refactor(topics): 멀티 에이전트용 지식 재편 — _Common(공통 기본기) + Domain_* 구조

에이전트 8종(대화형/프로그래머 C·S/디자이너/설계자/기획자/QA/PD/PM)에게 [공통 기본 능력 + 롤별 Specialty] 2층으로 지식을 주입하기 위한 재분류. 문서 내용·포맷은 무수정, 폴더 이동만 (6,372개 문서 수 보존 확인). - Topic_Programming → Domain_Programming (내부 구조 보존) - Topic_Graphic → Domain_Design - Topic_Business → Domain_Product - Topic_General → Domain_General - _Common 신설: Math(구 Topic_Math_Specialty), Reasoning(구 General/From_Thinking & Reasoning), Reasoning_Creativity(구 General/From_창의성), Communication(Poetic_Blog_Writing + From_writing) - 타 도메인의 From_* 폴더는 유지 (출처 표기일 뿐, 이미 도메인에 맞게 분류된 문서) - 빈 폴더 정리 (memory/procedures) - 에이전트→폴더 매핑은 workspace의 .astra/agent-knowledge-map.json (9개 에이전트) Co-Authored-By: Claude Fable 5 <noreply@anthropic.com>
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+---
+id: wiki-2026-0508-geriatric-medicine
+title: Geriatric Medicine
+category: 10_Wiki/Topics
+status: verified
+canonical_id: self
+aliases: [geriatrics, aging, elderly care, frailty, polypharmacy, CGA]
+duplicate_of: none
+source_trust_level: A
+confidence_score: 0.85
+verification_status: applied
+tags: [medicine, geriatrics, aging, frailty, healthcare, ai-medicine]
+raw_sources: []
+last_reinforced: 2026-05-10
+github_commit: pending
+tech_stack:
+  language: Medical / Clinical
+  applicable_to: [Healthcare AI, Elderly Care, Risk Stratification]
+---
+
+# Geriatric Medicine
+
+## 매 한 줄
+> **"매 elderly (65+) 의 specific medical care"**. 매 frailty + multimorbidity + polypharmacy + cognitive decline + functional decline. 매 modern: 매 ML risk stratification + 매 fall detection + 매 dementia screening.
+
+## 매 핵심
+
+### 매 syndromes (Geriatric Giants)
+- **Frailty**.
+- **Falls**.
+- **Cognitive decline / dementia**.
+- **Incontinence**.
+- **Iatrogenic** (medication-related).
+
+### 매 framework
+- **CGA** (Comprehensive Geriatric Assessment): 매 medical + functional + psychological + social.
+- **Frailty index** (Rockwood).
+- **ADL / IADL**: 매 activities of daily living.
+- **MMSE / MoCA**: 매 cognitive screen.
+
+### 매 modern AI
+- **Risk stratification**: 매 readmission, fall, mortality.
+- **Wearable monitoring**: 매 fall detection.
+- **Dementia screening**: 매 voice / writing.
+- **Polypharmacy**: 매 drug interaction LLM.
+- **Telehealth**.
+
+### 매 응용
+1. **Hospital readmission predict**.
+2. **Fall risk score**.
+3. **Frailty progression**.
+4. **Medication review**.
+5. **Cognitive assessment**.
+6. **End-of-life planning**.
+
+## 💻 패턴
+
+### Frailty index
+```python
+def frailty_index(deficits, max_deficits=70):
+    """매 Rockwood frailty: count of deficits / total."""
+    n_deficit = sum(1 for d in deficits if d.present)
+    return n_deficit / max_deficits  # 매 > 0.25 = frail
+```
+
+### Charlson Comorbidity Index
+```python
+CCI_WEIGHTS = {
+    'mi': 1, 'chf': 1, 'pvd': 1, 'cvd': 1, 'dementia': 1,
+    'copd': 1, 'connective': 1, 'ulcer': 1, 'liver_mild': 1,
+    'diabetes': 1, 'hemiplegia': 2, 'renal_mod_severe': 2,
+    'diabetes_complications': 2, 'tumor': 2, 'leukemia': 2,
+    'lymphoma': 2, 'liver_mod_severe': 3, 'metastatic_tumor': 6, 'aids': 6,
+}
+
+def cci_score(conditions, age):
+    score = sum(CCI_WEIGHTS.get(c, 0) for c in conditions)
+    if age >= 50: score += (age - 40) // 10
+    return score
+```
+
+### Fall risk (Morse Fall Scale)
+```python
+def morse_fall_scale(history_falls, secondary_diagnosis, ambulatory_aid, iv_therapy, gait, mental_status):
+    score = 0
+    if history_falls: score += 25
+    if secondary_diagnosis: score += 15
+    score += {'none': 0, 'crutch_cane_walker': 15, 'furniture': 30}[ambulatory_aid]
+    if iv_therapy: score += 20
+    score += {'normal': 0, 'weak': 10, 'impaired': 20}[gait]
+    score += {'oriented': 0, 'forgets_limit': 15}[mental_status]
+    
+    risk = 'low' if score < 25 else 'medium' if score < 45 else 'high'
+    return score, risk
+```
+
+### Polypharmacy detection (Beers / STOPP)
+```python
+BEERS_INAPPROPRIATE = {'diphenhydramine': 'anticholinergic load', 'amitriptyline': 'TCA elderly', ...}
+
+def beers_check(medications):
+    flagged = []
+    for med in medications:
+        if med.name in BEERS_INAPPROPRIATE:
+            flagged.append({'med': med.name, 'reason': BEERS_INAPPROPRIATE[med.name]})
+    return flagged
+```
+
+### Drug interaction (LLM-aided)
+```python
+def drug_interaction_check(medications, llm):
+    prompt = f"""Check drug interactions for elderly patient.
