Building capacity in gerontology and geriatric medicine in primary and secondary care is a part of the solution
Perhaps the most important emphasis missing from the editorial on the
European initiative on innovation and ageing (1) is the potential for
advances in the gerontological sciences to positively influence how
healthcare is delivered to an ageing Europe. The effectiveness of this
approach has been underlined by a recent Cochrane review which shows that
acute geriatric medical care in hospitals increases the likelihood of
surviving and living at home at six months by 25%, an effect size
equivalent to that of stroke units (2). This effect relies on
gerontological nursing, an informed multidisciplinary team and specialist
geriatricians to work, and is a potent metaphor for the many gains that
gerontological insights and expertise add to the care of older people in a
wide range of settings.
Unfortunately, despite advances in promoting geriatric medicine,
gerontological nursing and related age-attuned disciplines, there are
glaring gaps in widespread availability of these competencies across
Europe (3), and health policies for older people from major forums such as
the OECD or the World Economic Forum show worrying evidence of
gerontological illiteracy (4). Even the European Observatory's own report
on the responsiveness to health systems to ageing (5) omits the importance
of training in gerontology and geriatric medicine for those in primary and
seconday care, even though this was an important objective of the United
Nations' major blueprint for ageing societies, the Madrid International
Action Plan on Ageing.
Happily, the forthcoming European Observatory summer school mentioned
in the editorial (www.observatorysummerschool.org) has a generous
representation from geriatric medicine and gerontology among the faculty,
and hopefully will facilitate cross-fertilization of the ever more
critically important sciences of ageing with those of public health and
1) Fahy N, McKee M, Busse R, Grundy E. How to meet the challenge of ageing
populations. BMJ 2011;342:d3815.
2) Ellis G, Whitehead MA, O'Neill D, Langhorne P, Robinson D.
Comprehensive geriatric assessment for older adults admitted to hospital.
Cochrane Database Syst Rev 2011;7:CD006211.
3) Michel JP, Huber P, Cruz-Jentoft AJ. Europe-wide survey of
teaching in geriatric medicine. J Am Geriatr Soc. 2008;56:1536-42.
4) O'Neill D. Dialogue at Davos for an aging society. J Amer Geriatr
Soc (in press).
5) Rechel B, Doyle Y, Grundy E, McKee M. How can health systems
respond to population ageing? www.euro.who.int/en/what-we-do/data-and-
Competing interests: A number of members of the Executive and Academic Boards of the European Union Geriatric Medicine Society will be on the faculty of the forthcoming European Observatory summer school