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Hypertension is a major modifiable risk factor for cardiovascular disease. The current treatment strategy for treating hypertension in older adults has evolved through a series of randomised control trials over the past three decades. Beneficial effects of treating hypertension up to the age of 80 years has been unequivocally established while the benefits of treating it beyond that age need to be weighed against the risks involved in this vulnerable group of adults.

Chronic heart failure (CHF) is a common syndrome, and its symptoms include exercise intolerance due to breathlessness and fatigue with cardiac dysfunction. As a group, patients with CHF suffer ongoing symptoms, recurrent hospitalisations and a high mortality rate, but modern medical therapy can reduce each of these features.

Hypoglycaemia occurs when blood glucose drops below normal levels. Severe hypoglycaemia is defined as an episode in which the mental state of the patient is so disturbed that they are unable to self–treat. For elderly people who live alone this can be very dangerous as they have no one to help recognise the hypoglycaemic symptoms and act accordingly

Delirium is a very common syndrome in patients in hospital. Multiple factors contribute to its aetiology; however, it is five times more likely to develop in patients with pre-existing dementia. The condition is associated with significant mortality and morbidity, thus patients at high risk must be identified on admission and preventive measures put in place. This article reviews the prevention, diagnosis, assessment and management of delirium in elderly patients.

Myasthenia gravis is the most common neuromuscular disease. In elderly people it is often misdiagnosed as transient ischemic attack or stroke because of their shared symptoms, including muscle weakness, fatigue, and speech and swallowing disturbances. Here, we report on a case of delayed diagnosis that led to myasthenia crisis, and review the differential diagnosis and management of the disease.

Pneumothorax is a relatively common presentation in patients under the age of 40 years (approximately, 85% of patients are younger than 40 years). It is described as typically occurring in tall, thin, young men; hence, morbidity and mortality is reduced. However its presentation in the elderly is still an area of further study, with most patients presenting with an underlying respiratory disease.

Chronic heart failure (CHF) is a common condition, particularly among older patients, and is associated with a high rate of mortality and morbidity. In the first part of this article, we reviewed the diagnostic tools and medical therapies used in the management of CHF. In part two, we provide guidance on when patients should be referred for more intensive management and focus on device therapies.

Alcohol use disorders are common in the elderly, and on the increase as the population ages. While life changes may trigger the unhealthy use of alcohol, ageing physiology, comorbidities and polypharmacy can increase vulnerability to its effects. Alcohol use disorders are currently underdiagnosed in older people, in whom the early signs may be masked by altered patterns of drinking and non-specific presentations.

A third of people aged over 65 years fall each year and medication review is an important part of the assessment of these patients. Both polypharmacy and specific medications increase the risk of falls and discontinuing these medications may reduce this risk. This article examines the issues that need addressing during a medication review to reduce the risk of falls and related injuries in older people.

With its videos of unlikely singing sensations, sneezing pandas and tap-dancing cats, YouTube has become an international phenomenon. But, as well as being a source of amusement to the bored office worker, YouTube has the potential to be a valuable tool in reminiscence therapy for older people with depression or dementia. This article reviews the benefits of reminiscence therapy and explores how YouTube could be used in this treatment.

Multiple myeloma is a malignant disease characterised by a clonal population of plasma cells in the bone marrow. The disease occurs in the elderly and results in lytic bone lesions, blood cytopenias and the production of monoclonal immunoglobulin heavy and light chains. Multiple myeloma is an incurable condition and therefore treatment is reserved for symptomatic patients or those with documented bone lesions.

About 50% of patients with diabetes mellitus worldwide suffer from diabetic peripheral neuropathy (DPN). The most common form of DPN is a symmetrical, predominantly sensory, polyneuropathy with distal onset and slow proximal progression. However, some patients with diabetes may present with acute or subacute, progressive, asymmetrical weakness and pain of the muscles of the proximal lower limbs. The condition is commonly known as diabetic amyotrophy.

Reorganising health-care workers' functions is necessary to improve the quality of care in residential homes and to achieve the objectives of the National Dementia Strategy. General practitioners with a special interest in the mental€“health of older people and consultant psychiatrists for older adults with exclusive commitment to the community will be useful roles to develop.

There is little doubt that medical therapy has transformed the treatment of benign prostatic hypertrophy (BPH). The medical treatment of BPH continues to be based on two main classes of drugs, alpha adrenergic blockers and 5-alpha reductase inhibitors.

Giant cell arteritis is the most common chronic granulomatous vasculitis, mainly involving large and medium-sized vessels, and it almost exclusively affects patients older than 50 years. The initial event that triggers the cascade of immune-mediated responses and subsequent inflammation is unknown.