Providing high-quality medical care for older adults requires a special set of knowledge, clinical skills, and attitudes. Many resources contain current, accurate information on evaluation and management of the older patient. However, few are portable enough to be used in the examining room, on nursing home or hospital rounds, or when the clinician is on call outside the office.

In 1998, the American Geriatrics Society (AGS) first published Geriatrics At Your Fingertips (GAYF), a pocket guide that provides immediate access to specific information needed to care for older adults in various health care settings. The response was extraordinary, and GAYF soon became the society's best-selling publication. As electronic media have increasingly expanded into clinical practice, the AGS has created new platforms for GAYF including an Internet edition (www.geriatricsatyourfingertips.org) and Palm and Windows CE operating systems versions (available for download at the Web site listed above).

In this 9^th edition, we have added new sections on abdominal aortic aneurysm, dyspnea, euthyroid sick syndrome, knee pain and prostatitis, and have completely revised the CMS guidance on unnecessary drugs in nursing homes, based on new guidelines released in December 2006. Throughout the text and tables, we have updated information including recommended diagnostic tests and management strategies. Tables and lists of drugs are designed to facilitate appropriate prescribing. Generic and trade names are provided, as well as information on dosages, how the drugs are metabolized or excreted, and which formulations are available. Specific caveats and cautions to be observed when using the medication in older adults are also included. In this edition, we have replaced prescribing terms indicating the number of times a day (eg, bid, tid) with more precise dosing intervals (eg, q 12 h).

The goal of GAYF is to reduce to a minimum the amount of time that a practicing clinician must spend searching for specific information that is needed immediately to make patient care decisions. Accordingly, GAYF does not attempt to explain in detail the rationale underlying the strategies presented. In many instances, these strategies have been derived from guidelines published by organizations such as the Agency for Healthcare Research and Quality, the American Geriatrics Society, the American Heart Association, and the American Diabetes Association. Many of the guidelines can be obtained from the National Guideline Clearinghouse (www.guideline.gov). When no such guidelines exist, the strategies recommended herein represent the best opinions of the authors and the experts they have asked to review the chapters. In an effort to be comprehensive yet concise, references have been provided sparingly, but many others that are relevant are available from the organizations mentioned or in the most recent edition of the AGS Geriatrics Review Syllabus.

The authors welcome comments about the format and content of this edition of GAYF that may guide the preparation of future editions. All comments should be addressed to the American Geriatrics Society, Empire State Building, 350 Fifth Avenue, Suite 801, New York, NY 10118.

The authors are particularly grateful to Nancy Lundebjerg at the AGS, who has served a vital role in the development of this book and its readership. We are also grateful to the John A. Hartford Foundation for generously supporting the initial development and distribution of GAYF PDA versions.

We would also like to thank the following people who have reviewed parts of this edition:  

Catherine A. DuBeau, MD
Perry Fine, MD
Rita A. Frantz, PhD, RN
Gail Greendale, MD
Jerry C. Johnson, MD
James Judge, MD
Eric J. Lenze, MD
Elizabeth C. Reed, MD
Larissa Rodriguez, MD
Thomas T. Yoshikawa, MD

Guidelines of the following organizations are the basis of parts of specific chapters:

Advisory Committee on Immunization Practices
Agency for Healthcare Research and Quality
Alzheimer's Association
American Academy of Neurology
American Association for Geriatric Psychiatry
American College of Cardiology
American College of Chest Physicians
American College of Gastroenterology
American College of Obstetrics and Gynecology
American College of Rheumatology
American Diabetes Association
American Geriatrics Society
American Heart Association
American Lung Association
American Pain Society
American Psychiatric Association
American Society of Anesthesiologists
American Thyroid Association
American Urological Association
Ethnogeriatrics Committee, American Geriatrics Society
National Cholesterol Education Program
National Heart, Lung, and Blood Institute
U.S. Preventive Services Task Force
World Health Organization

Staff
Susan E. Aiello, DVM, ELS, Medical Editor
Carol S. Goodwin, Managing Editor
Pilar Wyman, Medical Indexer

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Technical development and production of print and electronic versions:
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Gwen Eckenrode, Composition
Jason Hughes, Technical Services Manager
Julie Stevens, Account Administrator
Terry Plyler, Systems Architect/Engineer