Geriatric Medicine

Normal-pressure hydrocephalus was first described more than 40 years ago as a syndrome of cognitive impairment, gait disturbance, and urinary incontinence affecting the older adult. It is a syndrome of symptoms and signs, which should be…

In older people, sleep disturbances are very common. Changes in sleep patterns may be a normal partof ageing, but many other factors in older people can contribute to sleep problems. Sleep disordersdecrease quality of life in older people…

General practitioners are at the forefront of the annual influenza vaccination, but they are not the only health workers with responsibility for vaccination. The aims of vaccination are to both protect the induvidual, and the wider…

Itching is a common and distressing symptom in elderly people and can disturb sleep. If no rash is present, then systemic causes of itch, such as iron deficiency, or neuropathy should be considered. The somewhat derogatory term senile…

Type-2 diabetes is an increasing public-health problem, both in terms of treating the condition itself,and in preventing complications. Optimising clinical outcomes depends on reducing HbA1C, as seenin the Quality and Outcomes Framework and…

Back pain is a common symptom that can indicate serious disease, particularly in elderly patients.Separation of the serious pathologies such as malignancy, infection, and cauda equina syndrome frombenign axial back pain is a challenge. The…

About a third of surgeries involve elderly patients; however, postoperative cognitive dysfunction is animportant adverse outcome in such patients. Doctors should be aware of this condition and consider therisk€“benefit ratio when referring…

Morbidity from ischaemic heart disease increases as patients age, and the burden of angina in elderlyindividuals can severely reduce their quality of life. The most common interventions are angioplasty,stenting, and coronary artery bypass…

Ticks are endemic in many regions of the UK and Europe. With recent mild winters, the tick populationhas been increasing and new areas affected. Tick bites can transmit infections to human beings and asubstantial number of ticks are…

A substantial proportion of older people have problems swallowing that can inhibit effective adherenceto solid oral treatment regimens. Causes of dysphagia include reductions in gastrointestinal motilitywith age, consequences of age-related…

Urinary retention after stroke is common and the mechanism is multifactorial. The management issimilar to its that of any other cause. In the majority of patients, it resolves with time and the overallprognosis seems favourable.

Age-related macular degeneration (AMD) is a progressive disorder of the retina in older adults. DryAMD, characterised by deposits in the fundus, does not cause significant vision loss. But if it progressesto advanced AMD, it can cause…

The lifetime risk for the development of ovarian cancer is one in 48 (2·1%) and according to recent statistics epithelial ovarian cancer is now the most commonly diagnosed form of gynaecological cancer in women.

Guidelines for treating osteoporosis issued by NICE in October 2008 were controversial throughout the consultation process and legally challenged early in 2009. The National Osteoporosis Guideline Group released an alternative set of…

Coronary artery disease remains one of the leading causes of mortality in the UK, accounting for more than one in four of all deaths. Since the prevalence of coronary artery disease increases with age, as our population grows older a larger…