The evolution of geriatric medicine.

The evolution of geriatric medicine has been associated with increasing knowledge about aging--social, psychologic and biologic--and its effect on the clinical presentation of illness. It also has been associated with varying patterns of the historical development of medical care in different countries. Overall, two main forms of geriatric medicine are developing worldwide--one an accredited specialty practiced within a State medical service, the other based in large hospitals for the aged where physicians train themselves but are not accredited. The system of geriatric care in Great Britain is described and the importance is emphasized of: 1) assessment before admission, 2) progressive care of the patient, and 3) the day hospital. Future developments in relation to internal medicine and family practice are considered. Research into the causes of atheromatous vascular disease and senile dementia is of fundamental importance for the whole future of geriatric medicine.