Scenario Analysis: This scenario presents a common challenge in geriatric medicine: identifying and addressing systemic issues impacting patient care quality. The investigation highlights a potential gap between observed patient outcomes and established quality benchmarks. Professionals must navigate the complexities of data interpretation, patient privacy, and the ethical imperative to improve care while adhering to regulatory frameworks governing healthcare quality and data use. The challenge lies in translating data insights into actionable, compliant improvements without compromising patient confidentiality or introducing new risks. Correct Approach Analysis: The best professional approach involves a systematic, data-driven quality improvement initiative that prioritizes patient safety and adheres strictly to relevant regulatory guidelines for data handling and reporting. This entails forming a multidisciplinary team to analyze the identified quality gaps, developing evidence-based interventions, implementing these changes, and then rigorously monitoring their impact on patient outcomes and safety indicators. Crucially, all data collection, analysis, and reporting must comply with patient privacy regulations, such as HIPAA in the US, ensuring de-identification or appropriate consent where necessary. This approach directly addresses the observed deficiencies, promotes continuous learning, and upholds ethical and legal obligations to provide high-quality, safe care. Incorrect Approaches Analysis: One incorrect approach involves immediately implementing broad, unverified changes based on initial data without a structured quality improvement framework. This risks introducing new problems, wasting resources, and failing to address the root cause of the observed quality gaps. It bypasses the essential steps of root cause analysis and evidence-based intervention design, potentially violating principles of good clinical practice and efficient resource allocation. Another unacceptable approach is to dismiss the investigation’s findings due to concerns about data interpretation or potential resource implications, without undertaking a formal review or quality improvement process. This inaction fails to uphold the professional and ethical duty to ensure patient safety and high-quality care. It ignores the potential for significant patient harm or suboptimal outcomes that the data may indicate, and it contravenes regulatory expectations for healthcare providers to proactively manage quality. A further flawed approach is to focus solely on individual clinician performance without considering systemic factors or implementing a supportive quality improvement program. While individual accountability is important, quality issues in geriatric medicine often stem from complex system-level factors, such as staffing, protocols, or resource availability. Addressing only individual performance without a systemic lens is unlikely to yield sustainable improvements and can foster a punitive rather than a collaborative improvement culture, potentially leading to ethical concerns regarding fair performance evaluation. Professional Reasoning: Professionals should approach such situations by first acknowledging the data and its potential implications. A structured quality improvement methodology, grounded in regulatory compliance and ethical principles, should then be initiated. This involves forming a team, defining the problem clearly, gathering further relevant data if needed, identifying root causes, developing and testing interventions, and monitoring outcomes. Throughout this process, patient privacy and data security must be paramount, and all actions must align with established professional standards and legal requirements for healthcare quality and patient safety.

This scenario presents a professional challenge due to the inherent tension between the need for timely patient care and the strict adherence to regulatory requirements for medical device implantation. Misinterpreting or bypassing these regulations can lead to significant patient harm, legal repercussions, and erosion of public trust. Careful judgment is required to balance immediate clinical needs with long-term safety and compliance. The best approach involves a thorough review of the specific regulatory framework governing the implantation of the geriatric-specific medical device. This includes consulting the manufacturer’s instructions for use (IFU), relevant national medical device regulations (e.g., MHRA guidelines in the UK, FDA regulations in the US, TGA in Australia, depending on the specified jurisdiction), and any professional body guidelines pertaining to geriatric medicine and device implantation. The core of this approach is to ensure that all pre-implantation checks, device compatibility assessments, and patient-specific contraindications are meticulously verified against the established regulatory standards before proceeding. This proactive compliance ensures patient safety, device efficacy, and legal defensibility. An incorrect approach would be to proceed with implantation based solely on the clinical judgment that the device is necessary and readily available, without verifying its regulatory compliance for the specific patient and indication. This bypasses critical safety checks mandated by regulatory bodies, potentially exposing the patient to risks associated with an inappropriate or non-compliant device. Such an action would violate the principle of “do no harm” and contravene regulatory requirements designed to protect patient well-being. Another unacceptable approach is to rely on anecdotal evidence or the experience of colleagues regarding the device’s general suitability, without consulting the official regulatory documentation. While collegial advice can be valuable, it cannot substitute for the specific, evidence-based requirements outlined in regulatory approvals and IFUs. This approach risks overlooking crucial contraindications or specific usage parameters that are essential for safe and effective implantation. Finally, delaying implantation indefinitely due to minor, easily rectifiable administrative or documentation issues, without exploring expedited regulatory clarification or temporary authorization pathways where applicable, would also be professionally unsound. While compliance is paramount, an overly rigid adherence to process that demonstrably jeopardizes patient health without exploring all avenues for compliant resolution is not in the patient’s best interest. Professionals should employ a decision-making framework that prioritizes patient safety through rigorous adherence to regulatory mandates. This involves a systematic process of: 1) identifying the relevant regulatory framework, 2) thoroughly reviewing all applicable guidelines and device-specific documentation, 3) assessing the patient’s condition against these requirements, 4) documenting all compliance checks, and 5) seeking clarification or alternative compliant solutions when ambiguities arise, always with the patient’s well-being as the ultimate guiding principle.

