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Dry eyes are a frequent problem, particularly in older people. The tear film is a complex structure with a superficial thin oily layer overlying the watery layer and then a mucous layer. Dry eyes are aggravated by drying conditions such as central heating or low blink rate, as seen when concentrating on television or driving. Many treatments are available for this condition and most can be purchased over the counter and self-adminstered by the patient.

Ulysses syndrome is the name attributed to needless investigations conducted as a result of false-positive test results. It causes needless distress to the patients and leads to waste of human and financial resources.

Hypokalaemia is one of the most common electrolyte abnormalities encountered in clinical practice. The most common cause of renal loss of potassium in primary care is use of loop or thiazide diuretics. Extra-renal causes include fasting or prolonged vomiting, and redistribution of potassium from the extracellular to the intracellular compartment may occur acutely in acidosis. Treatment includes potassium supplementation or dietary advice, but diet alone is not sufficient to replenish potassium after diuretic therapy, vomiting, or nasogastric drainage because potassium is not generally available naturally coupled with chloride, which is also depleted in these conditions.

Epilepsy is a serious neurological condition, affecting around 456,000, or one in 131, people in the UK. This article reviews the work of Epilepsy Action.

Skin cancer is the most common form of cancer and its incidence is increasing worldwide. Most skin cancers are non-melanoma, usually squamous-cell or basal-cell carcinoma.

The control of fluid balance in older people has an important influence on morbidity and mortality in high environmental temperatures. This article looks at management of fluid balance.

Depression and sleep disturbance are interlinked disorders, resulting in significant disability and both carry a risk of chronicity. Insomnia is a risk factor for depression and the majority of depressed patients complain of sleep dysfunction.

A study has indicated that neither geriatricians nor general practitioners adhere to guidelines for treatment of heart failure. Professor Peter Weissberg from the British Heart Foundation talks to Dawn Powell about the results of the survey and improving the management of heart failure in the UK.

Assisted dying has long been a subject of heated debate. Dr Simon Kenwright argues the case for, and Dr Helen Watt states the case against, assisted dying.  

Stroke is the most common cause of severe disability in the UK, which is frequently complicated by dysphagia. PEG in a useful procedure that can help maintain nutrition in such patients.

Epithelial skin cancers such as basal-cell and squamous-cell cancers are the most common cancers of the older population. These cancers are usually not life-threatening and can be cured easily with radiotherapy if recognised early.

Reminiscence is the name given to the process of accessing long-term memory and recalling past events, stories and experiences. It is an increasingly popular way of engaging older people with short-term memory problems.

Restless legs syndrome (RLS) refers to a symptom complex of spontaneous, continuous lower limb movements that may be associated with paraesthesias.

Osteoporosis is a major problem in healthcare and the role of bone densitometry in the assessment and measurement of this metabolic bone disease is being recognised.

This article reviews the evidence base for anticonvulsants commonly used in psychiatric disorders, focusing particularly on issues specific to older adults.