A previous newsletter outlined the BGS Parkinson's Disease (PD) programme which, from its inception in 2002, has gone from strength to strength.

The third Congress of the European Union Geriatric Medical Society (EUGMS) took place in Vienna in September 2004.

The venue was the magnificent Austria Centre, just out of the city centre in the Vienna International Centre, which also houses the modern United Nations Building. The meeting attracted the largest yet attendance at a EUGMS meeting and it was particularly pleasing that so many UK geriatricians were contributing or attending.

Once again a great deal of credit for the programme goes to Prof Alan Sinclair, who is the Director of the Academic Board of the organisation and co-chaired the meeting with Prof Boehmer, representing the host society. Alan has done an enormous amount of work to establish this meeting as one of the premier educational events in the geriatric calendar. The programme over the three days was wide ranging with many parallel sessions covering most of the important areas of geriatric medicine. One frustration is that it would have been nice to have attended more of the sessions than was possible, as there was often a choice of seven or eight different sessions to attend at any one time. The meeting was opened by Prof Jiulio Masotti, who is President of the EUGMS Executive Board and previously hosted the very successful meeting in Florence last year. Brian Williams, of course, is the immediate Past-President and played a very active part in the meeting and also on the EUGMS Executive Committee.

I had the pleasure of being the convenor of a parallel session on Gait Disorders. This was well attended and received, with Dr Helen Roberts, Senior Lecturer at Southampton, giving a superb review on Extra-pyramidal gait disorders, followed by the equally excellent Brian Wood from North Tyneside on Gait Disorders and Dementia. This was followed by an intellectually stimulating lecture by my great friend and previous colleague, Jed Rowe on Concepts of Gait Disorders. It was easy to see that Jed Rowe had been trained by Bernard Isaac, but I think his presentation went beyond his previous mentor to break new ground in changing the conceptual framework that we have around postural instability. It was not a surprise to me that immediately after the lecture he was invited to give a talk in America and will also be giving a similar address to the national meeting of BGS in the future.

The meeting started with a session on Geriatric Psychiatry with a great emphasis on co-morbidity, the background and biology of ageing and its relevance to dementia, as well as the popular topic in continental Europe on Nutrition in Alzheimer's disease. It is clear that the specialty is generating a first class evidence base. The following sessions included falls, osteoporosis, treatment of Alzheimer's disease, multimorbidity, rehabilitation in the older patient, driving in old age, dizziness, ethics and palliative care in geriatrics, pressure sores, elder abuse etc., all pointing to direct clinical relevance of the sessions and it is extremely valuable to develop a European view on these basic areas of geriatric practice. The oral presentations of research papers were uniformly of a high standard.

Cameron Swift chaired an excellent session on Pharmacotherapy and clinicopharmacology in geriatrics as part of the core curriculum. The session was started by an excellent presentation from the Dutch geriatrician Prof Van Der Cammen, from Rotterdam on Adverse Drug Reactions in the Older Person, Prevalence and Possibilities for Prevention. The emphasis of this lecture was on techniques which recognise inappropriate medication and looked at the evidence that such methods may be effective in reducing adverse drug reactions in the older patient. The Beers' criteria for inappropriate medication was supported as a useful instrument to audit good practice in prescribing. This was followed by Prof Topinkova from Prague, who dealt with the scale of inappropriate prescribing in older people, reviewing recent epidemiological findings and their implications. It is clear that work has been done in both North America and Europe, which indicates the inappropriateness of many medications and the inadequacy of the evidence base for their use in older patients. Prof Topinkova outlined collaborative international research in EU countries to increase quality and safety of drug prescribing in old age. Steve Jackson and Cameron Swift finished off the meeting with talks on the development and use of prescribing indicators and drug development safety, and the role of drug regulations. Both presentations were excellent. I was only sorry that my own programme in Gait Disorders clashed with a follow on session on ageism in prescribing drug and treatment, which was chaired by Peter Crome, who gave a UK perspective on age discrimination in prescribing.

Once again the challenging area of understanding and studying frailty had a prominent place in the programme with strong representation from North America. An outstanding highlight of the meeting was Shah Ibrahim's excellent lecture Is Ageing Preventable? Shah wearing his two hats of epidemiology and geriatric medicine, gave one of the most memorable lectures I have ever heard, combining both humour and scholarship. It was my pleasure to introduce Prof Anisimov, Professor of Gerontological Oncology, St Petersburg, who gave a challenging lecture on experimental ageing research, giving a wide ranging review of the role of oxidaine stress, insulin signalling pathways, the function of the pineal glands and telomerase in ageing and cancer. He reviewed possibilities of using drugs to expand lifespan and speculated what this meant in terms of international policy. His lecture was followed by Megan Geraghty, President of the American Geriatrics Society, who gave a review of Disease Management Programmes in the United States, a topic very relevant for the British geriatrician.

Another outstanding session was Ethics, Palliative Care in Geriatrics, End of Life Decisions in Nursing Homes, looked at from a Norwegian perspective by the Chair of this session Prof Husebo. One of the hosts of the Conference, Thomas Fruehwald from Vienna, gave a systematic review of ethical questions in geriatric medicine, followed by Prof Husebo considering euthanasia and finally, Dr Di Pollina from Geneva, considering the ethical challenge to the end of life. This session was packed and there was lively debate from views of both ends of the ethical spectrum and from different continents. It was lively, entertaining and intellectual, and typified the spirit of the EUGMS meeting.

The conference was fittingly closed by Prof Jean Pierre Michel with a key note lecture on interdisciplinary working. Jean Pierre, through his academy, is at the forefront of academic geriatric medicine in Europe.

I am sure that members of the BGS should give serious consideration to including in their study plans, the next EUGMS Conference in Paris in two years time, if not the smaller meeting in Spain next year.

Jerry Playfer