Scenario Analysis: This scenario is professionally challenging because it requires a geriatrician to balance the immediate need for diagnostic clarity with the unique vulnerabilities of elderly patients. The selection and interpretation of imaging studies in this population are complicated by potential comorbidities, altered physiological responses to contrast agents, and the risk of incidental findings that may not be clinically significant but can lead to further, potentially invasive, investigations. Ensuring patient safety, adhering to evidence-based guidelines, and maintaining cost-effectiveness are paramount. Correct Approach Analysis: The best professional practice involves a systematic approach that prioritizes clinical relevance and patient safety. This begins with a thorough clinical assessment to formulate a focused differential diagnosis. Based on this, the most appropriate imaging modality is selected, considering factors such as radiation exposure, the need for contrast, and the patient’s renal function. Interpretation then focuses on findings directly related to the clinical question, with careful consideration of age-related changes and the potential for incidentalomas. Any further investigations or interventions are then guided by the likelihood of significant pathology and the potential benefit versus harm to the individual patient. This aligns with ethical principles of beneficence and non-maleficence, and regulatory expectations for appropriate resource utilization and patient care. Incorrect Approaches Analysis: One incorrect approach involves ordering a broad range of imaging studies without a clear clinical indication, driven by a desire to “rule out everything.” This is professionally unacceptable as it exposes the patient to unnecessary radiation, potential contrast-related complications, and the risk of incidental findings that can lead to a cascade of further, potentially harmful, investigations. It also represents a failure in responsible resource allocation. Another incorrect approach is to dismiss imaging findings solely based on the patient’s age, without careful consideration of their clinical significance. While age-related changes are common, certain findings, even in older adults, can represent serious pathology requiring intervention. Failing to adequately investigate potentially significant findings due to age bias is a violation of the duty of care and can lead to delayed diagnosis and treatment. A third incorrect approach is to rely solely on the radiologist’s report without integrating it with the patient’s clinical presentation and the initial diagnostic question. Radiologists provide expert interpretation of images, but the clinical context is crucial for determining the significance of findings and guiding subsequent management. Ignoring this integration can lead to misinterpretation of results and inappropriate clinical decisions. Professional Reasoning: Professionals should employ a structured diagnostic reasoning process. This involves: 1) gathering comprehensive clinical information, 2) developing a prioritized differential diagnosis, 3) selecting the most appropriate diagnostic tests based on clinical suspicion, patient factors, and evidence-based guidelines, 4) interpreting test results within the clinical context, and 5) formulating a management plan that considers the potential benefits and harms to the individual patient. This iterative process ensures that diagnostic efforts are targeted, safe, and effective.

