older people

Geriatric medicine in Britain was born in the setting of a former poor law workhouse in London. Its early pioneers developed models of geriatric services and instigated research into the diseases pertinent to older people. Government initiatives championed the establishment of geriatric units but denied geriatric medicine the status of a clinical medical specialty. Despite an unfavourable image within the medical profession, medical services for older people flourished under the National Health Service to become one of the largest groups of medical specialties.

Background Primary percutaneous coronary intervention (PPCI) is the first-line treatment for acute ST-elevation myocardial infarction (STEMI). Evidence of benefit from PPCI in the elderly is sparse. Our aim was to evaluate survival outcomes in patients aged ≥85 years who undergo PPCI for STEMI.

Methods Clinical data were collected retrospectively on all patients aged ≥85 years who were referred and accepted for PPCI to our centre between 2013 and 2018.

Background This scoping survey is a preliminary part of the Scottish Care of Older People (SCoOP) audit programme, which aims to assess specialist service provision for older people with frailty in Scotland, and provide benchmarking data for improving services.

The strongest risk factors for avoidable hospital admission are age and
deprivation but ethnicity, distance to hospital, rurality, lifestyle and meteorological
factors are also important, as well as access to primary care. There is still
considerable uncertainty around which admissions are avoidable. In terms of
services to reduce admissions there is evidence of effectiveness for education, selfmanagement,
exercise and rehabilitation, and telemedicine in certain patient

This review is based on a presentation given by Dr Dhesi at the RCPE Care of the Elderly Symposium on 15 September 2010.

Henoch-Schönlein purpura (HSP) is a small vessel vasculitis with immunoglobulin A-dominant immune deposits found in vessel walls. It primarily affects children, is uncommon in adults and often under-recognised in the elderly population due to its rarity in this group. When a purpuric rash develops in an older person it is typically treated with antibiotics for presumed infection, rather than investigated as potentially HSP. It is important to recognise this condition, particularly in older adults, as diagnosis has implications for management and prognosis.