Recent changes in medical education as well as in the organization and delivery of health care in the UK have emphasized the need for doctors, nurses and other health care professionals to learn to work together as teams in order to provide the best possible care for patients. The importance of interprofessional education (IPE) and teamwork is, therefore, being increasingly recognized and given priority in medical education.

Population aging, escalating costs in pensions, health care and long-term care have prompted the emergence of a new policy agenda for active aging and quality of life in old age across the European Union. In the UK, the government has made a commitment to improve services for older people through combating age discrimination, engaging with older people, better decision-making for services for older people, better meeting of older people's needs and promoting a strategic and ‘joined-up’ approach. A raft of policy initiatives not only sets the tone for service reconfiguration but also specifies objectives and time scales.

Important and common syndromes of old age, such as dementia, parkinsonism, falls, depression, and urinary incontinence, may be associated with vascular pathology affecting subcortical brain structures. The advent of neuroimaging has brought this more to the attention of clinicians and researchers, with increasing evidence that the common findings of white matter change, and small lacunar infarcts are not entirely benign, as previously assumed. Such lesions are common in elderly populations: only 5% of 1077 subjects aged between 60 and 90 from the Rotterdam study were found to be completely free of white matter lesions. Even in otherwise healthy elderly people, such lesions may impact on cognitive and physical abilities.

Depression in old age is common, disabling and under-treated. This review will examine recent advances in our understanding of its clinical presentation, epidemiology, management and prognosis. The relationship of depression in old age with dementia and with physical illness is also discussed, as are the links between suicide, deliberate self-harm and depression in old age.

‘In this world nothing can be said to be certain, except death and taxes.’ To these two could be added rheumatic disease. Only one in 19 of us will escape one or more significant episode of rheumatic disease. Osteoarthritis is the single commonest cause of disability and handicap in Britain. Although arthritis is seen in childhood and early adult life, the burden of joint disease increases with age. The majority of arthritic conditions have a low incidence but a high prevalence. In other words, once you get arthritis, it stays with you. Nodal osteoarthritis is seen in about 70% of women by the end of their lives in Britain, and in 55 to 60% of men. Any inflammatory disorder that damages joints will lead to secondary osteoarthritis (OA). Injury, such as that seen with the menisci of the knees, will also be complicated in later life by secondary OA. Ankylosing spondylitis never burns itself out. This is all very gloomy and perhaps we should all be ordering our bath chairs now.

In 2002 the World Health Organisation (WHO) reported that worldwide, deaths due to chronic diseases were accountable for around 30 million people. An earlier report by the WHO revealed that the leading causes of deaths due to chronic disease were cardiovascular disease (17 million), cancers (7 million), chronic lung diseases (4 million) and diabetes (approximately 1 million). In developed nations, the most frequently reported risk factors associated with chronic diseases are exposure to tobacco products (12.2%), hypertension (10.9%), alcohol consumption (9.2%), elevated cholesterol (7.6%), and obesity (7.4%), unhealthy diets that include high saturated fat and sugar content (3.9%) and sedentary lifestyle (3.3%). In view of the demographic shifts, and the strong association with aging and chronic disease, it is estimated that worldwide, within the next two decades, the predicted number of deaths due to chronic illness will rise to around 50 million people per year. Amongst elderly populations in particular, circulatory diseases, respiratory diseases, mental health problems, and musculoskeletal diseases are frequently cited as causes of chronic illness. Population estimates in the UK suggest that around 70% of people by the age of 80 report some type of health-related disability. Patients with chronic conditions will often have multiple co-morbidities with complicated disease management which will necessitate considerable contributions from their caregivers. The caregivers of the chronically ill are often unpaid family members who are frequently placed under considerable stress, and as a result can themselves suffer from functional decline, depression, isolation and loneliness.

Successful aging seeks to counteract and replace the old ‘decline and loss’ paradigm that views aging as a series of individual decrements or losses to which both older people and society needed to adapt or adjust. This new gerontology, based on the concept of successful aging, adopts a preventive model: modify individual behaviours throughout life in order to avoid the decrements and losses. Research has led to the development of a variety of models for successful aging, which share the fundamental assumption that successful aging is a result of a lifelong developmental process that involves the combination or interaction of traits or predispositions present at birth or in early life and cumulative life experiences. Successful aging builds on a life history of successful adaptation, which in turn, is a result of interactions among inherited and learned personality attributes and levels of adversity or advantage and resources. Research driven by the successful aging theorist is turning attention to the development of indicators that might explain and predict successful old age. A number of factors are already well known to promote well-being, for instance regular exercise, cognitive stimulation, friendship and the presence of a confiding relationship. However, little is known on how persons from different age groups perceive the preparation of a good old age. In this exploratory study we attempt to expand this topic, since it will allow the understanding of how these perceptions can influence, in a positive or negative way, the achieving of a good old age.