Recent Advances: Geriatric Medicine

BMJ 1996;312:561-563 (2 March)

Education and debate

Rebecca D Elon, associate professor of medicine ^a

^a Johns Hopkins University School of Medicine, Johns Hopkins Geriatrics Center, Baltimore, MD 21224-2780, USA

Summary points

Exercise has protective effects: it is associated with decreased disability score and decreased rate of myocardial infarction; it is also effective in very old people
Multifactorial interventions decrease the likelihood of falls
Low body mass considerably increases the risk of hip fracture in older women; other risk factors include alcohol consumption, prior stroke, low activity levels, use of long acting benzodiazepines, large caffeine consumption, and visual impairment
Alendronate decreases vertebral fractures in older women and increases bone mass
Influenza vaccine is efficacious and cost effective
Though the apolipoprotein E4 allele is associated with Alzheimer's disease, a preventive strategy for Alzheimer's disease remains a distant goal

Laurin, D., Verreault, R., Lindsay, J., MacPherson, K., Rockwood, K. (2001). Physical Activity and Risk of Cognitive Impairment and Dementia in Elderly Persons. Arch Neurol 58: 498-504 [Abstract] [Full text]
Ensrud, K. E., Black, D. M., Palermo, L., Bauer, D. C., Barrett-Connor, E., Quandt, S. A., Thompson, D. E., Karpf, D. B. (1997). Trreatment With Alendronate Prevents Fractures in Women at Highest Risk: Results From the Fracture Intervention Trial. Arch Intern Med 157: 2617-2624 [Abstract]