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 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 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:
Department of Medicine for the
Elderly,
Tel: 0151 678 5111
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.
Contact:
Nuffield Institute for Health,
Tel: 01924 814400 or 0113 233 6633 * 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:
Department of Social Medicine,
Tel: 0117 928 7205 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:
Emory University School of Medicine,
Tel: 001 404 616 4420
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:
Addenbrookes Hospital,
Tel: 01223 217 292 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,
Tel: 0171 982 6365 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:
Department of Medicine for the
Elderly, President of the British Geriatric Society
Tel: 01204 390685/6 There's no such thing as agingJust 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:
Clinical Trial Service Unit and Epidemiological Studies Unit,
Tel: 01865 558379 * 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:
University of Otago
Medical School,
Tel: 00 64 3479 7454 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:
UMDS Department of Elderly Care and Statistics,
Tel: 0171 928 9292 bleep 0252 or 0171 922 8039 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.
Contact:
Division of Public Health Sciences,
Tel: 0171 922 8039 or 928 9292 x 3839 Embargo: 00.01 hrs Friday 24 October 1997 Please contact Public Affairs Division for the text of the paper & the authors for further comment For further information, please contactel:
Jill Shepherd on 0171 383 6529
or telephone (8.30am -
6.00pm): 0171 383 6254 Or fax requests to Public Affairs Division, BMA on 0171 383 6403. If you currently receive your British Medical Journal press release by mail and you would like it faxed to you please telephone (0)171 383 6123, Fax: (0)171 554 6123 or E-mail: LRiviere@mail.bma.org.uk When dialling the UK from abroad, remember to delete the first zero from the local area code, eg, (00 44) 171... BMA on Internet page: http://www.bma.org.uk If you intend to use any article publicised in this press release, ensure you quote the British Medical Journal as source
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