This paper will review some fundamentals of normal renal physiology necessary to understand the changes occurring with age and enable the reader to distinguish between chronic renal insufficiency and the consequences of normal ageing on kidney function.

In 2004 the Stroke Association stated ‘Each year over 130,000 people in England and Wales have a stroke. Of all people who suffer from a stroke, about a third are likely to die within the first 10 days, about a third are likely to make a recovery within one month and about a third are likely to be left disabled and needing rehabilitation. Stroke has a greater disability impact than any other medical condition. A quarter of a million people are living with long-term disability as a result of stroke in the UK.’

Primary total hip replacement (THR) is one of the most common and cost-effective major operations performed in the developed world: annually approximately 50,000 are undertaken in England and Wales and over half a million are performed worldwide. The majority of these operations are performed for primary or secondary osteoarthritis (over 75% from Swedish data), traumatic fracture (11.3%) or rheumatoid arthritis (6%), but indications are varied and include avascular necrosis, congenital dislocation, Paget's disease, and ankylosing spondylitis. The primary goal of the procedure is the relief of pain that can no longer be controlled by analgesia or non-operative procedures, but severely impaired mobility affecting independence is a secondary indication.

The incidence of deep vein thrombosis (DVT) and pulmonary embolism (PE), collectively called venous thromboembolism (VTE), increases with age and has been reported to be higher in males. The annual incidence rates per 1000 for DVT and PE are 1.3 and 1.8, respectively, for people aged between 65 and 69 years, rising to 2.8 and 3.1, respectively, in those aged between 85 and 89 years. Older people are about eight times more likely to develop VTE in hospitals, nursing homes or other chronic care facilities than younger adults. About 1.7% develop PE within one year of treatment for DVT, whilst the one year recurrence rate for PE was 8.0%. About 3% of patients with DVT and 21% of those with PE die in hospital. One year mortality with DVT is 21% and that with PE is 39%.

The clinical diagnosis of Alzheimer's disease (AD) involves neuropsychological testing to assess the integrity of higher order cerebral functions such as memory, cognition, visual perception, language and executive function. However, the onset of AD is insidious and diagnosing the very early stages may be precluded as such tests may lack the necessary sensitivity and specificity. This, together with the potential for similar shortcomings in relation to assessing disease progression and response to treatment, has prompted the search for disease markers based on abnormalities in additional aspects of brain processing. One area receiving increasing investigation is the integrity of visual and visual-attention-related processing.