While this may change as people grow older – for instance, physical activity is commonly reduced – some lifestyle factors may not change, for example, cigarette smoking. This may eventually lead to such conditions as CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD); ATHEROSCLEROSIS causing heart attacks and STROKE; osteoporosis (see BONE, DISORDERS OF) producing bony fractures; and cancer affecting the lungs and bladder.

This is associated with the MENOPAUSE in women and, in both sexes, with a reduction in the body's tissue elasticity and often a deterioration in mental and physical capabilities. When compared with illnesses described in much younger people, similar illnesses in old age present in an atypical manner – for example, confusion and changed behaviour due to otherwise asymptomatic heart failure, causing a reduced supply of oxygen to the brain. Social adversity in old age may result from the combined effects of reduced body reserve, atypical presentation of illness, multiple disorders and POLYPHARMACY.

When compared with illnesses in much younger people, similar illnesses in old age may present in an atypical manner – for example, confusion and changed behaviour caused by an otherwise asymptomatic heart failure resulting in a reduced supply of oxygen to the brain. Social adversity in old age may result from the combined effects of reduced body reserve, atypical presentation of illness, multiple disorders and taking a variety of medications – polypharmacy. This is dealt with specifically by the specialty of geriatric medicine (also called medicine of the elderly). The aim is to assess, treat and rehabilitate such patients who are, of course, steadily increasing in number. As the proportion of elderly in the population rises, along with the cost of hospital inpatient care, close co-operation between hospitals, COMMUNITY CARE services and primary care trusts (see under GENERAL PRACTITIONER (GP)) becomes increasingly important if senior citizens are not to suffer from the consequences of the tight operating budgets of the various medical and social agencies. Private or voluntary nursing and residential homes have expanded in the past 15 years and these now care for many elderly people who previously would have been occupying NHS facilities. Local authorities are now responsible for assessing the needs of elderly people in the community and deciding whether they are eligible for financial support (in full or in part) for nursing-home care.