Scenario Analysis: This scenario is professionally challenging because it requires a geriatrician to balance the immediate needs of an acutely unwell patient with the long-term management of chronic conditions and the proactive implementation of preventive strategies, all within the context of limited resources and potential patient or caregiver preferences. Effective risk assessment is paramount to prioritize interventions and ensure patient safety and well-being. Correct Approach Analysis: The best professional practice involves a comprehensive, multi-faceted risk assessment that integrates the patient’s acute presentation, underlying chronic conditions, and potential future health risks. This approach prioritizes immediate safety and stability while simultaneously planning for ongoing management and prevention. It aligns with ethical principles of beneficence and non-maleficence by addressing the most pressing issues and proactively mitigating future harm. Regulatory frameworks often emphasize a holistic approach to patient care, requiring practitioners to consider all relevant factors influencing a patient’s health trajectory. This method ensures that interventions are evidence-based, tailored to the individual, and consider the patient’s overall health status and potential for decline or improvement. Incorrect Approaches Analysis: One incorrect approach focuses solely on the acute presenting illness, neglecting the patient’s chronic conditions and preventive needs. This failure to consider the broader health context can lead to suboptimal management of underlying issues, increasing the risk of future acute exacerbations and complications. It may also violate regulatory requirements for comprehensive patient assessment and care planning. Another incorrect approach prioritizes only preventive measures without adequately addressing the acute symptoms or managing chronic conditions. This can be dangerous as it may delay necessary treatment for immediate health threats, potentially leading to adverse outcomes. Ethically, this approach fails to uphold the duty to treat existing illnesses. A third incorrect approach relies heavily on anecdotal evidence or personal experience without consulting current evidence-based guidelines or research. This can lead to outdated or ineffective treatment strategies, potentially harming the patient and contravening professional standards that mandate the use of evidence-based practices. Regulatory bodies typically require adherence to established best practices. Professional Reasoning: Professionals should employ a structured decision-making process that begins with a thorough understanding of the patient’s current situation, including acute symptoms, chronic diagnoses, and functional status. This should be followed by a systematic review of evidence-based guidelines relevant to each aspect of care. Risk assessment should then be used to prioritize interventions, considering the potential benefits, harms, and patient preferences. Continuous reassessment and adaptation of the care plan are crucial, especially in geriatric medicine where patient conditions can change rapidly.

Scenario Analysis: This scenario is professionally challenging because it requires balancing the need for consistent quality assurance in geriatric medicine with the ethical considerations of supporting physicians who may be struggling. The blueprint weighting and scoring directly impact the perceived fairness and validity of the proficiency verification process, while retake policies must be designed to be both effective in ensuring competence and compassionate towards individuals facing difficulties. Mismanagement of these elements can lead to a compromised assessment, damage to professional morale, and potential risks to patient care if unqualified individuals are not identified. Correct Approach Analysis: The best professional practice involves a transparent and evidence-based approach to blueprint weighting and scoring, ensuring that the assessment accurately reflects the critical competencies required for pan-regional geriatric medicine. This means the blueprint should be developed collaboratively with subject matter experts, regularly reviewed for relevance, and weighted according to the frequency and criticality of specific knowledge and skills in real-world geriatric practice. Scoring should be objective, with clear, pre-defined passing standards that are applied consistently to all candidates. Retake policies should be clearly communicated, offering opportunities for remediation and re-assessment after a defined period, with support mechanisms available to help candidates identify and address their weaknesses. This approach aligns with the ethical principles of fairness, validity, and beneficence in professional assessment, ensuring that the verification process is both rigorous and supportive. Incorrect Approaches Analysis: An approach that prioritizes a fixed, unchanging blueprint and scoring system without periodic review risks becoming outdated, failing to assess current best practices in geriatric medicine, and potentially penalizing physicians for knowledge gaps that are no longer considered critical. This lacks validity and fairness. Implementing a retake policy that imposes immediate, punitive re-testing without offering opportunities for targeted learning or support is ethically questionable, as it does not facilitate professional development and may disproportionately disadvantage individuals facing external challenges. Another incorrect approach would be to allow subjective adjustments to scoring based on individual circumstances or perceived effort. This undermines the objectivity and reliability of the assessment, creating an unfair playing field and compromising the integrity of the proficiency verification. A retake policy that offers unlimited re-takes without a structured remediation process can devalue the certification and fail to adequately protect patient safety by allowing individuals to repeatedly attempt an assessment without demonstrating mastery. Finally, an approach that weights blueprint sections arbitrarily or based on administrative convenience rather than clinical relevance leads to a flawed assessment of proficiency. If retake policies are vague or inconsistently applied, it creates confusion and distrust among candidates, potentially leading to perceptions of bias and undermining the overall credibility of the verification process. Professional Reasoning: Professionals should approach blueprint development and scoring by first establishing clear learning objectives derived from current clinical practice guidelines and expert consensus. This ensures the assessment is valid and relevant. Retake policies should be designed with a focus on remediation and continuous professional development, offering clear pathways for improvement and re-assessment. Transparency in all policies and procedures is paramount to fostering trust and ensuring fairness. When faced with a candidate struggling, the decision-making process should involve reviewing the assessment data objectively, identifying specific areas of weakness, and then recommending appropriate remedial resources or further assessment, always in alignment with established policies and ethical guidelines.

