When I was an intern, my first attending physician was a respirologist, who taught me that the major function of the heart was to separate the two lungs. As he later went on to become a physician-in-chief, then the Eaton Professor of Medicine at University of Toronto, and finally Dean of Medicine, he must have been correct. Although cardiovascular disease and cancer remain the most common causes of death among older adults, lung disease causes substantial morbidity and mortality as well. Cigarette smoking, the single most important factor in lung disease among older adults, remains a major societal problem despite a substantial decrease in prevalence over the last 40 years.

Our CME program this month is based on the article by Dr. Andrew McIvor, “Chronic Obstructive Pulmonary Disease in the Older Adult: New Approaches to an Old Disease.” For those of us who see patients in the emergency room, or work in long-term care or complex continuing care, the issue of long-term care-acquired pneumonia is incredibly common. Dr. Ted Marras and Dr. Mohammed Al Houqani review this topic in their article “Long-term Care-acquired Pneumonia among Older Adults.” Dr. John Granton and Dr. Suzanne Bridge have collaborated in an article on a disorder that is frequently diagnosed very late in its course titled “Pulmonary Arterial Hypertension in Older Adults: An Update.”

Our cardiovascular disease column this month is on “Syncope in Older Adults” and is written by Dr. Maxime Lamarre-Cliche. We also have the second of a two-part series on dementia by Dr. Abi Rayner entitled “Managing Psychotic Symptoms in the Older Patient.” Our Drugs & Aging feature this month is on “Incontinence among Older Adults” by Drs. David Staskin, Edward Zoltan and Alan Wein. We have an article on technology in medicine by Pooja Viswanathan, Jennifer Boger, Dr. Jesse Hoey, Pantelis Elinas and Dr. Alex Mihailidis called “The Future of Wheelchairs: Intelligent Collision Avoidance and Navigation Assistance.”

Enjoy this issue,

Barry Goldlist