Editor's Choice | This Week in BMJ | Press releases



BMJ No 7115 Volume 315

Press Releases Saturday 25 October 1997


Embargoed: 00.01 hrs 24 October 1997 UK time

Aging Press Conference: 21 October 1997

More of us are living longer - what does this mean and what are we doing about it?

This week's BMJ is devoted to the subject of "aging". It joins around 200 other medical journals, including BMJ Specialist Journals (please click here to view Specialist Journal Press Releases) in alerting readers, the public and governments across the world to the radical changes that will result from aging populations. The BMJ Publishing Group is contributing a substantial body of research and information on all aspects of aging.

Aging has become an important issue because of dramatic changes in life expectancy - only one in six Britons born 150 years ago reached 75 years, whereas two thirds of those born today will. People over 60 years currently constitute a fifth of the British population, but will be a third by 2030. We are not well prepared for a world where older people will outnumber children.

The Journal of American Medical Association (JAMA) will also be devoting many of its pages to aging: http://www.ama-assn.org/jama

Doctors must check older women for breast cancer too
Discrimination against older women and breast screening
Older people denied foot care
Heart disease kills more women than men in US
Can we prevent or delay age-associated ill health?
Why are numbers of winter deaths falling?
Why do we exclude older people from our research?
There's no such thing as aging
Exercise reduces falls in older women
Predicting which inpatients will fall
Stroke patients can safely be discharged early

Doctors must check older women for breast cancer too

(Breast examinations in older women: attitudes of patients and doctors)

Breast examination in older women is crucial because about 40% of occurs in patients aged over 70 years. In this week's special aging issue of the BMJ Morgan et al discuss their research into to whether older women are receiving the diagnosis and treatment that they should, or if the intimacy of breast examination deters patients or doctors.

The authors conclude that older women have positive attitudes towards breast examination which isn't reflected by the attitudes and practice of doctors. They stress the need for a change in attitudes and training so that older women do not miss out.

See Paper (Morgan et al) p 1058

Contact:
Dr Rosemary Morgan,
Consultant Geriatrician

Department of Medicine for the Elderly,
Arrowe Park,
Wirral
Merseyside

Tel: 0151 678 5111
Fax: 0151 604 7192

Discrimination against older women and breast screening

(Will you still need me, will you still screen, me when I'm past 64?)

In an editorial in this week's BMJ, Sutton examines whether breast screening policy is ageist. He considers the injustice of excluding women over 64 from breast screening, when there is good clinical reason to include them.

See Editorial (Sutton) p 1032

Contact:
Graham Sutton, senior clinical lecturer

Nuffield Institute for Health,
Leeds

Tel: 01924 814400 or 0113 233 6633
Fax: 0113 246 0899

* available at press conference

Older people denied foot care

(Foot morbidity and exposure to chiropody: a population based study)

Having pain-free feet can drastically improve an older person's quality of life. In a paper in this week's BMJ, Harvey et al find that 40 per cent of people aged 60 and over, who are in need of chiropody care, do not receive it. The authors reveal that the NHS currently gives low priority to foot problems and suggest that the purchasing process should consider ways of identifying those with a need for chiropody and make services accessible to them.

See Paper (Harvey et al) p 1054

Contact:
Dr Ian Harvey

Department of Social Medicine,
Canynge Hall,
Bristol

Tel: 0117 928 7205
Fax: 0117 928 7236
Email: i.harvey@bris.ac.uk

Heart disease kills more women than men in US

(Coronary Heart Disease: An Older woman's major health risk)

More US women than men now die from coronary heart disease (CHD) each year, making CHD the leading cause of mortality for adult women in the United States, reports a paper in this week's BMJ by Wenger et al. The figures challenge the traditional view that coronary heart disease is predominantly a male problem. The study suggests that a postmenopausal American woman is 10 times as likely to die from CHD as from breast cancer. The authors conclude that coronary illness is likely to become epidemic in such women as the population ages, unless successful preventive interventions are undertaken across the lifespan.

See Education and debate (Wenger et al) p 1085

Contact:
Professor Nanette Wenger, Consultant

Emory University School of Medicine,
Emory Heart Centre,
Grady Memorial Hospital,
Atlanta,
Georgia,
US

Tel: 001 404 616 4420
Fax: 001 404 616 3093
e-mail: nwenger@emory.edv


Can we prevent or delay age-associated ill health?

(Healthy Aging)

Living longer need not mean extra years of ill health according to a report in this week's BMJ by Khaw. Environmental and lifestyle factors - eg diet, exercise, and stopping smoking - appear to have major impacts on the likelihood of reaching maximum lifespan in good health. In Britain, about a fifth of our population is made up of men and women aged 60 years and over. By the year 2031 this is projected to rise to just under a third of the population .

The authors suggest that it is possible to prevent, or at least postpone, a substantial proportion of the chronic diseases associated with aging, eg cardiovascular disease, musculoskeletal diseases such as arthritis and osteoporosis and some cancers. Evidence indicates that increasing fruit and vegetable intake by 1-2 servings daily may decrease cardiovascular risk by 30%.