Scenario Analysis: This scenario is professionally challenging because it requires a candidate to balance the need for comprehensive preparation with the practical constraints of time and available resources, all while adhering to the rigorous standards expected for pan-regional geriatric medicine proficiency. Misjudging the preparation timeline or relying on inadequate resources can lead to a failure to meet the required competency levels, potentially impacting patient care and professional standing. Careful judgment is required to select a preparation strategy that is both effective and efficient. Correct Approach Analysis: The best professional practice involves a structured, multi-modal approach to preparation, prioritizing evidence-based resources and incorporating realistic timelines. This includes allocating dedicated study periods for core geriatric medicine domains, actively engaging with peer-reviewed literature and established clinical guidelines, and utilizing practice assessments that simulate the exam format and difficulty. This approach is correct because it directly addresses the breadth and depth of knowledge required for pan-regional proficiency verification, ensuring that preparation is systematic, current, and aligned with recognized standards of geriatric care. It acknowledges that mastery in a complex field like geriatric medicine is achieved through sustained effort and diverse learning methods, rather than superficial review. Incorrect Approaches Analysis: Relying solely on a single textbook or a brief review course without supplementary study is professionally unacceptable. This approach fails to account for the vast and evolving nature of geriatric medicine, potentially leading to gaps in knowledge and an incomplete understanding of current best practices. It neglects the importance of diverse learning modalities and the critical appraisal of up-to-date research. Focusing exclusively on memorizing past examination questions without understanding the underlying principles is also professionally unacceptable. While familiarity with question styles can be helpful, this method does not foster true comprehension or the ability to apply knowledge to novel clinical scenarios, which is essential for proficiency verification. It represents a superficial engagement with the material that does not equate to genuine expertise. Waiting until the last few weeks before the examination to begin intensive study is professionally unacceptable. This rushed approach does not allow for adequate assimilation of complex information, consolidation of knowledge, or sufficient practice with assessment tools. It increases the likelihood of superficial learning and can lead to significant stress and burnout, compromising the candidate’s ability to perform optimally. Professional Reasoning: Professionals should approach preparation for high-stakes examinations by first conducting a thorough self-assessment of their existing knowledge gaps. This should be followed by the development of a detailed study plan that allocates sufficient time for each topic, prioritizing evidence-based resources and incorporating active learning techniques. Regular self-testing and seeking feedback from peers or mentors are crucial components of this process. The plan should be flexible enough to adapt to evolving learning needs and the availability of new information, ensuring a comprehensive and effective preparation strategy.

Scenario Analysis: This scenario is professionally challenging because it requires balancing a patient’s immediate comfort and expressed wishes with the clinician’s ethical and professional responsibility to ensure comprehensive risk assessment, especially in a complex geriatric population where frailty and multiple comorbidities are common. The pressure to provide rapid relief can sometimes overshadow the need for thorough evaluation, potentially leading to suboptimal or even harmful interventions. Careful judgment is required to integrate patient autonomy with evidence-based geriatric care principles. Correct Approach Analysis: The best professional practice involves a systematic and comprehensive approach that prioritizes a holistic assessment of the patient’s condition. This includes gathering detailed information about the presenting complaint, performing a thorough physical examination, reviewing the patient’s medical history and current medications, and considering the patient’s functional status, cognitive abilities, and social support system. This approach is correct because it aligns with the core principles of geriatric medicine, emphasizing a multidimensional assessment to identify all contributing factors to the patient’s symptoms and to develop an individualized, safe, and effective care plan. This is ethically mandated by the principle of beneficence (acting in the patient’s best interest) and non-maleficence (avoiding harm), and professionally guided by best practice guidelines for geriatric assessment which advocate for a comprehensive, interdisciplinary approach. Incorrect Approaches Analysis: Focusing solely on the patient’s stated preference for a specific medication without conducting a thorough assessment of underlying causes or potential contraindications is professionally unacceptable. This approach risks overlooking other significant contributing factors to the patient’s distress, potentially leading to the prescription of a medication that is not the most appropriate, may have adverse effects, or could interact negatively with other conditions or medications. This fails to uphold the clinician’s duty of care and the principle of beneficence. Administering a broad-spectrum antibiotic based on a presumptive diagnosis without further investigation or diagnostic confirmation is also professionally unacceptable. While prompt treatment of infection is important, empirical antibiotic use without a clear indication or diagnostic workup can lead to antibiotic resistance, unnecessary side effects, and can mask or delay the diagnosis of other serious conditions. This violates the principle of non-maleficence and responsible antimicrobial stewardship. Initiating a palliative care consult immediately without a comprehensive assessment of the patient’s current medical status and potential for reversible causes of their symptoms is premature and may not be the most appropriate first step. While palliative care is a vital component of geriatric medicine, its role is to manage symptoms and improve quality of life, often in conjunction with active treatment. Skipping the initial diagnostic and management steps for potentially treatable conditions would be a failure in comprehensive care. Professional Reasoning: Professionals should employ a structured decision-making process that begins with a thorough understanding of the presenting problem, followed by a systematic assessment that considers all relevant domains of geriatric health. This involves active listening to the patient, performing a comprehensive physical and cognitive evaluation, reviewing all available data, and considering differential diagnoses. The decision-making process should then weigh the risks and benefits of various management options, prioritizing interventions that are evidence-based, individualized, and aligned with the patient’s overall goals of care and functional status. Ethical considerations, including patient autonomy, beneficence, non-maleficence, and justice, should guide every step.

