The changing face of geriatric medicine

摘要

Over the past few months, we have wondered whether wenare witnessing the changing face of geriatric medicine. Threenpatients aged over 80 years old stand out.nThe first, a heterosexual, Caucasian, English man withnHIV, presented with an acute confusional state. Followingnextensive assessment and investigation, he was diagnosednwith Alzheimers-type dementia with a superimposed deliriumnunrelated to his diagnosis of HIV.nHIV is now largely considered a chronic treatable conditionnwhen diagnosed early and treated and monitorednaggressively. With increasing longevity and the advent of improvednretroviral therapy, older patients with HIV are likelynto suffer from coexistent conditions traditionally managednby geriatricians [1, 2]. Physicians in elderly medicine shouldnmaintain an adequate working knowledge of the complicationsnof HIV, the treatments, their side-effects and theninterplay between these and the traditional ‘geriatric giants’.nWe should not forget undiagnosed HIV as a cause for unexplainednpresentations in older patients and should includenan assessment of high-risk behaviour [3].