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C P Denaro, director, associate professor1,2, A Mudge, staff physician1
1 Internal Medicine and Aged Care, Royal Brisbane and Womens Hospital, Brisbane 4029, Australia, 2 University of Queensland, Brisbane
Correspondence to: C P Denaro c.denaro@uq.edu.au
The development of geriatricshas greatly improved care for older people. Leon Flicker (doi: 10.1136/bmj.39538.481273.AD) believesspecialist care remains important for this vulnerable group,butC P Denaro and A Mudge argue that age divisions are no longer relevant
| The first 150 words of the full text of this article appear below. |
Our patients have changed. The inverted pyramid is imminent. Every developed country is facing an increase in older patients.1 2 The fastest growth in emergency admission rates is in the oldest age group.2 These changes translate into major changes in the profile of our hospital patients, as older patients with multiple chronic diseases and disabilities occupy more beds. In addition, improved survival is also leading to larger numbers of younger people with chronic disease and disabilities living in our communities.3 Thus it is not just geriatricians who have to be able to manage acute and accumulated chronic diseases and to assess and manage the functional, cognitive, and psychological impairments that can influence longevity, quality of life, use of health care, and treatment decisions.
The concepts of comprehensive assessment, multidisciplinary care, rehabilitation, and planned discharge have been championed by many groups, but particularly geriatric medicine. Recognition of subtle and atypical presentations of
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