Geriatric Medicine
Geriatric medicine, otherwise known as medicine for the elderly, expanded greatly as a specialty in the middle and late twentieth century, as a result of increasing knowledge of the health-care needs of frailer older people, together with increases in life expectancy with an associated rise in numbers of older people in the population. Geriatric Medicine is now the single largest specialty in General Internal Medicine in the UK.
The NHS Geriatrics services that have been established throughout the West of Scotland have always had close links with the University department, including contributing to the training of many of the current Consultants. These close links supported the delivery of Undergraduate medical education at Glasgow University when Geriatric Medicine was a separate part of the curriculum, and continue to support teaching of the principles of Geriatrics in the integrated curriculum to this present day.
The University’s David Cargill Chair of Geriatric Medicine was founded in 1964 and was endowed by the trustees of David Traill Cargill (died 1939), a director of the Burmah Oil Company.
World's first Professor in Geriatric Medicine
The world’s first Professor of Geriatric Medicine (1965-1979) was Sir William Ferguson Anderson (1914-2001), popularly known as “Fergie”.
His interest in geriatrics as a medical registrar (1939-1941) was fostered by Professor Noah Morris in the University Department of Materia Medica at Stobhill Hospital. He was awarded an MD with honours and the Bellahouston Gold Medal in 1942, and was subsequently Senior Lecturer and Consultant Physician at Stobhill Hospital before his professorial appointment. The Department of Geriatric Medicine was based at the Southern General Hospital.
Anderson’s publications included Practical Management of the Elderly (in five editions from 1967 to 1989). He pioneered social and preventive medicine for older people through several local organisations, for which the city of Glasgow awarded him the Saint Mungo prize in 1968.
He was appointed OBE in 1961 and KBE in 1974; and elected President of the Royal College of Physicians and Surgeons of Glasgow (1974-1976); President of the British Geriatrics Society (1975-1978); and President of the British Medical Association (1977-1978). He was an ambassador of geriatrics worldwide, including the role of an advisor to the World Health Organisation on the organisation of medical care (1973-1983).
Anderson’s successor as Professor (1979-1994) was Francis Caird (1928-2011). Read more
He was awarded a DM by the University of Oxford in 1960 for his research on the diagnosis and progression of cardiac valvular disease in older people. He came to Glasgow in 1967 as Senior Lecturer and Honorary Consultant Geriatrician; and was appointed as Reader in 1975. As Professor, he moved from Stobhill Hospital to the Southern General Hospital, where he aligned the department closely with the regional neurology and neurosurgical services.
Through his efforts elderly patients were able to benefit from new techniques of brain imaging, including computed tomography, opening up a new world of opportunities for treatment. He was a strong advocate for equity of access of older people to neurological investigation and treatment.
This service was greatly welcomed by geriatrician colleagues throughout west and central Scotland; they could rely on him to provide an expert opinion on their difficult and complex patients. Many trainees learned from watching him in action on the ward rounds or at the clinic.
His ability to recognise complex patterns of disease and reach specific and accurate diagnoses was legendary.
Caird published almost 200 peer-reviewed papers, including some on the epidemiology of disability, Parkinson’s disease and the diagnosis of neurological disorders in older age; he also wrote numerous book chapters and edited authoritative books. He was a strong supporter of the professions allied to medicine (particularly speech and language therapy) and their role in rehabilitation, and published extensively on this subject. His written output was always clear and easy to understand, even when exploring or explaining difficult concepts. His contributions were recognised by the award of an Honorary Fellowship of the Royal College of Speech and Language Therapists in 1992; and of the British Geriatrics Society’s President’s medal in 1993.
Caird was succeeded in the Chair by David Stott (1994-2019), and the department moved to Glasgow Royal Infirmary. Peter Langhorne joined the department as Senior Lecturer (1994) and became Professor of Stroke Care (2000-current). Terry Quinn joined as Lecturer (2009-2015) and became Senior Lecturer (2015-current). The Department’s main areas of interest include –
- Causes and prevention of ill-health, disability and cognitive decline in later life, including lifestyle and the impact of common diseases (including circulation, blood pressure, cholesterol and thyroid problems)
- Care of disabled older people including optimising rehabilitation to minimise and prevent disability after stroke
- Practical methods of cognitive assessment (including delirium and dementia) in older people
- Systematic reviews including the interpretation and implementation of research findings into clinical practice (focusing particularly on cognitive decline and dementia, rehabilitation after stroke and other disabling conditions in older age)
The group has been highly successful in securing substantial research funding from Government (including European Union FP7 program, Medical Research Council, National Institute for Health Research, and Scottish Executive Chief Scientist’s Office) and from charities (e.g. Stroke Association, Chest Heart and Stroke Scotland, Wellcome Trust).
The group is highly productive in outputs from research; this includes over 80 peer-review publications from start of 2016 to late 2017. Publications have featured in high profile scientific journals such as the New England Journal of Medicine, Annals of Internal Medicine, British Medical Journal and the Lancet.
This research has been highly influential in improving clinical practice, including contributing to evidence-based clinical guidelines. The Department has productive collaborations worldwide.
NHS Contributions
Dr John Dall was the first consultant appointed at the Victoria Infirmary Geriatric Unit (built 1971), renamed the Mansionhouse Unit in the late 1990s. It was the first stand-alone specialist geriatric unit of its kind in Scotland, opening in 1972, followed by the Day Hospital in 1973. He was President of the British Geriatrics Society. President of the Clinical Section of the International Association of Gerontology and of the European Region.
He retired from clinical practice in 1992 and thereafter was Chairman of the Board of Management of the Victoria Infirmary NHS Trust until 1996. He was awarded an OBE, Order of St John and Honorary Doctorate of the University of Ottawa for his work in developing Older People's services in Canada.
Dr Margaret Roberts was consultant at the Victoria Infirmary (1980- 2013). She was Associate Medical Director of the Health Board (2006-2014) and received a British Geriatrics Society Lifetime Achievement Award in 2015.
Dr Brian Williams was Senior Lecturer, University of Glasgow (1974-77) and Consultant in Administrative Charge, West Glasgow Geriatric Medicine Service (1977-2009). He was President of the British Geriatrics Society (1998-2000) and President of the Royal College of Physicians and Surgeons of Glasgow (2006-2009). He was awarded a CBE.
Dr Paul Knight is consultant physician in geriatric medicine, Royal Infirmary (1987-current), and Director of Medical Education, NHS Glasgow (2009-current). He was President, British Geriatrics Society (2012-2014). He was awarded an OBE in 2017 for services to geriatric healthcare.
Professor David Stott
Images unless otherwise noted provided by Professor Stott