Age and Ageing: 50th Anniversary

The BGS's official journal, Age and Ageing, celebrates its 50th year in 2022. First published in February 1972, it has since gone on to become the leading international clinical geriatric medicine journal with an impact factor of 12.782. Research and service evaluation have played an important role in the development of our specialty. Age and Ageing has been at the forefront of disseminating this work, publishing high quality, original research, reviews and opinion articles. We publish across a broad remit, including clinical, health policy, educational and service development. We particularly value papers that will be of interest to clinicians.

Academic journals are part of an eco-system that stimulates debate and disseminates new knowledge, allowing medical expertise to be constantly renewed. For its 50th anniversary, Age and Ageing commissioned leading thinkers to reflect on problems in healthcare for older people, and the state of services across the World Health Organisation’s six regions.

Responses fell into three groups: the philosophical, the retrospective and the state-of-the-art.

Olde Rikkert et al argued that illness is more important than disease in older age. We recognise the limitations of specifying individual diagnoses in an older person. Instead, defining networks of symptoms and problems, and applying modern computing to analyse and monitor them, may operationalise what we do intuitively in practice. O’Neill reflected on the uneasy relationship between older people and geriatric medicine, suggesting that unwitting collusion with a ‘failure model of medicine’ might be responsible. Instead he calls for greater recognition of our role as ‘guardians of the longevity dividend’ and a lesser focus on hospital-based crisis medicine.

Commentaries on falls, dementia, delirium and care homes celebrated the efforts of pioneers in establishing a body of specialist knowledge, discussed the exponential rise in research and translation into clinical services over recent decades, and highlighted future challenges. Developments in geriatric emergency medicine are held to be a model for frailty-friendly services in general. At the same time, Becker and Achterberg discuss the paradox of dwindling provision of geriatric rehabilitation in the face of ever-increasing need. Rehabilitation is person-centred because it addresses practical problems, and at the same time can help optimise the operation of wider health and social care systems.

Pitkala and Strandberg explain that while clinical trials have driven unprecedented advances in many areas of medicine, they are harder to do and interpret when the participants are frail older people, and indicate how problems have been addressed. Commentaries on frailty, sarcopenia, continence, polypharmacy and end-of-life care provide substantial reviews on emerging and established clinical problems. We rely on education and training as we build for the future; Romero-Ortuno et al discuss recent initiatives, and the theory underlying current practice.  Masoli et al explain how advances in genomics can give new insights into the problem of multimorbidity.

The commentaries on world regions draw attention to similarities and differences between countries. Demographic and epidemiological transitions are universal but occur on a compressed timescale in lower- and middle-income countries and have reached a phase of super-ageing in East Asian and European populations. Everywhere struggles with resources and the priority given to ageing, but health policy now clearly recognises a need, and there are many examples of innovation, educational and service development that provide a solid foundation for the future. The United Nations Decade of Healthy Ageing 2021-2030 forms a unifying thread.

Prof Rowan Harwood, Editor in Chief