Professor Rowan Harwood is a geriatrician at Nottingham University Hospitals NHS Trust, and the University of Nottingham, with particular interests in delirium, dementia and end of life care, who maintains an active portfolio of research. He tweets @RowanHarwood He will be speaking at the upcoming BGS Spring Meeting in Nottingham.
Why diagnose dementia? And why diagnose dementia early? Because we want to do something to make lives better? If so, what?
People living with dementia are vulnerable to a cascade of failing abilities, inactivity, deconditioning and crises from which they may not make a full recovery. Most people living with dementia are, by definition, frail – prone to deterioration and adverse events. The average age of diagnosis is about 85. Ideally early intervention should preserve activity and independence and reduce risk, including risk of the commonest adverse event, falls. Yet the ‘offering’ of health service in response to a dementia diagnosis is painfully thin – cholinesterase inhibitor drugs, cognitive stimulation therapy and a dementia advisor maybe. Continue reading
Clinical Psychologists have been part of Memory Clinics as long as they have been in existence as a part of service provision in the UK, using neuropsychology skills in the diagnostic process and in the development of coping strategies and employing clinical and psychotherapeutic skills in assisting with adjustment to a dementia diagnosis and in the support of families and carers. An overview of the Psychology position on dementia can be found in the recent paper to the British Psychological Society’s 
The size of the problem: the point prevalence of visual impairment in stroke survivors has been reported as 72% (Rowe, Hepworth, Hanna, & Howard, 2016). This visual impairment can be the result of a range of different problems either individually or in combination; these problems include visual field loss, eye movement disorders, reduced / blurred vision and visual perception defects. In the post stroke period, a person may be experiencing a visual impairment that is of new onset, or their visual problems may pre-exist the stroke. 
Between 47-90% of people with dementia (PWD) fall at least once a year (almost ten times more often than controls). After a fall, PWD are less likely to recover well, more likely to be hospitalised, are hospitalised for longer and are more likely to require increased care. We currently know little about the care received by these patients. There is evidence to suggest that staff may perceive PWD as less capable of rehabilitation and staff in community services providing follow-up care may not have specific training in the care of PWD. 
Can rules of thumb help manage uncertainty and the challenges facing practitioners caring for someone with dementia at the end of life?
How was your BGS Autumn Meeting 2017? I enjoyed meeting a lot of people with plenty of experience and don’t the Geriatricians look young these days! Remember that I am 78 years plus. What about that location? Very intimidating on first arrival but once in your allocated space, superb facilities. Plenty of toilets, plenty of overall space, good catering – with alternative if you didn’t mind going a bit further. Found the steps down between levels quite hard but recognise the need to do your daily exercise! One or two smaller rooms got a bit crowded for some presentations but, in general, presentations well supported. 
Is getting old about decline or about personal growth?
Asthma still presents a major challenge to society. Although classically regarded as a disease of children and young adults, accumulating evidence suggests that late onset asthma carries a poorer prognosis. Moreover although the death rate from asthma has fallen over the last 10-15 years in people under 75, in those aged over 75 it has doubled. Consequently the overall mortality rate has not changed.
British Geriatrics Society 