{{Short description|Medical speciality}} {{Infobox medical specialty | title = Geriatric psychiatry | subdivisions = | image = | caption = | system = Nervous system, mental health | diseases = Alzheimer's disease, vascular dementia, dementia with Lewy bodies, Parkinson's disease, depression, bipolar disorder, schizophrenia, delirium, behavioral and psychological symptoms of dementia, substance use disorder | tests = Mental status examination, cognitive testing, neuroimaging | specialist = Geriatric psychiatrist }}
'''Geriatric psychiatry''', also known as '''geropsychiatry''', '''psychogeriatrics''' or '''psychiatry of old age''', is a branch of medicine and a subspecialty of psychiatry dealing with the study, prevention, and treatment of neurodegenerative, cognitive impairment, and mental disorders in people of old age.<ref name=Barraclough>Barraclough, J.; Gill, D. (2007). ''Hughes' outline of modern psychiatry''. (5th ed.) New York: John Wiley & Sons. {{ISBN|978-0-470-51657-7}}</ref><ref>{{cite journal |last1=Marino, Zubenko |first1=Louis, George |title=Geriatric Psychiatry |journal=Psychiatric Clinics of North America |date=2022-12-01 |volume=45 |issue=4 |pages=xiii-xvi |doi=10.1016/j.psc.2022.08.001 |pmid=36396279 |url=https://dx.doi.org/10.1016/j.psc.2022.08.001}}</ref> Geriatric psychiatry as a subspecialty has significant overlap with the specialties of geriatric medicine, behavioral neurology, neuropsychiatry, neurology, and general psychiatry.<ref>{{cite journal |last1=Blazer, Schultz |first1=Dan, Susan |title=Geriatric Psychiatry |journal=Psychiatric Clinics of North America |date=2018-03-01 |volume=41 |issue=1 |pages=xiii-xv |doi=10.1016/j.psc.2017.10.014 |pmid=29412857 |url=https://dx.doi.org/10.1016/j.psc.2017.10.014}}</ref> Geriatric psychiatry has become an official subspecialty of psychiatry with a defined curriculum of study and core competencies.<ref>{{Cite journal|url=https://cgjonline.ca/index.php/cgj/article/view/66|title=Geriatric Psychiatry or Psychogeriatrics? Partnership at the CAGP/CCSMH 2012 Scientific Meeting|first1=Corinne E.|last1=Fischer|first2=Zahinoor|last2=Ismail|first3=Mark J.|last3=Rapoport|date=January 17, 2013|journal=Canadian Geriatrics Journal|volume=16|issue=1|pages=3–5|via=cgjonline.ca|pmid=23441142|doi=10.5770/cgj.16.66|pmc=3578771 }}</ref>
== Scope ==
{{Infobox Occupation | name = Geriatric psychiatrist | image = | caption = | official_names = Doctor, Psychiatry Specialist <!------------Details-------------------> | type= Specialty | activity_sector = Medicine, Psychiatry | competencies = | formation = *Doctor of Medicine (M.D.) * Doctor of Osteopathic Medicine (D.O.) * Bachelor of Medicine, Bachelor of Surgery (MBBS/MBChB) | employment_field= Hospitals, Clinics, Nursing Homes | related_occupation= }} A '''geriatric psychiatrist''' is a physician who specializes in the field of medical sub-specialty called geriatric psychiatry.<ref name="aagp">{{cite web |title=About Geriatric Psychiatry |url=https://aagponline.org/families-caregivers/about-geriatric-psychiatry/ |website=American Association for Geriatric Psychiatry |date=3 August 2022 }}</ref> A geriatric psychiatrist holds a board certification after specialized training after attaining a medical degree, residency, and an additional geriatric psychiatry fellowship training program.<ref name="aagp"/> The requirements may vary by countries.<ref name="auto"/><ref name="uk"/> Some geriatric psychiatrists also conduct research to determine the cause and better treatments for neurodegenerative disorders and late-life mental health disorders.<ref>{{Cite web|url=https://www.aagponline.org/index.php?src=gendocs&category=Advocacy|title=Federally Funded Programs–Geriatric Mental Health Research And Services Fact Sheet|website=www.aagponline.org |date=10 January 2019 }}</ref>
