Unit GERONTOLOGY AND GERIATRICS

GERONTOLOGY AND GERIATRICS - MOD. 1

Code	50999502
Location	TERNI
CFU	2
Teacher	Carmelinda Ruggiero
Teachers	Carmelinda Ruggiero
Hours	18 ore - Carmelinda Ruggiero
Learning activities	Caratterizzante
Area	Formazione clinica interdisciplinare e medicina basata sulle evidenze
Academic discipline	MED/09
Type of study-unit	Obbligatorio (Required)
Language of instruction	Italian
Contents	Demography of aging. Principles of biology and physiology of aging. Elderly patients and geriatric patients. Main geriatric syndromes. Recurring clinical issues in geriatric medicine. Aspects of physical therapy and assistance in the elderly. Ethical controversies in geriatric medicine.
Reference texts	- Elderly patient, geriatric patients and medical complexity. Foundations of Gerontology and Geriatrics. Senin U., Cherubini A., Mecocci P., 3rd Edition EdiSES Naples, 2011. - Hazzard's Geriatric Medicine and Gerontology, Seventh Edition, Mcgraw-Hill 2017
Educational objectives	The course aims to acquaint the student with the principles of Gerontology and Geriatrics, a completely autonomous discipline, with its own cultural and professional area. Discussed topics should bring to light the originality of the elderly patient, which differs from the adult in terms of anatomy, physiology, pathology, and clinical care; the relationship between evidence-based medicine, medical complexity and geriatric medicine; the frail elderly; the geriatric syndromes; the main recurrent diseases in geriatrics; behavioral principles in geriatric medicine. Upon this knowledge the student must be able to recognize the unique aspects of aging, atypical presentation of many systemic and organic diseases and the complexity of multimorbidity, interactions between psychic and organic conditions able to amend the prognosis of diseases, the risks associated with polypharmacy, the value of multidimensional geriatric assessment in different health care settings.
Prerequisites	Good knowledge of the main organic diseases and systemic syndromes in the internal medicine field is required in order to understand them and identify them in the elderly, the oldest old and the frail.
Teaching methods	Lectures and theoretical-practical activity in the acute care unit and in educational elective activities.
Other information	Practical training in the acute care unit and attendance of at least 75% of lectures is mandatory.
Learning verification modality	The exam includes a 30-minutes oral discussion to ascertain the level of knowledge and skills of deduction and clinical application on theoretical and practical content of the program. To this intent, practical training is essential. This must be carried out before the oral exam at the Department of S.C. Geriatrics (one week per student, from Monday to Friday from 8.30 to 10.30).
Extended program	- Principles of Biology and Physiology of aging - Aging: demographics in Italy, in Europe and outside Europe: implications in clinical practice - Introduction to the clinical method. Relationship between scientific method and clinical method. The clinical method in the light of the Evidence-Based Medicine and Narrative Medicine - Geriatric medicine as medicine of complexity - Chronic diseases, polypathology and disability; concept pertaining to active life - The congestive terminal (failure to thrive) - The concept of geriatric syndrome, atypical presentation of diseases in the elderly - “Frail Elderly”; poverty, isolation, neglect - Multidimensional geriatric rating: concepts, methods and instruments; Geriatric Assessment Units and teamwork - First and second generation VMD Tools - Geriatric care Network (UO Geriatric acute; Integrated Home Care, Residential Health Care, Day Care Centre) - Elderly assistance; social aspects and integration between healthcare and social care; interaction with the General Practitioner - Strategy of therapeutic decision. Methods of adherence to treatment and efficacy / tolerability monitoring - Principles of geriatric treatment: clinical implications of specific pharmacokinetic and pharmacodynamic processes - The iatrogenic disease. Risk of iatrogenic disease in peculiar conditions (elderly, polypharmacy, drug abuse, etc.) - Brain aging, cognitive disorders in the elderly, dementia in elderly; delirium - Depression in the elderly - Heart failure in the elderly - Sensory deficits and related clinical and practical complications - Postural instability, dizziness, sarcopenia, osteoporosis, falls and fractures in the elderly - Dizziness, postural hypotension, syncope - Nutritional problems in the elderly - Immobilization; bedsores - Urinary Incontinence - The role of physical activity and lifestyle changes in the treatment and prevention of diseases - Supporting health in the old age: primary and secondary prevention. - Principles of physical therapy - Ethical controversies in geriatric medicine

