"The Elderly" is the third monograph in a series on management and treatment in major patient groups and subspecialties. Each book is complete in its own right. The whole series, however, has fill a gap between standard text-books of medicine been prepared to and therapeutics and research reviews, symposia and original arti cles in specialist fields. The aim of the series is to present up-to-date authoritative advice on patient management with particular refer ence to drug treatment. The first two volumes in the series, on gastrointestinal diseases and rheumatic diseases, were addressed to major therapeutic areas or subspecialties. The present volume, "The Elderly", is intended to provide overall guidance on the manage ment of a range of medical problems in elderly patients. The elderly make up an increasing proportion of the population and require a substantial proportion of health care resources. The management of elderly patients falls not only upon specialist geriatricians but also upon a range of others, including general practitioners, general physicians and almost all other medical specialists with the excep tion of paediatricians. It has become apparent in recent years that the management of disease in the elderly in general and drug treatment in particular presents new problems and challenges. Some of these relate to the wide spectrum of disease in elderly patients, in whom there is often multiple pathology, while others concern age-induced changes in drug handling or drug effect.

Illness in old age is characterised by vague and atypical presenting features which are often missed and wrongly attributed to the ageing process. This is particularly true of endocrine disorders where hypothyroidism may mas querade as dementia, where electrolyte imbalance may cause lassitude, and where diabetes mellitus may produce a wide range of complications com monly associated with ageing. It is our intention that our book provide straightforward practical guidance in this difficult area by delineating the effects of ageing on endocrine function and the clinical consequences of these; and by describing in detail the wide range of presenting clinical fea tures of endocrine disease in the elderly. Physicians are also often baffled and misled by the effects of ageing and disease on laboratory tests used in the investigation of endocrine disease. Our book describes these changes in detail, and gives guidance on which tests are most appropriate. Ageing and disease also produce subtle changes in the response of patients to drugs and replacement, and this is also dis cussed in detail. Subjects included separately and in depth include thyroid disease, the clinical features and treatment of diabetes, postmenopausal changes, bone disease, fluid and electrolyte imbalance, energy imbalance, and drugs caus ing endocrine and metabolic disorders. These have been chosen because we consider that they present problems which are particularly relevant to the elderly. Many other issues are covered in general textbooks of endocrin ology and have been omitted.

If you are involved with the pastoral care of elderly people-as a carer, a member of the medical profession, or the ministry, then this book is a useful approach to the problems and the processes of old age. Written to promote awareness of the needs of elderly people, as well as those who look after them, many areas of concern are covered including the physical effects of ageing, the availability of much-needed services, the pros and cons of institutional care, relevant ethical issues, and the importance of the often neglected aspect of effective communication. 'So long as people retain their health, old age can be a time of both fulfilment and enjoyment ...'