Introduction

This is a review of recent and clinically relevant work on neuroimaging and its contribution to the diagnosis of neurodegenerative or other neurological and psychiatric diseases in older patients. Earlier research has been summarized in our previous review. We include publications on cranial computed tomography (CT) and magnetic resonance imaging (MRI), on single photon emission computed tomography (SPECT) and positron emission tomography (PET), electroencephalo-graphy (EEG), and on other methods.

The improvements of socio-environmental conditions, medical care and quality of life have caused a general improvement in the health status of the population and a consequent reduction of morbidity and mortality, resulting in an overall increased life-expectancy. The role of immunosenescence was negligible in the past, when the human lifespan was 40–50 years, and its impact on morbidity and mortality has emerged in combination with the extension of lifespan. Immunosenescence results from multifactorial processes that act on all components of the immune system. The changes associated with immunosenescence are playing an increasingly important role in the emergence of a series of age-related pathologies, conditioning the present epidemiology of old people.

Introduction

In 1995, Safe reviewed the major advances in the investigation and management of upper gastrointestinal tract (UGT) disorders over the previous 25 years. Further research over the past five years, particularly in the field of the ethics of nutrition in the elderly, has stimulated this review of the literature. Rather than attempt a comprehensive review, however, we focus on areas where the approach to the management of UGT disease has been significantly influenced. The following topics are covered: gastrooesophageal reflux disease (GORD); peptic ulcer disease (PUD); the management of non-steroidal drug-induced mucosal injury; UGT bleeding; UGT cancer and the ethics of artificial nutrition support.