See Education and debate (Khaw) p 1090

Contact:
Professor Kay-Tee Khaw, Prof Clinical Gerontology

Addenbrookes Hospital,
Cambridge

Tel: 01223 217 292
Fax: 01223 336 928
e-mail: cthl@medschl.cam.ac.uk

Why are numbers of winter deaths falling

(Mortality related to cold in elderly people in south east England, 1979 - 94)

In the two decades up to 1977, the decreasing excess mortality in winter in England was largely due to the decline in epidemics of influenza. In a paper in this week's BMJ, Donaldson and Keatinge find that recent falls in excess winter mortality among older people have been largely attributable to general improvements in medical care and diet, since baseline death rates have also fallen. Contributory factors have been home heating, greater car ownership and a reduction in outdoor exposure to the cold.

See Paper (Donaldson and Keatinge) p 1055

Contact: Professor W R Keatinge, professor of physiology

Department of Physiology,
Queen Mary and Westfield College,
London

Tel: 0171 982 6365
Fax: 0181 983 0467
Email: w.r.keatinge@qmw.ac.uk

Why do we exclude older people from our research?

(Exclusion of the elderly from clinical research) Results of studies based on young healthy people can not necessarily be applied to olde people. With older people forming an increasingly larger part of the population, it is important that we acquire hard information on which to base sound diagnosis and effective treatment of these patients, argue Banerjee et al in this week's BMJ. The authors found that about one in three research studies exclude older people, with no good reason. The authors conclude that excluding older people from trials, simply because it's easier to do so, is not good enough. Study populations should include a sufficient number of older people to allow valid conclusions to be drawn.

See Paper (Banerjee et al) p 1059

Contact:
Dr Arup Banerjee, consultant physician

Department of Medicine for the Elderly,
Royal Bolton Hospital,
Bolton.

President of the British Geriatric Society

Tel: 01204 390685/6
Fax: 01204 390933

There's no such thing as aging

Just because many diseases increase with age, "aging" should not be thought of as an underlying disease process, which itself results in disease. To understand individual diseases, researchers would do better, urge the authors, to focus on the specific mechanisms that lead to that particular disease, such as cancer. They argue that people concerned with biological mechanisms of disease should try to avoid careless use of such an undefined physical concept as "aging".

See Editorial (Peto and Doll) p 1030

Contact:
Professor Richard Peto and Sir Richard Doll (who has his 85th birthday this week)

Clinical Trial Service Unit and Epidemiological Studies Unit,
University of Oxford

Tel: 01865 558379
Fax: 01865 558817

* available at press conference

Exercise reduces falls in older women

(Randomised controlled trial of a general practice, home based exercise programme to prevent falls in elderly women)

Injuries in older people are an important public health problem, yet efforts to prevent injury are uncommon. In this week's special issue of the BMJ, Campbell et al examine the effectiveness of a trial to reduce falls, which are the most common cause of injury in older people. Women aged 80 years and older, were visited at home by a physiotherapist and given an individually tailored set of exercises and a walking plan. The programme was successful, and the authors conclude that older adults should be encouraged to increase their exercise levels to gain wide-ranging benefits.

See Paper (Campbell et al) p 1065

Contact:
Professor John Campbell, dean, faculty of medicine

University of Otago Medical School,
Dunedin,
New Zealand

Tel: 00 64 3479 7454
Fax: 00 64 3479 5459
Email: john.campbell@stonebow.otago.ac.nz

Predicting which inpatients will fall

(The development of an evidence-based risk assessment tool - STRATIFY - to predict which elderly inpatients will fall)

In a related paper in this week's BMJ, Oliver et al identify risk score for use by nurses looking after older patients to help ascertain which inpatients are most likely to fall and injure themselves. Such a procedure could enable targeted preventative measures.

See Paper (Oliver et al) p 1049

Contact:
Dr D Oliver

UMDS Department of Elderly Care and Statistics,
St Thomas' Hospital

Tel: 0171 928 9292 bleep 0252 or 0171 922 8039
Fax: 0171 928 2339

Stroke patients can safely be discharged early

(A randomised controlled trials to evaluate an early discharge scheme for stroke patients)

In a report in this week's BMJ, Rudd et al find that early discharge of stroke patients is feasible, so long as a facilities for specialist community rehabilitation are available. The authors conclude that as the number of stroke patients increase as the population ages, the only alternative to building more acute hospitals may be to develop alternative community based specialist care.

See Paper (Rudd et al) p 1039

Contact:
Dr Anthony Rudd, consultant physician

Division of Public Health Sciences,
UMDS,
St Thomas' Hospital,
London

Tel: 0171 922 8039 or 928 9292 x 3839
Fax: 0171 928 2339


Embargo: 00.01 hrs Friday 24 October 1997

Please contact Public Affairs Division for the text of the paper & the authors for further comment

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