Geriatric psychiatrists may perform neurological examinations, mental status examination, laboratory investigations, neuroimaging, cognitive assessments to investigate the causes of psychiatric or neurologic symptoms in old age.<ref>{{Cite web|url=https://www.aagponline.org/index.php?src=gendocs&category=Main|title=Careers in Geriatric Psychiatry|website=www.aagponline.org |date=10 January 2019 }}</ref>
=== Diseases === Diseases and disorders diagnosed or managed by geriatric psychiatrists include, but are not limited to:<ref>{{Cite web|url=https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/in-depth/alzheimers/ART-20048362?p=1|title=Alzheimer's or depression: Could it be both? - Mayo Clinic|website=www.mayoclinic.org|access-date=2019-11-20}}</ref> * Late-life Presentations of Psychiatric Disorders<ref>{{Cite web|url=https://medlineplus.gov/ency/article/001521.htm|title=Depression in older adults: MedlinePlus Medical Encyclopedia|website=medlineplus.gov|language=en|access-date=2019-11-20}}</ref> ** Late onset of depression is associated with higher rates of cardiovascular disease, higher risk of suicide, and higher possibility of treatment resistant depression.<ref>{{cite journal |last1=Jiang |first1=Wei |title=Depression and Cardiovascular Disorders in the Elderly |journal=Clinics in Geriatric Medicine |date=2020-05-01 |volume=36 |issue=2 |pages=211–219 |doi=10.1016/j.cger.2019.11.003 |pmid=32222297 }}</ref> *** Melancholic Depression ** Anxiety Disorders can be characterized by restlessness, irritability, and muscle tension, but in older adults can be misinterpreted as manifestation of aging.<ref>{{cite journal |last1=Wetherell, Petkus, McChesney, Stein, Judd, Rockwell, Sewell, Patterson |first1=Julie, Andrew, Kathleen, Murray, Patricia, Enid, Daniel, Thomas |title=Older Adults Are Less Accurate Than Younger Adults at Identifying Symptoms of Anxiety and Depression |journal=The Journal of Nervous and Mental Disease |date=August 2009 |volume=197 |issue=8 |pages=623–626 |doi=10.1097/NMD.0b013e3181b0c081 |pmid=19684501 |pmc=2773356 }}</ref> ** Bipolar Disorder in older adults is associated with increased risk of premature death, increased risk of dementia and cognitive deficits.<ref>{{cite journal |last1=Dols, Beekman |first1=Annemiek, Aartjan |title=Older Age Bipolar Disorder |journal=Clinics in Geriatric Medicine |date=2020-05-01 |volume=36 |issue=2 |pages=281–296 |doi=10.1016/j.cger.2019.11.008 |pmid=32222302 }}</ref> ** Schizophrenia after the age of 65 is considered very-late onset and is associated with higher rates of psychosis, which are often secondary to other medical comorbidities.<ref>{{cite journal |last1=Folsom, Lebowitz, Lindamer, Palmer, Patterson, Jeste |first1=David, Barry, Laurie, Barton, Thomas, Dilip |title=Schizophrenia in late life: emerging issues |journal=Dialogues in Clinical Neuroscience |date=1 April 2022 |volume=8 |issue=1 |pages=45–52 |doi=10.31887/DCNS.2006.8.1/dfolsom |pmid=16640113 |doi-access=free |pmc=3181756 }}</ref> ** Personality Disorders * Dementia: often focusing on behavioral disturbances related to mild cognitive impairment and different types of dementia such as:<ref name="auto">{{Cite web|url=http://www.cagp.ca/page-1257712|title=Canadian Academy of Geriatric Psychiatry - Definition of Geriatric Psychiatry|website=www.cagp.ca}}</ref> ** Alzheimer's Disease ** Vascular Dementia ** Frontotemporal Dementia ** Dementia with Lewy bodies ** Parkinson's Disease * Medical-Psychiatric disorders such as catatonia and delirium.