European Union Geriatric Medicine Society

In the context of the very welcome increase in longevity of Europeans over the last 50 years, geriatric medicine has evolved as a specialty to meet the challenges of the increased complexities of healthcare in later life. EUGMS was established in the year 1999. Blending the principles of gerontology (the science of ageing), internal medicine, rehabilitation and palliative care, geriatric medicine is now recognized as an effective instrument to deliver high-quality, humane, interdisciplinary, appropriate and cost-effective care to older people, proportionately the most significant group of healthcare users in all European populations.Through a wide range of services, including acute geriatric medicine (reducing death and disability by more than 25% compared to internal medicine), falls clinics, ambulatory assessment, dementia services, support for nursing home residents, the specialty has made a major impact in those countries where it is well established. In the 1990’s it became increasingly clear that there was a need for a European focus to support and promote the concept of specialist healthcare for older people in the European Union. In particular, a focus was needed for specific research into how the presentation of illness in later life differed from that of younger adults, and what methods might be most effective in terms of patient-focused services, both in for the patient and for health services regarding costs and personnel.  Part of the aim of geriatric medicine is to not only to engage in research in older people, but to also generate the parameters and terminology by which research and service development might be usefully directed.This has been a useful roadmap for a complex area, and in effect provides an agenda for the priority areas for development in healthcare for older people. The Silver Paper emphasizes the need for research that is both interdisciplinary and translational, and divides the areas of priority into basic research, health promotion and preventive action, and clinical care. The basic research elements prioritized include a better understanding of how ageing is modulated and a focus on epigenetic modulation of the ageing process. At a health promotion and preventive level, the elements covered include training of health professionals, vaccines, nutrition, exercise, injury prevention, mental stimulation, social activity and informal care giving.  The focus in the clinical area lies with the development of geriatric medicine and specialist training, appropriate regulation of medicines, comprehensive assessment protocols, age-attuned palliative care, old age psychiatry, long-term care and quality assurance.  The role of universities in assuring age-friendly training and research is emphasized. In particular, it is noted that health services research rarely includes frail older individuals. Research outcomes that are relevant for younger populations may lose importance at advanced age. Health services research is limited, and the impact of changes in organization and delivery of health services on function and health of older people is rarely considered.