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Substance misuse in older adults

Substance misuse is on the rise in older adults due to an ageing population and ‘the baby boomers’9 approaching older adulthood. It is estimated that substance misuse will double between 2001 and 2020 in adults over 65 and is related to increased mortality and morbidity. 1, 3 

Substances misuse ranges from the harmful use of alcohol, tobacco, and illicit drugs to prescribed and over the counter medication. Older people are more vulnerable to harmful effects of substance misuse due to the physiological changes associated with ageing, polypharmacy and co-morbid illnesses as well as the direct impact on physical health due to poor diet, isolation and poverty.1 Healthcare professionals may be uncomfortable asking about substance misuse in older people and the information may not be disclosed by patients or carers but certain symptoms should trigger screening for substance misuse especially as they can be easily attributed  to ageing or an early dementia1 (see box 1). Risk factors for substance misuse can include loneliness, retirement, isolation, bereavement or an underlying depression, anxiety or cognitive disorder. 

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The 2017/18 GP contract and the Electronic Frailty Index

Message from Dr Martin Vernon, National Clinical Director for Older People: The new GP contract for 2017/18 was announced on Tuesday (see report below). It withdraws the avoiding unplanned admissions enhanced service and aims to ‘put a mainstream focus’ on older people living with frailty through a requirement for routine frailty identification for people aged 65 and over using a validated tool (for example, the electronic Frailty Index) to proactively identify and support older people living with frailty.  For people with severe frailty (around 3% of over 65s) this will include a clinical review (medicines review, falls assessment and other clinically relevant interventions) and encouraging use of the additional information in the summary care record to promote safe, joined up care across different settings.  We hope you agree this is a step forward in the journey towards more proactive, person-centred care for older people living with frailty.

Our next step is developing the guidance that helps practices introduce the contractual requirements smoothly, as well supporting those practices that want to go further to take greater advantage of the opportunity that routine frailty identification offers for improved prevention and better care.  

We would value your continued support and guidance to help inform this and, in the meantime, if you have any queries or would like any further information please contact



Movement Disorders 2017 Powerpoints now available

The following files are secured pdf versions of the powerpoint files supporting presentations delivered at the the BGS Movement Disorders Meeting in 2017. These are published with the presenters' permission and the onus for assuring that copyright permissions are adhered to is vested in the individual presenters. They will remain on the BGS website under Resources/Powerpoint Library for two years:

A L Cunnington: National Parkinson's Audit 2015 and beyond

Helen Mann: Driving and Mobility

Biju Mohamed: New Treatments in Parkinsons

Claire Morris: The end of life in PD and the Parkinson's plus syndromes

Richard Walker: Parkinson's disease NICE guidelines 2017


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