<ref>{{cite journal |last1=Hshieh |first1=T. T. |last2=Inouye |first2=S. K. |last3=Oh |first3=E. S. |title=Delirium in the Elderly |journal=Clinics in Geriatric Medicine |date=May 1, 2020 |volume=36 |issue=2 |pages=183–199 |doi=10.1016/j.cger.2019.11.001 |pmid=32222295 |url=https://www.clinicalkey.com/#!/content/journal/1-s2.0-S074906901930103X}}</ref> * Many risk factors for Substance use disorder are seen commonly in the elderly population such as: polypharmacy, multiple co-morbid health conditions, and social isolation.<ref>{{cite journal |last1=Tampi |first1=Rajesh R. |last2=Tampi |first2=Deena J. |last3=Elson |first3=Alisandrea |title=Substance Use Disorders in the Elderly |journal=Psychiatric Clinics of North America |date=December 1, 2022 |volume=45 |issue=4 |pages=707–716 |doi=10.1016/j.psc.2022.07.005 |pmid=36396274 |url=https://www.clinicalkey.com/#!/content/journal/1-s2.0-S0193953X22000612}}</ref> * Neuropsychiatric complications from stroke, Multiple Sclerosis.<ref>{{cite journal |last1=Robinson |first1=Robert G. |last2=Jorge |first2=Ricardo E. |title=Post-Stroke Depression: A Review |journal=American Journal of Psychiatry |date=March 1, 2016 |volume=173 |issue=3 |pages=221–231 |doi=10.1176/appi.ajp.2015.15030363 |pmid=26684921 |url=https://psychiatryonline.org/doi/10.1176/appi.ajp.2015.15030363}}</ref>
== History == === Origins === [[File:Alois Alzheimer 003.jpg|thumb|Alois Alzheimer (1915), a German psychiatrist who identified the pathology involved in Alzheimer's disease]]
The origins of geriatric psychiatry began with Alois Alzheimer, a German psychiatrist and neuropathologist who first identified amyloid plaques and neurofibrillary tangles in a fifty-year-old woman he called Auguste D.<ref name="alois"/> These plaques and tangles were later identified as being responsible for her behavioural symptoms, short-term memory loss, and psychiatric symptoms.<ref name="alois">{{Cite journal|url=https://onlinelibrary.wiley.com/doi/abs/10.1002/gps.930050603|doi = 10.1002/gps.930050603|title = Alzheimer's disease: A conceptual history|year = 1990|last1 = Berrios|first1 = G. E.|journal = International Journal of Geriatric Psychiatry|volume = 5|issue = 6|pages = 355–365|s2cid = 145155424|url-access = subscription}}</ref> These brain anomalies would become identifiers of what later became known as Alzheimer's disease.<ref>{{Cite web|url=https://www.biography.com/people/alois-alzheimer-21216461|title=Alois Alzheimer|date=2 April 2014|website=Biography.com|access-date=19 February 2019|archive-url=https://web.archive.org/web/20180323115550/https://www.biography.com/people/alois-alzheimer-21216461|archive-date=23 March 2018|url-status=dead}}</ref>
=== Subspecialty === The subspecialty of geriatric psychiatry originated in the United Kingdom in the 1950s.<ref>{{cite book|url=https://www.researchgate.net/publication/227676404|title=The Development of Old Age Psychiatry in the UK|date=December 2010|doi=10.1002/9780470669600.ch2|author1=Clare Hilton|author2=Tom Arle|via=www.researchgate.net|pages=7–11 |isbn=9780470747230 }}</ref> In 1958, the first mental health service was designed specifically for the elderly under the guidance of Dr. Ronald Robinson in Scotland.<ref>{{cite journal |last1=Hilton |first1=Claire |title=Psychogeriatrics in England: Its Route to Recognition by the Government as a Distinct Medical Specialty, c.1970-89 |journal=Medical History |date=April 2016 |volume=60 |issue=2 |pages=206–228 |doi=10.1017/mdh.2016.4 |doi-access=free|pmid=26971597 |pmc=4847420 }}</ref> At this time, much of the knowledge related to this field was based on notable psychiatrists in the United Kingdom including: Sir Martin Roth (psychiatrist), Dr. Felix Post, Dr. Aubrey Lewis, and Dr. David Henderson.