Dr Shane O’Hanlon is a consultant geriatrician in Reading, and edits the BGS Blog; he tweets at @drohanlon
It seems like ages since the last quality textbook in geriatrics came out, so it is great to see this new addition to the popular “At A Glance” series. I’m a huge fan of these books, with their concise 2 page summary-style chapters that are ideal for quick reference. As a medical student they were perfect for revising, once you had read the main textbook: I spent many happy nights by candlelight with Pharm At a Glance, for example!
It was lovely to see that these books are now in full colour, although photographs are sparse: it’s more about making the general layout more appealing to the eye. The diagrams on each left hand page look lovely and keep the book from being too wordy.
It’s important to acknowledge that the BGS has influenced the development of this book! The editors, Adrian Blundell and Adam Gordon, led on the establishment of the national undergraduate curriculum in geriatrics. Thus the book is based on these learning outcomes, although they are not stated in each chapter. Be assured however that no conflict of interest has affected this review!
In terms of content, every major topic in geriatrics is covered. You can find excellent summaries of common issues such as dementia, falls and frailty; while important but often neglected areas are also covered, e.g. pressure ulcers, nutrition and constipation. The initial chapters set out core concepts and provide useful theory as well as epidemiology and physiology of ageing. The second section deals with common problems in older adults, and the third focuses on CGA (comprehensive geriatric assessment) in practice, including interface geriatrics and surgical liaison.
The most pleasantly surprising chapters for me were the two on physiotherapy and occupational therapy. I didn’t think these would add anything useful for me as a consultant geriatrician, but I was wrong! They were very enlightening and provide useful structure to understand the relevant assessments. Perhaps there should also be one on speech therapy, especially swallow difficulties? There is also an excellent ethics chapter that has clear explanations of vital legal topics such as mental capacity assessment and lasting power of attorney.
Some chapters such as osteoporosis and syncope push the limit and deal very comprehensively with important topics. Others such as the one on urinary incontinence don’t mention quite common related issues such as urinary retention. Dementia and parkinsonism are well balanced and provide excellent summaries of all the important knowledge. Many readers will find the care homes chapter (including explanation of funding) and elder abuse chapter very useful as they deal with issues that are not often taught elsewhere.
The only critical comments I have to make are probably related to the limited scope possible with a book of this size: e.g. cardiac conditions are under-represented and I would have liked to see more on cancer. If I was to really nit-pick I would say that the balance is a touch more theoretical and less clinical than I would like. But it’s not written for me, and for the target audience that’s probably what’s needed. I think it’s really important that we emphasise how dynamic and exciting geriatric medicine can be, and the book didn’t leave me with the feeling that I could hand it to a prevaricating FY1 and expect them to come in converted the next day. But they would certainly know what CGA is!
There is a small selection of MCQs to help check knowledge – I would suggest using these as a before and after self-assessment. I had the appetite for more of these, but again with limited size it’s just not possible and there are other books to satisfy this. The authors have done an excellent job with such a challenging project; it would be nice to know who wrote each chapter as there is only an overall list of authors at the beginning.
Geriatric Medicine at a Glance is an excellent quality reference book that is very accessible and covers everything the medical student or junior trainee would need to know. It helps to consolidate learning from larger textbooks but also serves as an excellent handbook of geriatric medicine in itself.