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Precision medicine presents an opportunity to use novel, data‐driven strategies to improve patient care. The field of precision medicine has undergone many advancements over the past few years. It has moved beyond incorporation of individualized genetic risk into medical decision‐making to include multiple other factors such as unique social, demographic, behavioral, and clinical characteristics. Geriatric medicine stands to benefit heavily from the integration of precision medicine into its standard practices. Older adults, compared with other populations, have high clinical and biological heterogeneity that can alter the risks and benefits of different approaches to patient care. These factors have not been routinely considered previously by geriatricians. Yet, geriatricians' ability to address older adults' baseline heterogeneity is increasingly recognized as a cornerstone of delivering quality care in a geriatric medical practice. Given the shared focus of individualized decision‐making, precision medicine is a natural fit for geriatric medicine. This manuscript provides, via cases and discussion, examples that illustrate how precision medicine can improve the care of our older patients today. We will share specific and existing tools and evidence, and review the existing multilevel barriers to further incorporate and implement these tools into clinical practice. We propose methods to address these barriers and to help realize the full potential of precision medicine for the care of older adults. We conclude with a brief discussion of potential future directions of research of precision medicine in the care of older adults. [ABSTRACT FROM AUTHOR]

Background: Electronic frailty indices (eFIs) can expand measurement of frailty in research and practice and have demonstrated predictive validity in associations with clinical outcomes. However, their construct validity is less well studied. We aimed to assess the construct validity of the VA‐FI, an eFI developed for use in the U.S. Veterans Affairs Healthcare System. Methods: Veterans who underwent comprehensive geriatric assessments between January 31, 2019 and June 6, 2022 at VA Boston and had sufficient data documented for a comprehensive geriatric assessment‐frailty index (CGA‐FI) were included. The VA‐FI, based on diagnostic and procedural codes, and the CGA‐FI, based on geriatrician‐measured deficits, were calculated for each patient. Geriatricians also assessed the Clinical Frailty Scale (CFS), functional status (ADLs and IADLs), and 4‐meter gait speed (4MGS). Results: A total of 132 veterans were included, with median age 81.4 years (IQR 75.8–88.7). Across increasing levels of VA‐FI (<0.2; 0.2–0.4; >0.4), mean CGA‐FI increased (0.24; 0.30; 0.40). The VA‐FI was moderately correlated with the CGA‐FI (r 0.45, p < 0.001). Every 0.1‐unit increase in the VA‐FI was associated with an increase in the CGA‐FI (linear regression beta 0.05; 95% confidence interval [CI] 0.03–0.06), higher CFS category (ordinal regression OR 1.69; 95% CI 1.24–2.30), higher odds of ADL dependency (logistic regression OR 1.59; 95% CI 1.20–2.11), IADL dependency (logistic regression OR 1.68; 95% CI 1.23–2.30), and a decrease in 4MGS (linear regression beta −0.07, 95% CI −0.12 to −0.02). All models were adjusted for age and race, and associations held after further adjustment for the Charlson Comorbidity Index. Conclusion: Our results demonstrate the construct validity of the VA‐FI through its associations with clinical measures of frailty, including summary frailty measures, functional status, and objective physical performance. Our findings complement others' in showing that eFIs can capture functional and mobility domains of frailty beyond just comorbidity and may be useful to measure frailty among populations and individuals. [ABSTRACT FROM AUTHOR]