<ref>{{cite journal |last1=Hilton |first1=Claire |title=The origins of old age psychiatry in Britain in the 1940s. |journal=History of Psychiatry |date=2005 |volume=16 |issue=3 |pages=267–289 |doi=10.1177/0957154X05050075 |pmid=16193625 |url=https://journals.sagepub.com/doi/10.1177/0957154X05050075?utm_source=researchgate.net&utm_medium=article|hdl=2262/51551 |hdl-access=free }}</ref>
In the United States, the American Association for Geriatric Psychiatry was founded in 1978 under the direction of its first president, Dr. Sanford Finkel.<ref>{{cite journal |last1=Grossberg |first1=George |title=Geriatric psychiatry--an emerging specialty. |journal=Missouri Medicine the Journal of the Missouri State Medical Association |date=2010 |volume=107 |issue=6 |pages=401–405 |pmid=21319689 |pmc=6188242 }}</ref> It was not until 1991 when the American Board of Psychiatry and Neurology began to conduct examinations for this subspecialty.<ref>{{cite journal |last1=Juul |first1=Dorthea |last2=Colenda |first2=Christopher C. |last3=Lyness |first3=Jeffrey M. |last4=Dunn |first4=Laura B. |last5=Hargrave |first5=Rita |last6=Faulkner |first6=Larry R. |title=Subspecialty Training and Certification in Geriatric Psychiatry: A 25-Year Overview. |journal=The American Journal of Geriatric Psychiatry |date=May 2017 |volume=25 |issue=5 |pages=445–453 |doi=10.1016/j.jagp.2016.12.018 |pmid=28214074 }}</ref>
== Diagnosis ==
There are many different screening tools used in the elderly.<ref>{{cite journal |last1=Abrams |first1=Robert C. |last2=Boné |first2=Blanca |last3=Reid |first3=M. Cary |last4=Adelman |first4=Ronald D. |last5=Breckman |first5=Risa |last6=Goralewicz |first6=Ronald |last7=Palombo |first7=Marlena |last8=Stern |first8=Amy |last9=Shengelia |first9=Rouzi |last10=Teresi |first10=Jeanne |title=Psychiatric assessment and screening for the elderly in primary care: design, implementation, and preliminary results |journal=Journal of Geriatrics |date=29 March 2015 |pages=1–9 |doi=10.1155/2015/792043 |doi-access=free |pmid=25954771 |pmc=4420197 }}</ref> * The Patient Health Questionnare-9 (PHQ-9) is used to screen for depression.<ref>{{cite web |title=Depression and Suicide Risk in Adults: Screening |url=https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/screening-depression-suicide-risk-adults |website=U.S. Preventive Services Task Force}}</ref> * The Generalized Anxiety Disorder 7 (GAD-7) is typically used to screen for anxiety, however it is typically used in younger adults (19–64).<ref name=gai>{{cite web |title=Geriatric Anxiety Inventory |url=https://www.apa.org/pi/about/publications/caregivers/practice-settings/assessment/tools/geriatric-anxiety |website=American Psychological Association}}</ref> In those 65+, the Geriatric Anxiety Inventory is used in its place.<ref name="gai"/> * The Alcohol Use Disorders Identification Test (AUDIT-C) is used to assess alcohol consumption to screen for alcohol use disorder.<ref>{{cite journal |last1=Bush |first1=K. |last2=Kivlahan |first2=D. R. |last3=McDonell |first3=M. B. |last4=Fihn |first4=S. D. |last5=Bradley |first5=K. A. |title=The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol Use Disorders Identification Test |journal=JAMA Internal Medicine |date=September 14, 1998 |volume=158 |issue=16 |pages=1789–1795 |doi=10.1001/archinte.158.16.1789 |pmid=9738608 }}</ref> thumb|Caption Clock Drawing Test to Differentiate between Normal vs. MCI vs. AD
