ABIM (American Board of Internal Medicine), ADL (activity of daily living), AGA (American Gastroenterological Association), COX (cyclooxygenase), GERD (gastroesophageal reflux disease), GI (gastrointestinal), IBS (irritable bowel syndrome), NASH (nonalcoholic steatohepatitis), PEG (percutaneous endoscopic gastrostomy), RR (relative risk) The population is rapidly aging as the “baby boom” cohort of adults reaches the age of 60+ years. This group differs from those previously moving through the geriatric age range. They are more proactive concerning their health and also more interested in aggressive management of their gastrointestinal (GI) problems. The current older “old” patients in the age range of 70–95 years are also becoming more interested in their health and in maintenance of function. This will drive health care expenditures up over the next 10 years, because individuals aged 65 years or older account for 60% of all medical expenditures and are the most likely to use other expensive resources such as intensive care unit beds and Medicare-funded long-term care beds. This report has been prepared to identify issues that the American Gastroenterological Association (AGA) Future Trends Committee believes are likely to impact gastroenterology practice. The following is a list of the 3 most important issues that were identified as being likely to impact practice in the near future. 1 Research is needed to define the “best evidence-based care” for the geriatric population. Existing databases emphasize the relative lack of large, randomized trials in the geriatric population and the lack of inclusion of patients with common comorbidities such as hypertension, diabetes, renal disease, and cardiovascular disease. Guidelines of care for specific GI issues in aged patients need to be developed. 2 Increasing acuity and medical complexity of geriatric patients will drive modification of current clinic and hospital practice. Geriatric patients take longer to see and require more complex management by specialists. Research is needed to define parameters that may impair the ability of gastroenterologists to deliver appropriate care to older patients. Issues of scheduling and billing, particularly existing Medicare reimbursement, will need urgent action. Increased demand by older patients for specialist gastroenterology treatment and procedures will put tremendous pressure on the existing workforce. It is unlikely that modification of clinic and hospital scheduling will compensate for the expected increase in numbers of older patients requiring treatment by gastroenterologists. Research is urgently required to determine the best practice model for delivery of gastroenterologic care, including the potential expansion of models that include physician assistants and nurse practitioners in clinic and hospital settings. Other issues believed to have an impact on future gastroenterology practice include the following: defining appropriate limits for screening tests for GI neoplasias, expanding research into age-specific treatments of common GI disorders in the elderly (diarrhea, constipation,