiting the Department of Geriatric Medicine)Medical history interview, consultation, and entry in the interview sheet | ||
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Outpatient forgetfulness assessment
| Inpatient forgetfulness assessment (duration: approximately 1 week) Comprehensive geriatric assessment (CGA)Blood and urine tests, X-rays, electrocardiography, head CT/MRI scans, SPECT-based cerebral blood flow measurement, carotid ultrasound, pulse wave velocity test, 24-hour ambulatory blood pressure monitoring (ABPM), body sway testExplanations of test results and treatment methodsOral medication guidance by pharmacists > | |
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| Continuation of outpatient treatment in our hospital or initial facilities. | ||
Areas of expertise, treatment and examination methods
Target diseases and symptoms
- Dementia (such as Alzheimer's disease, vascular dementia, dementia with Lewy bodies, frontotemporal dementia and normal pressure hydrocephalus)
- Diseases negatively influencing the cognitive function and ADL (such as normal pressure hydrocephalus and subdural hematoma)
- Examination of weight loss and anorexia
- Sarcopenia, Frailty
- Review and adjustment of multi-drug combination
- Arteriosclerosis, hypertension, and metabolic disorders in the elderly (such as dyslipidemia and diabetes)
- Respiratory diseases in the elderly (such as aspiration pneumonia, COPD, interstitial pneumonitis, and pulmonary cancer)
- Sleep apnea syndrome
- Osteoporosis and vertebral compression fractures
- Urinary tract infection, sepsis, chronic inflammatory diseases, and malignant tumors in the elderly
- Others including: Parkinsonism, depression, syncope, falls, orthostatic hypotension, sarcopenia, malnutrition, dysuria, and dizziness
