The last three decades produced a striking increase in investigations of the neurobiological basis of brain aging and aging-related changes in neural and cognitive function. Experimental and clinical studies of aging have become more valuable as the population, at least in industrialized countries, has become ‘greyer’. The increase in adult life expectancy that occurred in the twentieth century produced the motivation and necessity to invest resources in increasing ‘health span’ as well as lifespan, in order to maximize quality of life and minimize the financial and social burdens associated with disability in the later years of life. Specific interest in the aging nervous system is driven by recognition that increased longevity has little appeal for most people unless it is accompanied by maintenance of cognitive abilities. Indeed, surveys of older individuals routinely show that loss of mental capacity is among their greatest fear. In recent years, neuroscientists and gerontologists, with a variety of training and experimental approaches, have applied increasingly powerful quantitative methods to investigate why neural function declines with age. New animal model systems have been developed and old ones have become better characterized and standardized. The necessary and important descriptive studies that dominated the field in earlier years are increasingly supplemented by more hypothesis-driven research, resulting in sophisticated investigations and models of the mechanisms of brain aging. This review provides a selective overview of recent and current research on brain aging. The focus throughout will be on normal brain aging and the moderate cognitive changes that often accompany it, not on aging-related neurodegenerative diseases that result in dementia. To provide a context for studies of neurobiological changes in the aging brain, a brief overview of the types of cognitive changes that are commonly seen in aging humans is first provided. The remainder of the review focuses on animal studies that are progressively overcoming the unique challenges of aging research to reveal the neurobiological mechanisms of aging-related cognitive dysfunction, and suggest new targets for therapies to prevent or ameliorate cognitive decline.

Pressure ulcers are the visible evidence of pathological changes in the blood supply to dermal tissues. Pressure ulcers are rare, affecting only about 0.5% of the total population. The distribution is clustered into two groups, peaking once in younger, mostly neurologically impaired persons and again in older persons. The cluster in the geriatric population accounts for about 70% of all pressure ulcers.

Orthostatic hypotension (OH) is a clinical condition which frequently results in troublesome symptoms such as dizziness, giddiness, blurred vision and light-headedness. It is a common disorder associated with an increased risk of falling, especially in older individuals. OH is the presenting haemodynamic manifestation of several different and diverse underlying pathological conditions, including disorders of blood pressure (BP) regulation and disorders leading to reduced intravascular volume. In younger and middle-aged adults, the presence of OH should not be considered a primary diagnosis in itself but rather a starting point in the diagnostic pathway before the primary underlying abnormality has been identified. In older patients however, asymptomatic blood pressure drops are very frequently encountered so that, in certain cases, an exhaustive diagnostic search for an underlying cause is not warranted. However, reversible causes of OH do frequently exist in older patients. Prominent among these are the use of several commonly prescribed cardiovascular drugs and vitamin B12 deficiency.

Over the last three decades there has been a change in attitude to the care of patients after stroke from a somewhat nihilistic stance to a predominantly acute focus with potential for rehabilitation. More recently there has been a widening of perspective, with recognition that stroke is a long-term condition. Aligned with this has been a gradual shift in focus from a primarily biomedical approach to stroke care, to one that considers the psychological and social elements of the poststroke experience. However, the evidence base for stroke is still dominated by prevention and early-care treatments: only eight of the 238 recommendations reported in the UK national clinical guidelines for stroke specifically address longer-term management. The Australian clinical guidelines for stroke offer a similar pattern: 22 (14%) of 162 recommendations relate to community participation and organization of longer-term support. However, ongoing research efforts to develop and evaluate interventions for longer-term stroke care are beginning to address the imbalance in the evidence base. In our previous review, surveys reporting the types and prevalence of longer-term problems experienced after stroke were summarized and synthesized within a structured framework. The review demonstrated the complexity and diversity of the longer-term stroke experience, and highlighted the challenges that support services face in meeting the needs of patients and carers living with the aftermath of stroke. Keeping abreast with this challenging subject area is key to promoting the continued development of stroke services. This review is an update of our previous work, presenting the most recently published data on the prevalence of longer-term stroke-related problems.

Nutritional assessment in older people to detect malnutrition or risk of malnutrition is essential to avoid adverse nutrition-related outcomes. Poor nutritional status appears to be a major contributing factor for poor prognosis in malnourished individuals. Nowadays, nutritional assessment is considered to be one of the domains which should be evaluated in comprehensive geriatric assessment (CGA). CGA is a comprehensive assessment tool with the capacity of detecting impairments in older people and, at the same time, suggest interventions. Although many assessment tools are proposed, those used in CGA are not widely agreed. After 20 years of clinical practice and research, the Mini Nutritional Assessment (MNA) seems to be the tool most widely accepted by health carers and patients for the assessment of nutritional impairment in CGA.