This symposium covered a wide range of conditions of interest to the geriatrician, the general physician and the general practitioner, including demographic shift, the epidemiology of ageing, diabetes in older people, investigation and management of falls, an update on stroke (including the role of neurovascular clinics, stroke thrombolysis and rehabilitation) and the management of coronary heart disease in the elderly.
VitaAJTerryRBHubertHB Aging, health risks, and cumulative disability. N Engl J Med 1998; 338:1035–41. doi:10.1056/NEJM199804093381506
2.
SauvagetCJaggerCActiveArthur AJ.impairmentfreecognitive life expectancies: results from the Melton Mowbray 75+ health checks. Age Ageing 2001; 30:509–15. doi:10.1093/ageing/30.6.509
3.
KamperAMStottDJHylandM for the PROSPER study group. Predictors of functional decline in elderly people with vascular risk factors or disease. Age Ageing 2005; 34:450–5. doi:10.1093/ageing/afi137
4.
VermeerSEKoudstaalPJOudkerkM Prevalence and risk factors of silent brain infarcts in the population-based Rotterdam Scan Study. Stroke 2002; 33:21–5. doi:10.1161/hs0102.101629
5.
Longstreth WT Jr. Brain vascular disease overt and covert. Stroke 2005; 36:2062–3. doi:10.1161/01.STR.0000179040.36574.99
6.
Neuropathology Group. Medical Research Council Cognitive Function and Ageing Study (MRC CFAS). Lancet 2001; 357:169–75. doi:10.1016/S0140-6736(00)03589-3
7.
VibertiGKahnSEGreeneDA A diabetes outcome progression trial (ADOPT): an international multicenter study of the comparative efficacy of rosiglitazone, glyburide, and metformin in recently diagnosed type 2 diabetes. Diabetes Care 2002; 25:1737–43. doi:10.2337/diacare.25.10.1737
8.
BuseJBKlonoffDCNielsenLL Metabolic effects of two years of exenatide treatment on diabetes, obesity, and hepatic biomarkers in patients with type 2 diabetes: an interim analysis of data from the open-label, uncontrolled extension of three double-blind, placebo-controlled trials. Clin Ther 2007; 29:139–53. doi:10.1016/j. clinthera.2007.01.015
9.
PratleyRERosenstockJPi-SunyerFX Management of type 2 diabetes in treatment-naive elderly patients: benefits and risks of vildagliptin monotherapy. Diabetes Care 2007; 30:3017–22. doi:10.2337/dc07-1188
10.
HuffJSDeckerWWQuinnJV Clinical policy: critical issues in the evaluation and management of adult patients presenting to the emergency department with syncope. Ann Emerg Med 2007; 49:431–44. doi:10.1016/j.annemergmed.2007.02.001
11.
DaviesAJSteenNKennyRA.Carotid sinus hypersensitivity is common in older patients presenting to an accident and emergency department with unexplained falls. Age Ageing 2001; 30:289–93. doi:10.1093/ageing/30.4.289
12.
ParrySWKennyRA.Drop attacks in older adults: systematic assessment has a high diagnostic yield. J Am Geriatr Soc 2005; 53:74–8. doi:10.1111/j.1532-5415.2005.53013.x
13.
ZaidiACloughPCooperP Misdiagnosis of epilepsy: many seizure-like attacks have a cardiovascular cause. J Am Coll Cardiol 2000; 36:181–4. doi:10.1016/S0735-1097(00)00700-2
14.
Guideline for the prevention of falls in older persons. American Geriatrics Society, British Geriatrics Society, and American Academy of Orthopaedic Surgeons Panel on Falls Prevention. J Am Geriatr Soc2001; 49:664–72.
15.
KerrSRPearceMSBrayneC Carotid sinus hypersensitivity in asymptomatic older persons: implications for diagnosis of syncope and falls. Arch Intern Med 2006; 166:515–20. doi:10.1001/archinte.166.5.515
16.
