- ABERDEEN

Four hundred and fifty of us came by plane, train, ferry and car (and all such combinations), to the BGS Scientific Meeting in the Grampian city of Aberdeen - centre of learning since the 15th century.

Those who travelled by car or train enjoyed the rich variety of scenery up the eastern coast of Scotland or along the spectacular A9 motorway. Special arrangements had been made for sunshine during our stay in Aberdeen, according to the Chairman of the Organising Committee, Steve Hamilton, who certainly appeared to have a direct line of influence because Aberdeen opened its grey granite arms and filled them with swathes of nodding daffodils and basking seals on the Don. We came from the four corners of the United Kingdom, across the sea from Ireland, colleagues from continental Europe returning after their excellent time at Cork, and travellers from Australia, New Zealand and USA, who had braved the concerns of the SARS epidemic.

Business proper began with a state of the art lecture by Stuart Ralston (Aberdeen), who everyone agreed captivated and stimulated his audience as he made genetics appear simple, and helped us understand why mutations of uncommon bone and collagen diseases could help unlock the mechanisms of osteoporosis. More directly, he reminded us that a family history of fracture, including the famous first citizen family residing on Deeside, was an important predictive factor (nearly 4 fold) for the 50% of us women in the audience likely to be afflicted with osteoporosis.

Never too late Finbarr Martin (London) introduced the theme of exercise in preventing muscle loss in older ages, and this theme was returned to in the Healthy Ageing Special Interest Group (SIG), by Archie Young (Edinburgh). Both gave us the encouraging information that exercise could limit the age-related decline in muscle bulk. The message here was that ‘it is never too late’ to stop the 1-2% loss in strength each year, with the possibility of postponing or reducing disability by up to 10 years even in the oldest old. An important message by Dr Salota, (Nottingham) that Calcium and Vitamin D supplementation may be as effective as a regime which includes bisphosphonates merits further study, since many older people manifest poor tolerance of bisphosphonates.

Dr Donald Newnham - Golf Guru

Parallel sessions
Parallel sessions in psychiatry and respiratory medicine were welcomed by the specialist registrars who felt that the sortie by Graham Douglas (Aberdeen) into use of NPPV by CPAP was especially useful in their day to day management of COPD on the acute medical take.

In the psychiatry update, Nitin Purandare (Manchester) reminded us that chronic diseases such as stroke, Parkinson’s disease, dementia and cancer are accompanied by serious depression in 15% of people. Salient points were beautifully illustrated by holiday slides. In this session too, Brian McGurn (Edinburgh) demonstrated elegantly, the information which can be gained from longitudinal studies; in this case the IQs from the 1932 Scottish cohort of 11 years olds could be used to estimate and validate the relationship of pre-morbid intelligence to tests for dementia using the National Adult Reading Test. Other information from cohort studies was presented in the Cerebral Ageing and Mental Health SIG under the leadership of John Starr.

US cohort studies presented by William Barker (Oregan) suggests that congestive cardiac failure is increasing exponentially as the population ages. The value of longitudinal studies in ageing as an evidence base in directing and planning policy for the demographic changes expected in the population life expectancy, was further emphasized by Sian Griffiths (Oxford) in the Healthy Ageing SIG.

Holistic vision
Ian Philp gave us some of the background to the government and his thinking behind the National Service Framework for Older People and how his holistic vision for older people had to be tempered with the government preoccupation with emergency admission and waiting lists. Two years have passed since the publication of the National Service Framework; the main improvements to date relate to combating age discrimination and developing intermediate care services. The next two years will focus on developing integrated services for strokes, falls and mental health, and reforming acute hospital care. Putting older people at the centre of the emergency care reform with geriatricians providing the medical leadership is the key challenge.

Brian Williams (Glasgow) gave a spirited account of integrated care for older people, Scottish style. Incisive questioning to Ian Philp revealed that ‘intermediate care’ might have been better termed ‘integrated care’ and that he hoped ‘champions for old age’ could be seen as part of the working plan for improving older people’s services in England. Geriatricians would provide leadership as clinical champions.

Those who attended Thursday afternoon’s drug symposium had a fine overview of stroke risk factors by Ron MacWalter, followed by the cardiologist view by Adrian Brady (Glasgow). A questioner reminded us all that drug sponsored lecturers should carry a conflict of interest warning.

Friday dawned early for those who had taken the message on exercise therapy seriously and had ceilidh’ed till the wee hours. However, a very respectable Friday morning group made it to the breakfast symposium, and then settled into the more intimate choices within the four special interest groups.

With lunch beckoning Gordon Lowe gave an excellent talk on secondary vascular prevention, which was praised by all for its clarity of presentation, useful new information and helpful ABCDEF mnemonic. Lunchtime on Friday, like Thursday, saw a healthy array of delicious buffet food ranging from Deeside salmon, colorful salads and a range of hot food. The large conference hall with the tables surrounded by the 80+ poster boards and the drug exhibition units made for easy circulation for viewing and discussion during poster sessions. It was also conducive to a chat during meal and coffee breaks. Those of us not familiar with ‘coffee and tablet’, discovered that our medication was a Grampian style fudge square! Friday afternoon came, and with feet weary from pounding new carpets and bags becoming increasingly heavy with yet more freebies from the exhibition stands, we recharged the mental batteries and found useful snippets of information in medical ophthalmology, hearing difficulties in consecutive medical admissions and in visualization of gait using an accelerometer in Parkinson’s disease.

Dr Alan Cox receives prize for best paper read at a Spring Meeting

Revalidation
Those colleagues attending the update in prostatic disease praised the clarity of the presentation but came away with concerned thoughts about ‘what to do’. At 4.00 p.m. after further ‘coffee and tablet’, we settled into Graham Catto’s view from the GMC. His delivery and comfortable style is an example of communication ease with an audience as he cantered through GMC in times past and times future, with information about revalidation and license to practice for us all to digest. We all learnt a lesson in communication skills from the short clip of ‘Doctor in the House’, followed by his own interview with the ‘interviewer from H—-’. Full marks to him for using his own discomfiture as a learning experience for us all – and useful too for ‘communication’ skills training for our medical students and young doctors

The social evening hosted by the Lord Provost in the Art Centre showed Aberdeen as a city of culture and for those of us unfamiliar with Aberdeen, we saw some of the fineness of its architecture and understood why Victoria loved to visit, and why Albert had to get a tartan of his own! At our dinner at Ardoe house, we sampled more Grampian cuisine, the Balmoral piper and ‘a wee dram’. Our president Bob Stout, in his usual effortless style, thanked all the Aberdeen organizing committee for a successful conference, presented the President’s medal to Dr Roger Smith for his long and excellent service to geriatric medicine in Scotland, and reminded us in stories about St Peter that as ‘physicians responsible for delayed discharges, we might find ourselves as trolley waits outside the Pearly Gates’!

Dr Willie Primrose	Prof Gwyn Seymour	Dr John Wood

Haste ye back again
Saturday morning saw an interesting multidisciplinary meeting about seating, posture and spasticity followed by community care, for a small but enthusiastic audience. As we packed our bags and headed for the airport, station or road out of Aberdeen, the road signs told us to ‘Haste ye back again’ - surely an invitation too good to refuse!

Maeve Rea
Ed Hodkinson