Older People

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  NICE and SIGN on dementia
  Osteoporosis
This DTB review looks at the role of zoledronic acid, which is an annual bisphosphonate preparation licensed for the treatment of osteoporosis in post-menopausal women
  Falls and frailty
In this section we shall consider falls assessment and prevention and the concept of frailty.
  Parkinson's disease
The new SIGN guidelines on the diagnosis and pharmacological management of Parkinson's disease (PD) were issued in January 2010.
  QFractureScore
NICE do not specifically recommend screening for osteoporosis but recommend that we evaluate further those 'opportunistically identified as being at risk'. We are all aware of certain markers that increase an individual's risk and there are existing risk prediction tools but the majority of these require DEXA scan results to perform a comprehensive risk assessment. This is expensive and time consuming.
  Dementia
NICE updated their guidance in March 2011 to extend the use of anticholinesterase inhibitors to all those with a diagnosis of Alzheimer's disease, regardless of its severity and this is summarised below. In addition we consider recent research findings which should influence best practice care for this difficult condition.
  Osteoporosis
Not all of our patients who fall or suffer from osteoporosis are elderly, but the majority are, hence this section is included in our chapter on older people.
  Unintentional weight loss in older adults
Unintentional weight loss is a well-known red flag symptom amongst GPs and patients alike. This BMJ review considers the diagnostic challenge of approaching the investigation and management of unintentional weight loss in an older adult.