* Three tools used for detection of mild cognitive impairment and dementia include: Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and the Clock Drawing Test.<ref>{{cite journal |last1=Aiello |first1=Edoardo Nicolò |last2=Gramegna |first2=Chiara |last3=Esposito |first3=Antonella |last4=Gazzaniga |first4=Valentina |last5=Zago |first5=Stefano |last6=Difonzo |first6=Teresa |last7=Maddaluno |first7=Ottavia |last8=Appollonio |first8=Ildebrando |last9=Bolognini |first9=Nadia |title=The Montreal Cognitive Assessment (MoCA): updated norms and psychometric insights into adaptive testing from healthy individuals in Northern Italy |journal=Aging Clinical and Experimental Research |date=February 2022 |volume=34 |issue=2 |pages=375–382 |doi=10.1007/s40520-021-01943-7 |pmid=34313961 |pmc=8847194 }}</ref><ref>{{cite journal |last1=Arevalo-Rodriguez |first1=I. |last2=Smailagic |first2=N. |last3=Roqué-Figuls |first3=M. |last4=Ciapponi |first4=A. |last5=Sanchez-Perez |first5=E. |last6=Giannakou |first6=A. |last7=Pedraza |first7=O. L. |last8=Bonfill Cosp |first8=X. |last9=Cullum |first9=S. |title=Mini-Mental State Examination (MMSE) for the early detection of dementia in people with mild cognitive impairment (MCI) |journal= Cochrane Database of Systematic Reviews|date=July 27, 2021 |volume=7 |issue=7 |pages=CD010783 |doi=10.1002/14651858 |pmid=34313331 |pmc=8406467 }}</ref><ref name="cdt" /> ** The Clock Drawing Test (CDT) can be used to quickly assess cognitive function through visuospatial skills and executive function.<ref name="cdt">{{cite journal |last1=Hubbard |first1=E. |last2=Santini |first2=V. |last3=Blankevoort |first3=C. |last4=Volkers |first4=K. |last5=Barrup |first5=M. |last6=Byerly |first6=L. |last7=Chaisson |first7=C. |last8=Jefferson |first8=A. |last9=Kaplan |first9=E. |last10=Green |first10=R. |title=Clock Drawing Performance in Cognitively Normal Elderly |journal=Archives of Clinical Neuropsychology |date=2008 |volume=23 |issue=3 |pages=295–327 |doi=10.1016/j.acn.2007.12.003 |pmid=18243644|pmc=2752157 }}</ref> ** The CDT can be interpreted as normal, Mild Cognitive Impairment (MCI), possible Alzheimer's Disease (AD), or other diagnoses.<ref name="cdt" />
== Treatments == When determining appropriate next steps in treatment for psychiatric conditions in the elderly, the discussion first focuses around pharmacologic intervention vs. non-pharmacologic intervention.<ref>{{cite journal |last1=MacQueen |first1=G. M. |last2=Frey |first2=B. N. |last3=Ismail |first3=Z. |last4=Jaworska |first4=N. |last5=Steiner |first5=M. |last6=Lieshout |first6=R. J. |last7=Kennedy |first7=S. H. |last8=Lam |first8=R. W. |last9=Milev |first9=R. V. |last10=Parikh |first10=S. V. |last11=Ravindran |first11=A. V. |author12=CANMAT Depression Work Group |title=Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 6. Special Populations: Youth, Women, and the Elderly |journal=The Canadian Journal of Psychiatry / La Revue Canadienne de Psychiatrie |date=2016 |volume=61 |issue=9 |pages=588–603 |doi=10.1177/0706743716659276 |pmid=27486149 |pmc=4994788 }}</ref>
===Pharmacologic interventions=== In the geriatric population, careful pharmacologic consideration is required due to possibility of drug-drug interactions, co-morbid conditions, and risk of adverse effects.<ref name= "pharm">{{cite journal |last1=Kok |first1=Rob M. |last2=Reynolds |first2=Charles F. |title=Management of Depression in Older Adults A Review |journal=JAMA |date=2017 |volume=317 |issue=20 |pages=2114–2122 |doi=10.1001/jama.2017.5706 |pmid=28535241 }}</ref> In 2023, The American Geriatric Society updated the Beers Criteria to outline potentially inappropriate medications in the elderly.