Even before the demographic revolution, a few physicians, psychologists, and social scientists saw the need for a new specialty to deal with senescence. "Geriatrics" has over time become a legitimate medical subspecialty. Yet it still lacks the personnel and scientific tools to address a nation of elders in the making.
Ignatz L. Nascher coined the term Geriatrics, when he published a text by that title in 1914. He drew an analogy to pediatrics. In 1880, when the American Pediatrics Society was founded, there were fewer than 50 child specialists in the nation. Once the field organized, membership grew. "As interest in the dependent child led to the scientific study of child welfare," reasoned Nascher, "so might an interest in the dependent aged lead to the scientific study of senility, of the needs and wants, the peculiarities and infirmities, the happiness and welfare of the aged."
Emulating the organizational strategy of the father of American pediatrics, Nascher founded the New York Geriatrics Society in 1915, and two years later inaugurated a feature in the prestigious Medical Review of Reviews.
Alas, Nascher failed to impress his colleagues. He had difficulty finding a publisher for Geriatrics. By his own count, Nascher was the only fulltime geriatrician in America in 1926-even his son was reluctant to pay dues to the New York Geriatrics Society.
Nascher might have undermined his cause by making comparisons to pediatrics. Kids generally are adorable, and they heal quickly. Old people did not attract sympathy. "The idea of economic worthlessness instills a spirit of irritability if not positive enmity against the helplessness of the aged," Nascher conceded. To overcome the animus against age while sparking the geriatric imagination, bio-medical researchers and clinicians had to see opportunities for advancing the science of senescence.
Foundations, medical societies, and university-based research institutes convened bio-medical researchers to address the basic processes, mechanisms, and pathologies of aging. The road was rocky. In 1940, for instance, the Josiah Macy, Jr. Foundation gave the U.S. Public Health Service $10,000 to support a specialist in aging. Their designated choice resigned after a year. His successor was to report to work on December 8, 1941.
But in due course a professional infrastructure took shape. The American Geriatrics Society was founded in 1942. Thirty-two years later Congress established the National Institute on Aging (NIA) to oversee research on aging processes and age-related diseases. Subsequent legislation made NIA the primary Federal agency on Alzheimer's disease research. Family practice, internal medicine, and psychiatry now provide board certification in geriatrics.
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Dr. Andrew Achenbaum is a noted gerontologist and visiting fellow at The University of Texas McGovern Center of Health, Humanities and the Human Spirit.
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