+Medications: {medications}
+
+Output JSON list:
+- pair: [drug1, drug2]
+- severity: minor / moderate / severe
+- mechanism
+- recommendation"""
+    return json.loads(llm.generate(prompt))
+```
+
+### Cognitive screen (MoCA)
+```python
+def moca_total(scores):
+    """매 30-point — 26+ normal, 18-25 mild, < 18 mod-severe."""
+    return sum(scores.values())  # 매 visuospatial + naming + memory + attention + language + abstraction + delayed recall + orientation
+```
+
+### Readmission risk (LACE)
+```python
+def lace_index(length_of_stay, acuity_admission, charlson, ed_visits_6mo):
+    """매 30-day readmission risk."""
+    los_score = {1: 1, 2: 2, 3: 3, 4: 4, 5: 5, 6: 5, 7: 6, 8: 6, 9: 7}.get(min(length_of_stay, 9), 7)
+    acuity = 3 if acuity_admission else 0
+    charlson_score = min(charlson, 5)
+    ed_score = min(ed_visits_6mo, 4)
+    return los_score + acuity + charlson_score + ed_score
+```
+
+### Fall detection (wearable)
+```python
+def detect_fall(accelerometer_data, threshold_g=2.5):
+    """매 spike + post-impact stillness."""
+    magnitudes = np.linalg.norm(accelerometer_data, axis=1)
+    spikes = np.where(magnitudes > threshold_g)[0]
+    for spike in spikes:
+        if spike + 50 < len(magnitudes):
+            post = magnitudes[spike+10:spike+50]
+            if post.std() < 0.1:  # 매 still
+                return {'fall_detected': True, 'time': spike}
+    return {'fall_detected': False}
+```
+
+### Sarcopenia (SARC-F)
+```python
+def sarc_f_questionnaire():
+    return {
+        'strength': 'how much difficulty lifting 10lb',
+        'walking': 'how much difficulty walking across room',
+        'rising': 'how much difficulty rising from chair',
+        'climbing': 'how much difficulty climbing 10 stairs',
+        'falls': 'how many falls in last year',
+    }
+# 매 score >= 4 → sarcopenia screen positive
+```
+
+### CGA (comprehensive)
+```python
+def comprehensive_geriatric_assessment(patient):
+    return {
+        'medical': cci_score(patient.conditions, patient.age),
+        'functional': adl_score(patient.adls),
+        'cognitive': moca_total(patient.moca),
+        'mood': geriatric_depression_scale(patient.gds),
+        'social': social_isolation_score(patient),
+        'frailty': frailty_index(patient.deficits),
+        'medications': beers_check(patient.medications),
+    }
+```
+
+### LLM clinical assistant
+```python
+def geriatric_consult(patient, llm):
+    prompt = f"""You are a geriatrics expert. For this patient:
+{patient}
+
+Output:
+1. Top 3 medical priorities
+2. Medication review (Beers / STOPP)
+3. Functional intervention recommendations
+4. Goals of care discussion points
+DO NOT diagnose without confirmation. Always defer to attending."""
+    return llm.generate(prompt)
+```
+
+### End-of-life (POLST)
+```python
+@dataclass
+class POLST:
+    cpr_preference: str  # 매 attempt / DNR
+    medical_intervention: str  # 매 full / selective / comfort
+    artificial_nutrition: str
+    
+    def is_complete(self):
+        return all([self.cpr_preference, self.medical_intervention, self.artificial_nutrition])
+```
+
+## 매 결정 기준
+| 상황 | Approach |
+|---|---|
+| Hospital admission | CGA + LACE |
+| Fall risk | Morse + ambient sensor |
+| Multi-medication | Beers / STOPP + LLM check |
+| Cognitive concern | MoCA + DEM screen |
+| Frailty | Rockwood index |
+| End-of-life | POLST + family meeting |
+
+**기본값**: 매 CGA + 매 risk stratification + 매 multi-disciplinary team + 매 wearable monitoring + 매 LLM medication check.
+
+## 🔗 Graph
+- 부모: [[Aging]]
+- 변형: [[Frailty]] · [[Polypharmacy]]
+
+## 🤖 LLM 활용
+**언제**: 매 risk stratification. 매 medication review. 매 documentation.
+**언제 X**: 매 final diagnosis (clinician-only).
+
+## ❌ 안티패턴
+- **Generic adult protocol**: 매 elderly different.
+- **Polypharmacy ignore**: 매 cascade.
+- **No functional assessment**: 매 hospitalization missing.
+- **AI without clinician**: 매 liability.
+
+## 🧪 검증 / 중복
+- Verified (Beers Criteria 2023, AGS, MoCA, Rockwood frailty).
+- 신뢰도 A.
+
+## 🕓 Changelog
+| 날짜 | 변경 |
+|---|---|
+| 2026-04-26 | Auto |
+| 2026-05-08 | Phase 1 |
+| 2026-05-10 | Manual cleanup — geriatric giants + 매 Frailty / Beers / Morse / MoCA / fall code |