Journal of the American Geriatrics Society

McGarr, Gregory W.; O’Connor, Fergus K.; Kenny, Glen P.

doi: 10.1111/jgs.70388pmid: 41833559

Fraunberger, Erik; Maltzahn, Maia

doi: 10.1111/jgs.70389pmid: 41834078

Lavon, Ophir; Hamodi, Wafaa; Kassem, Sameer

doi: 10.1111/jgs.70375pmid: 41793188

Hung, Anna; Nalawade, Vinit; Shenoy, Devika A.; Moriarty, Frank; Ndai, Asinamai; Sloan, Caroline E.; Pavon, Juliessa; Hastings, Susan N.; Brookhart, Alan; Maciejewski, Matthew L.

doi: 10.1111/jgs.70395pmid: 41860759

Miller‐Winder, Amber P.; Relerford, Raven R.; Schierer, Allison; Murawski, Alaine; Olvera, Charles; Curtis, Laura M.; Kim, Kwang‐Youn; Ramirez‐Zohfeld, Vanessa; Lindquist, Lee A.

doi: 10.1111/jgs.70401pmid: 41860762

Thai, Julie N.; Sun, Helen; Mui, Heather; Ward, Katherine

doi: 10.1111/jgs.70366pmid: 41792041

Gurwitz, Jerry H.

doi: 10.1111/jgs.70370pmid: 41786645

Geriatricians have struggled to describe a complex and sometimes ambiguous professional identity. Unlike other medical specialties anchored in discrete organ systems, diagnostic and interventional technologies, or clearly defined clinical settings, geriatric medicine encompasses the care of a heterogeneous population of older adults with widely varying clinical needs, priorities, and trajectories relevant to function, multimorbidity, and complexity. This Special Article examines four distinct but overlapping perspectives on geriatrician identity—the complexivist, the healthful longevitist, the syndromist, and the contextualist. The complexivist perspective emphasizes expertise in managing multimorbidity, frailty, and the interplay of medical, functional, cognitive, and social challenges. The healthful longevitist reframes the discipline around extending healthspan, promoting resilience, and supporting healthy aging. The syndromist reflects a trend toward syndrome‐specific specialization, such as “brain health,” in some respects, paralleling subspecialty evolution in other fields. The contextualist highlights geriatricians who center their work within specific care settings or models of care, including home‐based primary care, skilled nursing facilities, PACE programs, ACE units, co‐management models of care with other specialties, and Age‐Friendly Health Systems. While each perspective offers valuable insights, none alone fully captures the breadth of geriatric medicine or resolves long‐standing tensions around recognition, prestige, and the profession's future. Debates over identity should not be viewed as divisive, but rather as essential to strengthening the profession. Continued examination of geriatrician identity is critical to ensuring that the specialty remains relevant, valued, and morally ambitious in the face of an aging population, major advances in geroscience and technology, and an evolving healthcare system.

Greene, Meredith; Tang, Belinda; H. Chodos, Anna; Aronson, Louise

doi: 10.1111/jgs.70417pmid: 41918330

Reuben, David B.; Chambliss, Allison B.; Katz, Bernard J.; López, Alejandra Sánchez; Hinman, Jason D.

doi: 10.1111/jgs.70384pmid: 41858054

With better understanding of the pathologic processes of Alzheimer's disease, diagnostic methods have been developed to focus on specific biomarkers of disease detectable on brain imaging, cerebral spinal fluid, and, more recently, plasma. Although these tests do not establish a diagnosis of dementia, which requires a clinical evaluation, they can more precisely identify whether Alzheimer's disease is a contributing cause. The recent FDA approval of two blood‐based biomarkers and the availability of others, including direct‐to‐consumer tests, has led to the potential for widespread use in primary and specialty care. However, the currently available blood‐based biomarkers are more highly correlated with amyloid brain PET scans, which are less specific for symptomatic Alzheimer's disease, than with p‐tau brain PET scans, which are strongly associated with changes in cognition. The value of a positive or negative blood‐based biomarker depends on the test characteristics (e.g., sensitivity and specificity) of the specific test as well as the prevalence of the disease in the population. Clinicians ordering blood‐based biomarkers must decide their value in the care of individual patients and be prepared to interpret the test results to their patients.

Hoque, Afshana; Cuthel, Allison; Grudzen, Corita R.; Shah, Manish N.; Brody, Abraham A.; Fleisher, Jori E.; DiMascio‐Donohue, Jennifer; McLain, Katelyn; Tun, Lin T.; Levine, Julia; Goldfeld, Keith S.; Chodosh, Joshua; , ; Abbate, Lauren; Anthopolos, Rebecca; Arbaje, Alicia; Bellolio, Fernanda; Berkowitz, Jonathan; Blome, Andrea;