Search & Filter

New guidance from the General Medical Council supports doctors in making challenging and complex decisions about care at the end of patients' lives.

Drug-induced movement disorders are common in the elderly and responsible for significant morbidity and reduction in quality of life. It is important that they are recognised early to enable prompt initiation of treatment. Unfortunately some drug-induced movement disorders are difficult to treat, so prevention is important.

The optimum management of pain in older patients with cancer requires comprehensive assessment, particularly as older people may under report pain. This article reviews the assessment and management of pain in older people with cancer.

This article aims to give a brief overview of the epidemiology, diagnostic issues and treatment of multiple sclerosis (MS). The disease is common, especially in the UK. People are often diagnosed in their 20s and 30s but live for a median of 35 years with their disease. The degree of disability accrued is very variable. There are now increasing options for both disease modification and symptom management.

Alzheimer's disease affects an ever growing number of people, with almost half a million patients in the UK alone. Unfortunately approaches to treating Alzheimer's disease are limited and cholinesterase inhibitors are the most commonly used agents.

Psychological factors may influence and explain some aspects of older people's functioning status. Therefore, knowledge and understanding of these factors may help to improve care and management of older people. This article is an introduction to the psychology of ageing.

Evidence is growing for a distinct subtype of depression arising in later life, characterised by a distinct clinical presentation and an association with cognitive impairment. Awareness of late-onset depressive disorder as a separate entity that contributes heavily to the morbidity and mortality is the first step.

Parkinson's Disease (PD) is the second most common neurodegenerative disorder after Alzheimer's Disease. Most of the earlier breakthroughs in treating the illness focused on the motor manifestations but in recent years, there has been an increasing awareness of the nonmotor complications of the disease. Psychotic phenomena are common and their presence leads to significant morbidity.

The Counterweight Project was launched in 2000 as the result of a national group of consultant physicians recognising the need to tackle obesity management in primary care. Counterweight is the only fully evaluated, evidence based primary care weight management programme within the UK. It is a low-cost nurse-led programme that equips GPs and practice nurses to be able to produce evidence-based approaches to weight loss management.

Prostate cancer continues to be a major health issue. The treatment of patients with localised prostate cancer has developed over the last 15 years. Clinicians and patients need a clear understanding of the different treatment options available to allow for fully informed treatment decisions. In this article, we discuss the management of localised prostate cancer referring to the National Institute for Health and Clinical Excellence (NICE) guidance for the disease.

We present here an interesting case of a woman who presented with features of stroke but later emerged to have metastatic spine disease as the cause of her symptoms. The learning point to take from this case report is to maintain a broadly open mind to the possibility of other diseases (malignancy in particular), as these can clearly present in disguise.

Dysphagia, or swallowing difficulties, is a prevalent disorder associated with certain neurological, obstructive and muscular conditions; stroke is the most recognised neurological cause. Swallowing difficulties are known to adversely affect all aspects of quality of life. Early identification and management is essential. Prognosis is variable and is improved with multidisciplinary management.

Neuropathic pain differs from inflammatory pain both in terms of its symptoms and its management. This article outlines these differences and highlights some neuropathic pain conditions found in older patients with reference to pharmacological and non-pharmacological treatment options.

The use of fracture prediction tools in osteoporosis has improved the management of patients by empowering risk factors other than bone mineral density to be considered, thereby improving fracture prediction. The FRAX tool is the most popular tool worldwide. One limitation is that it lacks the facility of incorporating falls risk, which is an independent risk factor for fractures.

The importance of exercise for older people is great. Exercise delays the onset of a variety of diseases, increases performance and quality of life, reduces dependency and prolongs life. There is a dose€“response relationship between the amount of exercise taken and the benefits which accrue. Unfortunately, although a higher level of exercise produces greater benefits it is less likely to be maintained.