GERONTOLOGY AND GERIATRICS - MOD. 2

Code	50999701
Location	TERNI
CFU	1
Teacher	Patrizia Mecocci
Teachers	Patrizia Mecocci
Hours	9 ore - Patrizia Mecocci
Learning activities	Caratterizzante
Area	Formazione clinica interdisciplinare e medicina basata sulle evidenze
Academic discipline	MED/09
Type of study-unit	Obbligatorio (Required)
Language of instruction	Italian
Contents	Physiological brain aging and the main neurodegenerative diseases in advanced age.
Reference texts	Elderly patient, geriatric patients and medical complexity. Foundations of Gerontology and Geriatrics. Senin U., Cherubini A., Mecocci P., 3rd Edition EdiSES Naples, 2011. Hazzard's Geriatric Medicine and Gerontology, Seventh Edition, Mcgraw-Hill 2017
Educational objectives	The course aims to acquaint the student with physiological brain aging and the main neurodegenerative diseases in advanced age.
Prerequisites	Understanding of topics requires knowledge of Anatomy and Physiology of the C.N.S.
Teaching methods	Frontal lesson.
Other information	Practical training in the acute care unit and attendance of at least 75% of lectures is mandatory.
Learning verification modality	The exam includes a 30-minutes oral discussion to ascertain the level of knowledge and skills of deduction and clinical application on theoretical and practical content of the program. To this intent, practical training is essential. This must be carried out before the oral exam at the S.S. Geriatria.
Extended program	- Brain aging - Cognitive impairment and dementia

