The last year has seen much change in Reviews in Clinical Gerontology, and this will continue over the next year.

At the beginning of last year I took over as Editor from Professor Ray Tallis, whose vision, drive and initiative were instrumental in establishing what Age Ageing has recently referred to as one of the major review journals in the field on gerontology. The year also saw a major change in the section editors, the only one remaining from l’ancien regime being Bob Baldwin, our section editor for Old Age Psychiatry. The contributions of David Barer, Ioan Davies, Emily Grundy, Jackie Oldham and Peter Overstall have been considerable, and their contribution, with Ray, to Reviews cannot be understated.

Over a lifetime, the human lung is exposed to a multitude of factors capable of altering its structure and function. The frequency of acute, self-limiting lung disease, exposure to environmental pollutants and previous tobacco consumption in elderly people makes it difficult to identify pulmonary changes that can be attributed to ‘normal aging’ alone. It is likely that all these factors may have some influence on both lung structure and function.

The term syncope has been used to describe collapse of any nature but this is not the appropriate use of the word. Syncope originates from the Greek and means ‘cessation’ or ‘interruption’. The specific application of the word syncope is a temporary loss of cerebral blood flow, resulting in loss of consciousness and postural tone, thus leading to collapse. Although other conditions resulting in collapse may be difficult to disentangle from a syncopal event, it is the broad spectrum of diagnoses resulting in syncope to which this article is dedicated.

As the proportion of older people in the population rises, health services must continue to develop to meet their special needs. This includes accident and emergency (A&E) services which work at the interface between primary and secondary health care for individuals of all ages. This literature review aimed to answer the following questions:

1) What are the characteristics and special needs of older people in A&E?

2) Which of the current literature describes, evaluates or advocates service initiatives aimed at meeting the needs of older people in A&E?

3) What are the policy implications of the literature reviewed for British A&E services?

It is widely acknowledged that ‘rewarding personal and sexual relationships promote health and well-being’, an opinion exemplified by the identification of sexually-transmitted infections (STIs) as one of the key targets for disease reduction in the Health of the Nation White Paper. Indeed, since the advent of the AIDS pandemic in the early 1980s, a substantial body of research has been undertaken in the area of sexual health.

Alcohol misuse among older people has now been investigated for over 30 years. Schonfeld and Dupree previously described studies of alcohol use and abuse in the USA and UK, categories of older problem drinkers, age-inappropriate assessments, and examples of age-specific treatment. This review addresses more recent studies on drinking behaviour across several countries, screening assessment for older adults, alcohol problems in primary care medical settings, current age-specific treatment programmes, and treatment recommendations by expert panels, as well as in-home detoxification and use of the medication naltrexone as adjuncts to treatment.

The last five years have produced a large output on the epidemiology of dementia and cognitive impairment, specially on apolipoprotein E (apo E), vascular changes, and education as risk factors. Minor cognitive deficits have been studied prospectively to assess their value in predicting dementia. Reviews of work from particular centres and articles on special aspects give more detail. Preference is given to population-based over clinic-based studies and to those published in or after 1994.

‘When I use a word, it means just what I choose it to mean’. So it is with rehabilitation, except that several definitions and explanations have been proposed. Although the similarities between the definitions are considerable and far eclipse any differences, the perceived diversity of view has contributed to confusion over the purpose and process of rehabilitation. Is it ‘elderly care’? Is it ‘therapy’? Is it ‘post-acute’ care? The apparent ambiguity and the intangible qualities of rehabilitation contrast with the concrete ‘ologies’ of contemporary organ-based medicine and contribute to its vulnerability in our modern general hospitals. Pressures caused by rising emergency admissions and cost-driven bed closures have necessitated steadily reducing lengths of stay and rehabilitation, as a less visible component of care, has tended to be squeezed out. Paradoxically, the consequences of the ‘sicker and quicker’ discharge approach, with fresh burdens placed on community health and social services, have drawn attention to rehabilitation as a missing ingredient. We have now entered a phase of rediscovering at a strategic policy level the rehabilitation needs of older people but redefined in new terminology as ‘recuperation’ or ‘recovery’ This article will describe the core concepts of rehabilitation for older people and set the scene for forthcoming articles addressing specific rehabilitation topics.