Geriatric Care for the AANP FNP exam
Older adults are 30 percent of the exam. Geriatric judgment is woven through pharmacology, falls, dementia, and end-of-life questions. This chapter has 22 topics, a video lecture, an audio lesson, clinical scenarios, exam pearls and a quiz.
What you will learn
- Apply Beers Criteria to deprescribing decisions
- Differentiate dementia, delirium, and depression
- Recognize subtypes of dementia (AD, vascular, LBD, FTD)
- Conduct a falls risk assessment
Topics in this chapter
- Comprehensive geriatric assessmentComprehensive geriatric assessment domains, ADLs vs IADLs, frailty phenotype, Mini-Cog, gait speed.
- Falls and falls preventionCDC STEADI, fall risk factors, Tinetti, Timed Up and Go, intervention bundle, vitamin D.
- DeliriumCAM diagnosis, hyperactive vs hypoactive, precipitants, management without antipsychotics first, prevention bundle.
- DementiaDistinguishing dementia subtypes, workup, mild cognitive impairment vs dementia, cholinesterase inhibitors, BPSD.
- Urinary incontinence in older adultsStress vs urge vs overflow vs functional, workup, pelvic floor PT, medications by type.
- Pressure injuriesStaging (1-4, unstageable, deep tissue injury), prevention bundle, dressing choice by stage, Braden scale.
- Sensory impairmentHearing loss screening, presbycusis, cerumen, vision changes (cataract, AMD, glaucoma), driving safety.
- Goals of care and end-of-lifeAdvance directives, POLST/MOLST, hospice eligibility, palliative care principles, surrogate decisions.
- Elder abuse and capacityForms of elder abuse, screening tools, mandatory reporting, capacity assessment basics.
- Sarcopenia and nutritionDiagnostic criteria, protein needs, exercise prescription, weight loss workup in elderly.
- Pharmacology in older adultsBeers Criteria highlights for geriatrics, BP targets in frail elderly, deprescribing approach for older adults.
- Immunizations in older adultsAdult vaccines focused on older adults: pneumococcal sequence, RSV, zoster, COVID, flu high-dose.
- Sex-specific issues in older adultsMenopause symptoms, hormone therapy, perimenopause, andropause considerations, screening differences.
- Age-Related Physiologic Changes by Organ SystemA system-by-system map of normal aging: renal, hepatic, cardiac, pulmonary, GI, GU, sensory, integumentary, and immune changes and how each shifts presentation, dosing, and risk.
- Parkinson Disease and Essential TremorTelling Parkinson disease apart from essential tremor: rest versus action tremor, the cardinal motor signs, red flags for atypical parkinsonism, and first-line management in older adults.
- Osteoporosis and Hip-Fracture Management in EldersScreening, diagnosis, and treatment of osteoporosis in older adults, plus the acute and post-acute management of hip fracture, including surgical timing, delirium prevention, and secondary fracture prevention.
- Chronic Constipation in Older AdultsWhy constipation is so common in elders, how to evaluate it, the red flags that demand colonoscopy, a stepwise laxative approach, and the danger of fecal impaction with overflow.
- Atypical Presentations of Acute Illness in EldersHow serious disease hides in older adults: silent or atypical acute MI, the blunted acute abdomen, asymptomatic bacteriuria versus true UTI, and giant cell arteritis as a vision-threatening emergency.
- Stroke and TIA Recognition in Older AdultsWhy stroke and TIA hide in elders, the BE-FAST screen, time-is-brain urgency, and the anticoagulation balancing act in older patients with atrial fibrillation.
- Pneumonia and Sepsis Presenting Atypically in EldersBacterial pneumonia and sepsis in older adults frequently arrive without fever or cough, masquerading instead as confusion, falls, or functional decline, and they deteriorate fast.
- Geriatric Oncology and When to Stop Cancer ScreeningCancer screening in older adults is driven by life expectancy, not chronological age: when remaining life expectancy is under roughly ten years, the harms of mammography and colonoscopy usually outweigh the benefit.
- See also: elder presentations covered in other chaptersElder-relevant conditions taught in full in their own chapters, with the geriatric angle.
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Last updated November 4, 2026. Verify exam details against the official AANPCB Candidate Handbook before exam day.