Clinical Review

Recent advances: Geriatric medicine

BMJ 1997; 315 doi: http://dx.doi.org/10.1136/bmj.315.7115.1071 (Published 25 October 1997) Cite this as: BMJ 1997;315:1071
  1. Marco Pahor, associate professora,
  2. William B Applegate, professora
  1. a Department of Preventive Medicine, University of Tennessee, Memphis, TN 38105, USA
  1. Correspondence to: Dr Pahor
  • Accepted 28 August 1997

Introduction

The primary aims of geriatric medicine are to relieve suffering in old people and to increase the number of years free of disability that they can enjoy. Here we focus on new evidence about the benefits of interventions commonly used in geriatric medicine.

We decided to focus on clinical interventions because of their importance to clinicians. We then selected the interventions that we judged (as editors of the Journal of the American Geriatrics Society) to be the more important ones dealt with in the English language medical journals in the past 18-24 months. We carried out thorough Medline searches on each intervention selected. In this article we have chosen a “lifetime” perspective; we have covered new studies whose subjects included middle aged people because the interventions are relevant to disorders related to aging.

Non-steroidal anti-inflammatory drugs

Their role in dementia and cancer

Non-steroidal anti-inflammatory drugs are used mainly to control pain and inflammation, but they may also protect from dementia and cancer. Two observational studies in cohorts of elderly subjects—the established populations for epidemiologic studies of the elderly and the Baltimore longitudinal study on aging—have shown that long term use of non-steroidal anti-inflammatory drugs is associated with improved cognitive function and a reduced risk of Alzheimer's disease.1 2 A case-control study found that the regular use of aspirin or other non-steroidal antiinflammatory drugs such as ibuprofen, indomethacin, naproxen, and piroxicam was related to a reduced risk of breast cancer.3 However, a large cohort study found no such association with aspirin.4 Another case-control study in people of middle age and older showed an inverse association between the use of any non-steroidal anti-inflammatory drugs and the risk of colorectal cancer.5 Two small randomised, placebo controlled clinical trials showed that indomethacin suppositories and oral sulindac limited the growth of polyps in young and middle aged patients with familial …

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