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Myopathy is the term used to describe diseases of the muscle that are not attributable to nerve dysfunction. It is an umbrella term that encompasses myopathies that are inherited and those that are acquired. Here, we consider the common myopathies that can occur in later life. We discuss the clinical manifestations, investigation and management of drug-induced, toxic and endocrine myopathies as well as the inflammatory muscle disorders. We also consider the inherited muscle disorders that can present in older patients, including myotonic and oculopharyngeal dystrophy, and facioscapulohumeral. We briefly discuss the neuromuscular disorder myasthenia gravis, which whilst not a primary disorder of muscle, has many overlapping features of a myopathy.

Urinary continence in women is subject to many influences, not least age, obesity, diabetes and parity. In addition, several drugs used in cardiovascular medicine have the potential to affect continence. Women should be sympathetically questioned with regard to urinary continence prior to prescribing cardiac medications and counselled regarding potential effects.

It was just under a year ago that I unpacked my newly purchased iPad and set it up. I thought I would find it useful but since purchase I have found it invaluable. Of course there are other forms of tablet computers around but I think my experiences of using a tablet computer can apply to the number of different types and brands available on the market today.

This report is based on presentations given at the satellite symposium When stable PD patients begin to fluctuate, which took place at the 2011 Autumn meeting of the British Geriatrics Society, Brighton. This meeting and the report were sponsored by Teva Pharmaceuticals Ltd and Lundbeck Ltd.

Leg discomfort is a common presentation among the elderly and can be a manifestation of many different disease processes. One key issue is how to differentiate between the benign and the more serious causes. This article will explore the main differential diagnoses including the most common causes and management of these, and the recognition of potentially life or limb threatening causes with an overview of red flag signs and symptoms.

Aortic stenosis (AS) is a narrowing or obstruction of the aortic valve and is the third most prevalent form of cardiovascular disease in the Western world after hypertension and coronary artery disease. AS is a potentially life-threatening condition that may present with symptoms related to valve obstruction or heart failure or may be diagnosed incidentally on €œroutine€ clinical examination.

Doctors have a very important role in public safety by ensuring that patients understand their medical condition may impair their ability to drive. The aim of our study was to determine whether appropriate driving advice based on national guidelines was given to patients admitted with TIA or acute stroke.

There is a lack of literature specifically exploring the management of fractured neck of femur patients who may have palliative care needs for illnesses besides malignancy such as those with end stage dementia. Patients with dementia are not considered to have a terminal illness and consequently receive suboptimal palliative care.

The number of older people having surgery is increasing and geriatrician involvement is being increasingly sought. This article uses guidance from the European Society of Cardiology1 and the American College of Cardiology to provide a practical guide for geriatricians advising on preoperative cardiac optimisation in older people. Preoperative investigations should be justified according to risk. These include blood tests, electrocardiograms (ECGs), echocardiograms, stress tests and angiography. Optimising and initiating treatment for cardiac disease reduces adverse postoperative outcomes.

The SPECAL (Specialised Early Care for Alzheimer's) method aims to give patients with dementia a feeling of being in control and being able to make decisions which are carried out. It incorporates a number of core tools and best practice techniques including validation therapy, life history work, distraction techniques, orientation strategies, communication skills and reminiscence therapy.

Metastatic bone disease is a common cause of pain and disability for patients with advanced cancer. Early detection and appropriate management can limit pain, reduce disability and prevent complications such as hypercalcaemia, pathological fracture and spinal cord compression. In specific cases surgical resection of an isolated bone metastasis may improve survival. This article provides an evidence-based overview of the investigation and management of patients with metastatic bone disease.

The benefits of strict glycaemic control in delaying the onset and progression of micro and macrovascular complications in diabetes are undisputed but determining appropriate HbA1c targets remains controversial. This is a particular dilemma when treating patients who have coronary heart disease, particularly the very elderly, many of whom are frail and have several comorbid medical disorders.

A significant proportion of older mental health patients will need to be transferred to a district general hospital for assessment and treatment of comorbid physical conditions. What is the best way to do this?

Coronary heart disease peaks in the older age groups and cholesterol lowering can help reduce the risk. The aim of treating hyperlipidaemia is to prevent or reduce the risk and complications of CVD. Such risk reduction includes nondrug measures (such as addressing lifestyle factors) and drug treatment using lipid-lowering therapy.

Social care/domiciliary care is purchased by or on behalf of thousands of elderly people in the UK who wish to remain living in their own home. The majority of social care is delivered on an hourly basis from early in the morning to later in the evening and the services provided are regulated, efficient and safer for both individuals and their care staff. The care staff are trained with care plans and risk assessments are carried out .