Geriatric Medicine

Clinicians should recognise that older patients are often sexually active and, therefore, at risk of sexually transmitted infections. Syphilis and HIV are two such infections with particular relevance in an older population, since the…

Pain in older patients is often poorly treated. Some patients have a tendency to under-report their symptoms or are unable to communicate their pain. Clinicians do not always adequately investigate pain or are unaware of non-verbal cues of…

An Englishman's home is said to be his castle€”the same is, of course, true for an Englishwoman too. I would say one's home is more than a castle, particularly for older people who want to live and die in their own home. The home that one…

Coronary heart disease and cerebrovascular disease are the two main forms of cardiovascular disease. In 2003 there was a totalof 58,420 deaths in Scotland. Cardiovascular disease accounted for 38% and cancer for 26%.This article discusses…

Polyarthralgia is a common presentation in primary care. Because chronic arthritides may present abruptly, they need to be considered in patients who present with acute polyarticularpain. This condition pain poses a diagnostic challenge…

When reading the article on management of trigeminal neuralgia in GM December 2008, I was surprised that it did not mention use of tricyclic antidepressants. The authors recommend carbamazepine as treatment of first choice. Locally, I do…

The management of pain for older people with cancer is complex and multimodal. Older individuals are more likely than younger people to have other medical problems and disabilities; comorbidities may be a predictor of poorer pain control,…

Parkinson's disease remains a clinical diagnosis and a reminder of the UK brain bank criteria can help ensure that our clinicaldiagnoses maintain a reasonable level of specificity. DaTSCANs„¢ can be helpful where diagnostic uncertainty…

In spite of overwhelming clinical evidence to support the cardiovascular benefits of antihypertensive treatments, less than half oftreated hypertensive individuals achieve good blood pressure control. Poor concordance remains one of the…

The physical environment and design of a ward or care setting for people with dementia can have a profound effect on patients' quality of life as well as improving symptoms of the disorder. We discuss good practice in the design of such…

Kleine-Levin syndrome is more commonly known as recurrent primary hypersomnia. The patient can lapse into a deep sleep at any time without warning, sometimes lasting as long as 16 hours. It is often associated with compulsive overeating and…

The Code of Practice for the Mental Capacity Act 2005 states that those working with vulnerable people must be able to demonstrate that they comply with the code. Or, as I am fond of pointing out, they may one day have to explain to the…

Seizure after stroke is common and late-onset seizures have higher recurrence rate and poorer prognosis. Patients with poststroke epilepsy are difficult to rehabilitate and are more likely to be hospitalised for an extended period of time.…

Management of behavioural disturbance in the setting of dementia can be challenging. There are many potential causes including poor physical health, prescribed drugs, depression, impaired vision and hearing as well numerous environmental…

Osteoporosis management in older people should be aimed at fracture prevention. Most trial evidence involving antiosteoporoticmedications in reducing fragility fractures exists in women up to the age of 80 years. In this review we…