<ref name="beers">{{cite journal |title=2023 AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults |journal=Journal of the American Geriatrics Society |date=March 2023 |volume=71 |issue=7 |page=C1, 2033–2357 |doi=10.1111/jgs.18372) |doi-broken-date=21 January 2026 }}</ref> The Beers Criteria is meant to identify medications that may cause harm to geriatric patients, but it requires case by case interpretation for each patient.<ref>{{cite web |title=AGS Releases New Beers Criteria® Alternatives List to Support Safer Prescribing for Older Adults |url=https://www.americangeriatrics.org/media-center/news/ags-releases-new-beers-criteriar-alternatives-list-support-safer-prescribing |website=American Geriatrics Society}}</ref>
Common psychiatric medications used in the elderly include:<ref name="beers"/> * Antidepressants and anxiolytics such as SSRI's, SNRI's, TCA's, MAOi's. * Antipsychotics such as Aripiprazole and Quetiapine. * Mood stabilizers such as Lithium and Valproic Acid.
Adverse effects, particularly concerning in this age group include drowsiness, increased risk of falls, postural hypotension, and sleep disturbances.<ref name="pharm"/>
===Non-pharmacologic interventions=== Non-pharmacologic interventions such as exercise, phototherapy, and psychotherapy can be tried before, after, or in conjunction with pharmacologic treatment.<ref name="nonpharm">{{cite journal |last1=Gramaglia |first1=Carla |last2=Gattoni |first2=Eleonora |last3=Marangon |first3=Debora |last4=Concina |first4=Diego |last5=Grossini |first5=Elena |last6=Rinaldi |first6=Carmela |last7=Panella |first7=Massimiliano |last8=Zeppegno |first8=Patrizia |title=Non-pharmacological Approaches to Depressed Elderly With No or Mild Cognitive Impairment in Long-Term Care Facilities. A Systematic Review of the Literature |journal=Frontiers in Public Health |date=July 16, 2021 |volume=9 |article-number=685860 |doi=10.3389/fpubh.2021.685860 |doi-access=free |pmid=34336772 |pmc=8322575 |bibcode=2021FrPH....985860G }}</ref> Two common psychotherapy styles used in the elderly are cognitive behavioral therapy and psychodynamic therapy.<ref name="nonpharm"/>
When pharmacologic intervention has failed, electroconvulsive therapy is an option for treatment resistant depression, agitation secondary to delirium, catatonia, psychosis, and other psychiatric conditions in the elderly.<ref>{{cite journal |last1=Meyer, Swetter, Kellner |first1=Justine, Samantha, Charles |title=Electroconvulsive Therapy in Geriatric Psychiatry |journal=Clinics in Geriatric Medicine |date=2020-05-01 |volume=36 |issue=2 |pages=265–279 |doi=10.1016/j.cger.2019.11.007 |pmid=32222301 |url=https://www.clinicalkey.com/#!/content/journal/1-s2.0-S0749069019301119}}</ref>
== Training ==
=== International === The International Psychogeriatric Association is an international community of scientists and healthcare geriatric professionals working for mental health in aging.<ref>{{Cite web|url=https://www.ipa-online.org/|title=International Psychogeriatric Association|website=www.ipa-online.org}}</ref> ''International Psychogeriatrics'' is the official journal of the International Psychogeriatric Association.<ref>{{Cite web|url=http://www.blackwellpublishing.com/journal.asp?ref=1346-3500|title=''Psychogeriatrics'' journal|website=www.blackwellpublishing.com|access-date=2008-10-24|archive-date=2012-09-29|archive-url=https://web.archive.org/web/20120929223824/http://www.blackwellpublishing.com/journal.asp?ref=1346-3500|url-status=dead}}</ref>