PROFESSIONAL TRAINING IN GERONTOLOGY AND GERIATRICS - I

Code	50997301
Location	TERNI
CFU	1
Teacher	Carmelinda Ruggiero
Teachers	Carmelinda Ruggiero
Hours	20 ore - Carmelinda Ruggiero
Learning activities	Altro
Area	Tirocini formativi e di orientamento
Academic discipline	MED/09
Type of study-unit	Obbligatorio (Required)
Language of instruction	Italian
Contents	Demography of aging. Principles of biology and physiology of aging. Elderly patients and geriatric patients. Main geriatric syndromes. Recurring clinical issues in geriatric medicine. Aspects of physical therapy and assistance in the elderly. Ethical controversies in geriatric medicine.
Reference texts	- Elderly patient, geriatric patients and medical complexity. Foundations of Gerontology and Geriatrics. Senin U., Cherubini A., Mecocci P., 3rd Edition EdiSES Naples, 2011. - Hazzard's Geriatric Medicine and Gerontology, Seventh Edition, Mcgraw-Hill 2017
Educational objectives	The course aims to acquaint the student with the principles of Gerontology and Geriatrics, a completely autonomous discipline, with its own cultural and professional area. Discussed topics should bring to light the originality of the elderly patient, which differs from the adult in terms of anatomy, physiology, pathology, and clinical care; the relationship between evidence-based medicine, medical complexity and geriatric medicine; the frail elderly; the geriatric syndromes; the main recurrent diseases in geriatrics; behavioral principles in geriatric medicine. Upon this knowledge the student must be able to recognize the unique aspects of aging, atypical presentation of many systemic and organic diseases and the complexity of multimorbidity, interactions between psychic and organic conditions able to amend the prognosis of diseases, the risks associated with polypharmacy, the value of multidimensional geriatric assessment in different health care settings.
Prerequisites	Good knowledge of the main organic diseases and systemic syndromes in the internal medicine field is required in order to understand them and identify them in the elderly, the oldest old and the frail.
Teaching methods	Lectures and theoretical-practical activity in the acute care unit and in educational elective activities.
Other information	Practical training in the acute care unit and attendance of at least 75% of lectures is mandatory.
Learning verification modality	The exam includes a 30-minutes oral discussion to ascertain the level of knowledge and skills of deduction and clinical application on theoretical and practical content of the program. To this intent, practical training is essential. This must be carried out before the oral exam at the Department of S.C. Geriatrics (one week per student, from Monday to Friday from 8.30 to 10.30).
Extended program	- Principles of Biology and Physiology of aging - Aging: demographics in Italy, in Europe and outside Europe: implications in clinical practice - Introduction to the clinical method. Relationship between scientific method and clinical method. The clinical method in the light of the Evidence-Based Medicine and Narrative Medicine - Geriatric medicine as medicine of complexity - Chronic diseases, polypathology and disability; concept pertaining to active life - The congestive terminal (failure to thrive) - The concept of geriatric syndrome, atypical presentation of diseases in the elderly - “Frail Elderly”; poverty, isolation, neglect - Multidimensional geriatric rating: concepts, methods and instruments; Geriatric Assessment Units and teamwork - First and second generation VMD Tools - Geriatric care Network (UO Geriatric acute; Integrated Home Care, Residential Health Care, Day Care Centre) - Elderly assistance; social aspects and integration between healthcare and social care; interaction with the General Practitioner - Strategy of therapeutic decision. Methods of adherence to treatment and efficacy / tolerability monitoring - Principles of geriatric treatment: clinical implications of specific pharmacokinetic and pharmacodynamic processes - The iatrogenic disease. Risk of iatrogenic disease in peculiar conditions (elderly, polypharmacy, drug abuse, etc.) - Brain aging, cognitive disorders in the elderly, dementia in elderly; delirium - Depression in the elderly - Heart failure in the elderly - Sensory deficits and related clinical and practical complications - Postural instability, dizziness, sarcopenia, osteoporosis, falls and fractures in the elderly - Dizziness, postural hypotension, syncope - Nutritional problems in the elderly - Immobilization; bedsores - Urinary Incontinence - The role of physical activity and lifestyle changes in the treatment and prevention of diseases - Supporting health in the old age: primary and secondary prevention. - Principles of physical therapy - Ethical controversies in geriatric medicine

PROFESSIONAL TRAINING IN GERONTOLOGY AND GERIATRICS - II

Code	50997201
Location	TERNI
CFU	1
Teacher	Patrizia Mecocci
Teachers	Patrizia Mecocci
Hours	20 ore - Patrizia Mecocci
Learning activities	Altro
Area	Tirocini formativi e di orientamento
Academic discipline	MED/09
Type of study-unit	Obbligatorio (Required)
Language of instruction	Italian
Contents	Physiological brain aging and the main neurodegenerative diseases in advanced age.
Reference texts	Elderly patient, geriatric patients and medical complexity. Foundations of Gerontology and Geriatrics. Senin U., Cherubini A., Mecocci P., 3rd Edition EdiSES Naples, 2011. Hazzard's Geriatric Medicine and Gerontology, Seventh Edition, Mcgraw-Hill 2017
Educational objectives	The course aims to acquaint the student with physiological brain aging and the main neurodegenerative diseases in advanced age.
Prerequisites	Understanding of topics requires knowledge of Anatomy and Physiology of the C.N.S.
Teaching methods	Frontal lesson.
Other information	Practical training in the acute care unit and attendance of at least 75% of lectures is mandatory.
Learning verification modality	The exam includes a 30-minutes oral discussion to ascertain the level of knowledge and skills of deduction and clinical application on theoretical and practical content of the program. To this intent, practical training is essential. This must be carried out before the oral exam at the S.S. Geriatria.
Extended program	- Brain aging - Cognitive impairment and dementia