Clinical issues in old age ‐ the challenges of geriatric medicine

Geriatric medicine is the branch of general medicine concerned with the clinical, preventive, remedial and social aspects of illness in older people. Rather than being defined by some arbitrary cut‐off in chronological age, it recognises that most older people, especially the ‘young‐old’, are in good health for most of the time. They are likely to benefit from standard medical management by generalists. Geriatricians focus on the more challenging patients ‐ those older people who are physically and cognitively frail, many of whom will be among the growing numbers of the ‘old‐old’. This population is characterised by non‐specific presentation of illness, functional dependency and a need for a multidisciplinary approach to care and judicious use of drug therapy. Drawing on publications from the department of geriatric medicine in Cardiff, this article illustrates important aspects of clinical care of older people and highlight the need for better recognition and prevention, better assessment and diagnosis and better therapeutic tools to manage acute and chronic illness in old age.