Geriatric Medicine

Generalised anxiety disorder is common and can present in older people, often in conjunction with depressive symptoms. Pharmacological treatments have included tricyclic antidepressants, benzodiazepines, and antipsychotics, but a selection…

Low back pain is a common presenting symptom in older patients and results in significant disability and functional decline. We look at the important causes of low back pain, the imaging techniques to diagnose the underlying pathology, and…

Gallstone disease and its complications are extremely common in elderly populations; therefore in the context of the UK's ageing population and recent advances in biliary tract surgery, this review outlines the key aspects of managing…

Dementia with Lewy bodies is a common form of dementia that remains underdiagnosed and poorly understood by most health-care professionals. The general practitioner will often mbe the first doctor that patients or their concerned relatives…

The psychostimulants methylphenidate and dexamfetamine have been used safely in child psychiatry for attention deficit and hyperactivity disorder for more than two decades. Use of stimulants in elderly people probably predates that in…

One thing about being a doctor, whether in general practice or in hospital, that never gets easier, is telling a patient that their test results are not good€”and then fielding the inevitable €œHow long have I got?€ Once the patient has…

Venous thromboembolism is a major cause of morbidity and mortality in hospital, and elderly patients are at particularly high risk. Trials consistently show the efficacy of prophylactic low molecular-weight heparin in reducing thromboses. A…

Older patients can benefit greatly from elective surgery, but complications and adverse events must be considered. Variables that affect outcome include the differing risks of particular procedures and the functional capacity and…

Carotid endarterectomy is a surgical procedure in which an atherosclerotic plaque is removed from the carotid artery to avoid future stroke. A small proportion of patients will have adverse effects from surgery and need emergency…

Falls and related fractures are a major cause of disability and mortality in older people. Falls prevention services have been available in the UK for many years, but audits of these services show that improvements are needed. We discuss…

Difficulty swallowing (dysphagia) imposes a heavy burden on the NHS and patients, and can undermine nutrition, result in aspiration pneumonia, compromise quality of life, and hinder administration of solid medications. 

Stroke is the leading cause of adult disability in the UK. 70% of strokes occur in adults older than 65 years of age. Oral health and mouth care are usually forgotten, but are important aspects of care. Studies have highlighted the poor…

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 polyarticular pain. This pain poses a diagnostic challenge because of…

Cardiopulmonary resuscitation is undoubtedly an important form of medical therapy that has saved many lives. However, as clinicians we come across situations in which resuscitation would clearly not benefit the patient. Therefore, in the…

In May, NICE issued updated treatment guidelines for type-2 diabetes. This advice gives doctors the option of using thiazolidinediones or dipeptidyl peptidase-4 inhibitors in patients whose blood-glucose control is inadequate. However,…