Scenario Analysis: This scenario is professionally challenging because it requires balancing the immediate clinical needs of a geriatric patient with the potential long-term implications of an undiagnosed genetic predisposition. The physician must navigate the ethical imperative to provide comprehensive care while respecting patient autonomy and avoiding unnecessary or potentially harmful interventions based on speculative genetic information. The integration of foundational biomedical sciences, specifically genetics, into clinical decision-making for an elderly patient presents unique considerations regarding the utility and interpretation of such data. Correct Approach Analysis: The best professional practice involves a thorough clinical assessment that prioritizes the patient’s current symptoms and functional status. This approach involves a detailed history, physical examination, and targeted investigations to address the presenting complaints. If, during this process, a specific clinical suspicion arises that could be illuminated by genetic testing (e.g., a strong family history of a specific neurodegenerative disease), then a discussion about the potential benefits, risks, and limitations of genetic testing should occur with the patient. This discussion must be informed, voluntary, and respect the patient’s right to decline testing. The justification for this approach lies in the principle of beneficence (acting in the patient’s best interest by addressing current needs) and non-maleficence (avoiding harm from unnecessary or anxiety-provoking genetic investigations). It also upholds patient autonomy by ensuring informed consent for any further diagnostic steps. Incorrect Approaches Analysis: Pursuing broad genetic screening without a clear clinical indication or patient consent is ethically problematic. It risks generating incidental findings that may cause significant psychological distress to the patient and their family, without offering immediate clinical benefit. This approach violates the principle of non-maleficence by potentially causing harm through anxiety and the burden of managing unsolicited genetic information. Furthermore, it disregards patient autonomy by proceeding without informed consent. Recommending genetic testing solely based on age and a vague family history, without a specific clinical hypothesis, is also inappropriate. This lacks the necessary scientific rationale for genetic investigation in this context and can lead to misinterpretation of results, potentially causing undue worry or leading to inappropriate clinical management. Focusing exclusively on the patient’s current symptoms without considering any potential underlying genetic factors that might influence treatment response or prognosis, even if not immediately apparent, is also a missed opportunity for comprehensive care. While addressing current symptoms is paramount, a holistic approach that considers all relevant biomedical information, including potential genetic predispositions when clinically relevant, is ideal. Professional Reasoning: Professionals should adopt a systematic approach to patient care. This begins with a comprehensive clinical assessment to understand the presenting problem. Based on this assessment, a differential diagnosis should be formulated. If foundational biomedical sciences, such as genetics, are relevant to the differential diagnosis or potential management strategies, then their integration should be considered. This integration must be guided by clinical relevance, evidence-based practice, and patient-centered decision-making, always prioritizing informed consent and the patient’s well-being.

