Prototype of the Geriatric Syndrome

I am writing this editorial after finishing our falls prevention clinic at the Toronto Western Hospital. Falls are the prototype of the classic geriatric syndrome, in which one cause is rarely the issue but rather a substantial number of possible contributing factors are found. However, it is a rare older patient who does not have some musculoskeletal disorder as one of the predisposing conditions for falls. One of my patients today had severe osteoarthritis of her knees as well as painful feet with bunions and corns that contributed to her falls. As I have mentioned before on these pages, mobility is an essential quality of life issue for older adults, and so I am always excited when our issue focuses on musculoskeletal disorders.

We have several superb articles on our theme in this issue. The common topic of “Crystal-induced Arthritis” is tackled by Dr. Ian Tsang and Dr. Simon Huang, while Dr. R. Martinez-Galliano, L. Burke, and Dr. Bob McCormack delineate “An Active Approach to the Treatment of Frozen Shoulder.” We seldom appreciate how much we rely on our shoulder’s range of motion until we lose it! Our continuing education article this month is on the most common of the inflammatory arthritides. The article “Rheumatoid Arthritis among Older Adults” is by the distinguished rheumatologist, Dr. Arthur Bookman. For a variety of reasons, some people get much better care for their arthritis than others, something which theoretically should not happen in a country with universal health care. The reasons for this disturbing occurrence are discussed in the article “How to Make Sure Your Patient with Osteoarthritis Gets the Best Care” by Dr. Cornelia Borkhoff and Dr. Gillian Hawker.

As usual, we have a range of articles on other geriatric topics. The article “An Update on Prostate Cancer among Older Men” is by Dr. Michel Carmel, a researcher with our partner association, the Canadian Society for the Study of the Aging Male. Our cardiovascular column is on “Treatment of Hypertension in Older Adults” by Dr. W.S. Aronow, a prolific contributor both to our journal and the peer reviewed medical literature. Our psychology of aging column this month is called “Personality Traits: Stability and Change with Age” and is written by Drs. Antonio Terraciano, Robert McCrae, and Paul Costa, Jr. Our dementia column is on a topic that has become an important topic both for stroke neurologists and dementia experts, namely “Post-stroke Dementia among Older Adults.” It is written by Dr. Aleksandra Klimkowicz-Mrowiec.

Enjoy this issue,
Barry Goldlist