=== Canada === The Royal College of Physicians and Surgeons of Canada is responsible for training and certifying geriatric psychiatrists in Canada.<ref>{{cite journal |last1=Laliberté |first1=V. |last2=Rapoport |first2=M. J. |last3=Rabheru |first3=K. |last4=Rej |first4=S. |title=Practice eligible route for certification in geriatric psychiatry: why some Canadian psychiatrists are disinterested in writing the RCPSC subspeciality examination? |journal=International Psychogeriatrics |date=July 14, 2016 |volume=28 |issue=10 |pages=1749–1750 |doi=10.1017/S1041610216000909 |pmid=27411496 }}</ref> Geriatric psychiatry requires an additional year of subspecialty fellowship training in addition to general psychiatry training.<ref name="auto"/>
=== United Kingdom === The Royal College of Psychiatrists is responsible for training and certifying psychiatrists in the United Kingdom.<ref name=oldage>{{cite web |title=Accreditation for Specialist Registration in Psychiatry Portfolio Pathway 2023 |url=https://www.rcpsych.ac.uk/international/accreditation-to-become-a-psychiatrist-with-specialist-registration |website=Royal College of Psychiatrists}}</ref> Within the Royal College of Psychiatrists, the Faculty of Old Age Psychiatry is responsible for training in Old Age Psychiatry.<ref name="oldage"/> Doctors who have membership of the Royal College of Psychiatrists can undertake a three or four-year training program to become a specialist in Old Age Psychiatry.<ref>{{cite web |title=Faculty of Old Age Psychiatry |url=https://www.rcpsych.ac.uk/members/your-faculties/old-age-psychiatry |website=Royal College of Psychiatrists}}</ref> There is currently a shortage of old age psychiatrists in the United Kingdom.<ref name="uk">{{Cite journal|last1=Blewett|first1=Charlotte|last2=Milward|first2=Kate|last3=Bailey|first3=Alex|last4=McAlpine|first4=Lynsey|date=June 2019|title=Recruitment into old age psychiatry|journal=BJPsych Bulletin|volume=43|issue=3|language=en|pages=131–135|doi=10.1192/bjb.2018.112|issn=2056-4694|doi-access=free}}</ref>
=== United States === The American Association for Geriatric Psychiatry (AAGP) is the national organization representing health care providers specializing in late life mental disorders.<ref name="aagp"/> ''The American Journal of Geriatric Psychiatry''<ref>http://ajgponline.org/ ''The American Journal of Geriatric Psychiatry''</ref> is the official journal of the AAGP.The American Board of Psychiatry and Neurology and the American Osteopathic Board of Neurology and Psychiatry both issue a board certification in geriatric psychiatry.<ref>{{Cite web|url=https://www.abpn.com/become-certified/taking-a-subspecialty-exam/geriatric-psychiatry/|title=Geriatric Psychiatry|website=American Board of Psychiatry and Neurology}}</ref><ref>{{cite web|url=https://certification.osteopathic.org/neurology-psychiatry/certification-process/geriatric-psychiatry/|title=Specialties & Subspecialties|publisher=American Osteopathic Association|access-date=23 September 2012}}</ref>
After a 4-year residency in psychiatry, a psychiatrist can complete a one-year fellowship in geriatric psychiatry.<ref>{{Cite web |url=http://www.wpic.pitt.edu/education/clinical_fellowship_in_geriatric.htm |title=Geriatric psychiatry fellowship |access-date=2008-10-24 |archive-url=https://web.archive.org/web/20081230120716/http://www.wpic.pitt.edu/education/clinical_fellowship_in_geriatric.htm |archive-date=2008-12-30 |url-status=dead }}</ref>
==See also== * Geriatrics * Psychiatry * Neuropsychiatry * Mild cognitive impairment * Dementia * Delirium * Late life depression
==References== {{reflist}}
==External links== *{{Commons category-inline}}
{{Psychiatry}}
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Category:Geriatric psychiatry Category:Geriatrics