This scenario presents a significant professional challenge due to the inherent conflict between a patient’s expressed wishes and the perceived best interests of their care, particularly in the context of geriatric medicine where capacity can fluctuate and be complex to assess. Navigating this requires a delicate balance of respecting autonomy while ensuring patient safety and well-being, all within a robust ethical and legal framework. The health systems science aspect comes into play by considering the resources and processes available to support such complex decision-making. The best approach involves a thorough and documented assessment of the patient’s capacity to make decisions regarding their treatment. This includes understanding the specific decision at hand, the information provided, the patient’s comprehension of that information, and their ability to weigh the risks and benefits and communicate their choice. If capacity is deemed present, their informed consent, or refusal, must be respected, even if it differs from the clinician’s recommendation. This aligns with the fundamental ethical principles of autonomy and beneficence, as well as legal requirements for informed consent, which mandate that competent individuals have the right to make decisions about their own medical care. The health system should provide resources for capacity assessment, including access to geriatric psychiatry or other specialists if needed, and clear protocols for managing disagreements. An approach that overrides the patient’s wishes solely based on the clinician’s judgment of what is “best” without a formal capacity assessment is ethically and legally flawed. It violates the principle of autonomy and can lead to accusations of battery or lack of informed consent. Similarly, proceeding with a treatment the patient has refused, even with good intentions, disregards their right to self-determination and can erode trust within the patient-clinician relationship. Involving family members to make the decision for the patient, without first establishing the patient’s lack of capacity and without appropriate legal or ethical authorization (such as a valid advance directive or guardianship), is also problematic. While family input can be valuable, the ultimate decision-making authority rests with the competent patient. Professionals should employ a structured decision-making process that begins with assessing the patient’s understanding of their condition and proposed treatments. This should be followed by a formal capacity assessment, utilizing validated tools and, if necessary, multidisciplinary input. If capacity is confirmed, the patient’s informed decision must be honored. If capacity is lacking, the process must then shift to identifying the patient’s previously expressed wishes (e.g., through advance directives) or appointing a legally authorized surrogate decision-maker, always acting in the patient’s best interests as defined by their known values and preferences. Documentation at each stage is crucial.

This scenario is professionally challenging because it requires balancing the immediate needs of individual patients with the broader public health mandate of addressing systemic inequities in geriatric care. The pressure to demonstrate progress on population health metrics can sometimes overshadow the nuanced understanding of how historical and ongoing social determinants of health disproportionately affect specific elderly populations. Careful judgment is required to ensure that interventions are both effective at a population level and ethically sound, avoiding the perpetuation of disparities. The best approach involves a comprehensive risk assessment that explicitly integrates social determinants of health and health equity considerations into the evaluation of population health outcomes for older adults. This method acknowledges that disparities in access, quality of care, and health outcomes are not random but are often rooted in systemic factors like socioeconomic status, race, ethnicity, geographic location, and disability. By proactively identifying these underlying causes, interventions can be targeted more effectively to address the root of the problem, leading to more sustainable improvements in health equity. This aligns with the ethical imperative to promote justice and fairness in healthcare and the public health principle of addressing social determinants to achieve population health goals. An approach that focuses solely on aggregate health metrics without disaggregating data by relevant demographic and socioeconomic factors fails to identify or address health inequities. This is ethically problematic as it can mask significant disparities and lead to interventions that benefit already advantaged groups while leaving vulnerable populations behind. It also falls short of public health best practices, which emphasize understanding and mitigating the impact of social determinants. Another inadequate approach is to prioritize interventions based on the highest prevalence of disease in the elderly population without considering the underlying reasons for that prevalence. This can lead to a misallocation of resources, as high prevalence might be a symptom of inequitable access or social disadvantage rather than an inherent characteristic of the disease itself. Ethically, this approach risks perpetuating a cycle of disadvantage by not addressing the root causes of poorer health in specific groups. Finally, an approach that relies on anecdotal evidence or the loudest voices within a community, while well-intentioned, lacks the systematic rigor required for effective population health management and health equity. It may lead to interventions that are not evidence-based or that do not reflect the true scope of needs across the entire diverse elderly population. This can result in inefficient resource allocation and a failure to address the most pressing systemic issues contributing to health disparities. Professionals should employ a decision-making framework that begins with a thorough understanding of the population’s demographic and socioeconomic landscape. This involves actively seeking disaggregated data and engaging with diverse community stakeholders to identify specific needs and barriers. Risk assessment should then be conducted through a health equity lens, explicitly considering how social determinants of health contribute to observed health outcomes. Interventions should be designed and evaluated not only for their impact on aggregate health metrics but also for their ability to reduce disparities and promote equitable access and outcomes for all older adults.