Memorandum by The British Geriatrics Society
(Scotland)
Following discussion at our recent Council meeting
I have been asked to submit the following comments on behalf of
BGS (Scotland):
BIOLOGICAL PROCESSES
OF AGEING
A disproportionate quantity of research on genetics
and molecular biology is being supported. Influences on lifestyle
(exercise, nutrition, smoking etc) in later life are more promising
areas of research, with the potential for immediate impact on
peoples' lives, but such clinically-orientated research is not
viewed as competitive by many funding councils.
A key determinant of quality of life in later
life is health. As the presence of several chronic diseases is
common in later life, better medical assessment, diagnosis and
disease management are major influences. Concern is growing that
initiatives such as intermediate care are depriving older people
of access to such comprehensive geriatric assessment. There is
overwhelming evidence that this approach is effective in enabling
older people to remain independent for longer and to enjoy a better
quality of life. Health services research on how to improve access
to these cornerstones of medical/health care are urgently required.
APPLICATION OF
RESEARCH IN
TECHNOLOGY
Some technologies have the potential to be helpful
in later life. The problem with many is expense and limited availability.
The three main fears of old age are loneliness, "being a
burden" and having to give up one's home to move into nursing
home care. Strategies with the potential to modulate any or all
of these would be welcomed.
RESEARCH CO-ORDINATION
The Charity, the Health Foundation, was a major
funder of patient-orientated, clinical research. Unfortunately,
it has shifted its focus away from older people. This now leaves
Research into Ageing as the sole charitable funder of ageing research
in the UK. There is no doubt that ageing research (and older people)
is suffering as a consequence. There is major concern that major
trials of therapies and pharmaceuticals still exclude "typical"
older people. The mean age of participants in heart failure (a
disease of old age) trials for example is 62 years, when the mean
age of onset is 75 years. Arbitrary upper age limits of 70 or
75 years are still commonly applied to trials. This is not acceptable
as most medicine are prescribed to older people. Furthermore in
contrast to the profile of most trial participants (male, middle
aged, single pathology, otherwise fit and well, excellent compliance)
the actual consumers of most medicine are female, over 75, suffering
from multiple medical problems, receiving multiple different medicines,
and compliance is sub optimal). This mismatch should be addressed.
September 2004
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