KennyRASeiferC.Brief report – SAFE PACE 2 Syncope And Falls in the Elderly Pacing and Carotid Sinus Evaluation: a randomized control trial of cardiac pacing in older patients with falls and carotid sinus hypersensitivity. Am J Geriatr Cardiol1999; 8:87.
17.
ParrySWSteenNBextonRS Pacing in elderly recurrent fallers with carotid sinus hypersensitivity (PERF-CSH): a randomised, double-blind, placebo controlled crossover trial. Heart 2009; 95:405–9. doi:10.1136/hrt.2008.153189
18.
University of Michigan. Health and retirement study: a longitudinal study of health, retirement and aging. Available from: http://hrsonline.isr.umich.edu
19.
KennyRAKalariaRBallardC. Neurocardiovascular instability in cognitive impairment and dementia. Ann NY Acad Sci 2002; 977:183–95. doi:10.1111/j.1749-6632.2002.tb04816.x
20.
KennyRAShawFEO’BrienJT Carotid sinus syndrome is common in dementia with Lewy bodies and correlates with deep white matter lesions. J Neurol Neurosurg Psychiatry 2004; 75:966–71. doi:10.1136/jnnp.2003.023812
21.
RothwellPMGilesMFFlossmanE, A simple score (ABCD) to identify individuals at high early risk of stroke after transient ischaemic attack. Lancet 2005; 366:29–36. doi:10.1016/S0140-6736(05)66702-5
22.
RothwellPMBuchanAJohnstonSC.Recent advances in management of transient ischaemic attacks and minor ischaemic strokes. Lancet Neurol 2006; 5:323–31. doi:10.1016/S1474-4422(06)70408-2
23.
Tissue plasminogen activator for acute ischemic stroke. The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. N Engl J Med1995; 333:1581–7.
24.
HackeWKasteMBluhmkiE Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke. N Engl J Med 2008; 359:1317–29. doi:10.1056/NEJMoa0804656
25.
HarrafFSharmaAKBrownMM.A multicentre observational study of presentation and early assessment of acute stroke. BMJ 2002; 325:17. doi:10.1136/bmj.325.7354.17
26.
SeenanPLongMLanghorneP. Stroke units in their natural habitat. Systematic review of observational studies. Stroke 2007; 38:1886–92. doi:10.1161/STROKEAHA.106.480871
27.
LanghornePHolmqvistLW; Early Supported Discharge Trialists. Early supported discharge after stroke. Cochrane Database Syst Rev 2005; (2):CD000443.
28.
Global Registry of Acute Coronary Events (GRACE) risk score. Available from: http://www.outcomes-umassmed.org/grace/
29.
SubherwalSBachRGChenAY Baseline risk of major bleeding in non-ST-segment-elevation myocardial infarction: the CRUSADE (Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA Guidelines) Bleeding Score. Circulation 2009; 119:1873–82. doi:10.1161/CIRCULATIONAHA.108.828541
30.
Fifth Organization to Assess Strategies in Acute Ischemic Syndromes Investigators, Yusuf S, Mehta SR, Chrolavicius S Comparison of fondaparinux and enoxaparin in acute coronary syndromes. N Engl J Med 2006; 354:1464–76. doi:10.1056/NEJMoa055443
31.
LopesRDAlexanderKPManoukianSV Advanced age, antithrombotic strategy, and bleeding in non-ST-segment elevation acute coronary syndromes: results from the ACUITY (Acute Catheterization and Urgent Intervention Triage Strategy) trial. J Am Coll Cardiol 2009; 53:1021–30. doi:10.1016/j.jacc.2008.12.021
32.
WiviottSDBraunwaldEMcCabeCH Prasugrel versus clopidogrel in patients with acute coronary syndromes. N Engl J Med 2007; 357:2001. doi:10.1056/NEJMoa0706482
33.
PfistererMBuserPOsswaldS Outcome of elderly patients with chronic symptomatic coronary artery disease with an invasive vs optimized medical treatment strategy: one year results of the randomized TIME trial. JAMA 2003; 289:1117–23. doi:10.1001/jama.289.9.1117
