Interface of geriatric medicine and geriatric psychiatry.

Proper care of rapidly growing numbers of elderly individuals, particularly the oldest-old, whose numbers are increasing more than any other subgroup, requires an integration of geriatric psychiatry and geriatric medicine on the clinical level. This dictates that educational programs at the medical school and residency level include both medical and psychiatric aspects of aging and that fellowship programs which are based in one discipline provide a meaningful exposure to the other. Nonetheless, it is highly unlikely that a single specialty of geriatrics will be developed which includes both psychiatry and medicine, and much more likely that the individual disciplines will maintain their identity and separate training programs. Specific clinical facilities being developed, such as geriatric assessment units and geriatric hospitals, will increasingly provide a creative environment for interdisciplinary interactions of psychiatrists and internists committed to the proper care of the elderly. It is through the experience of these emerging clinical units and joint clinical research programs that the further integration of the two subspecialties is likely to be forged.