ABSTRACT
You can probably practise competently as a geriatrician knowing little about the meaning or mechanisms of biological ageing. Most of our work with the current cohort of older people is concerned with illness, disability or death associated with recognised diseases. These diseases are considered to be the result of environmental factors such as accidents, infection, carcinogens and so on. Genetic and lifestyle differences contribute to the considerable variability observed between individuals. Age-related increased incidence of cardiovascular disease, cancers, certain infections and arthritis suggest that ageing may be a contributory factor in their development. Preventative public health measures highlight avoidable risk factors but treatments are not predicated on affecting the underlying ageing processes. Likewise, although remedial therapies and other rehabilitative approaches acknowledge the important loss of functional reserve in older patients, the therapeutic optimism characteristic of modern geriatric medicine is not based on attempts to influence ageing. Rather, it is based on the alternative conviction that much of the disability and distress that we see is not an inevitable part of growing old.
