Loneliness has been consistently identified as one of the specific ‘social problems’ which accompanies old age and growing older: 90 per cent of the general population of Britain feel that loneliness is a problem associated with old age. There is a widespread presumption that loneliness and isolation have become more prevalent in Britain in the period since the Second World War as a result of the decline in multi-generation households and changes in family structure. This paper examines the accuracy of this stereotype and considers if current cohorts of older people are more likely to report experiencing loneliness than previous generations of elders, through a comparative analysis of historical and contemporary data. Historical data are provided by three ‘classic’ social surveys undertaken in England between 1945 and 1960. Contemporary data are from a postal survey of 245 people aged 65–74 living in South London in 1999. The questions used in all four surveys were comparable, in that respondents self-rated their degree of loneliness on scales ranging from never to always. The overall prevalence of reports of loneliness ranged from five to nine per cent and showed no increase. Loneliness rates for specific age or gender sub-groups were also stable. Reported loneliness amongst those living alone decreased from 32 per cent in 1945 to 14 per cent in 1999, while the percentages decreased for both those reporting that they were never lonely and that they were ‘sometimes’ lonely.

PIP amongst older people in the UK, although declining, remains at a high level. The association of PIP with age, deprivation and care homes is largely explained by the higher overall prescribing rates in these groups. The overall rise in prescribing emphasizes that polypharmacy does not necessarily increase PIP and attempts to reduce PIP by focusing on polypharmacy have not been successful. Reductions in PIP have previously been achieved by introducing national guidelines (e.g. co-proxamol), but might also be achieved by alerting practitioners at the point of prescribing.

PURPOSE. To examine whether treatment with oral blood-pressure-lowering medication or statins influences the risk of glaucoma. METHODS. This study was a case-control investigation, nested within a computerized primary care database of 177 general practices across the United Kingdom; 8778 cases diagnosed and/or treated for glaucoma between 2000 and 2007, and 8778 glaucoma-free controls matched for age, sex, and practice. Odds ratios for treatment with oral antihypertensives (including selective beta(1) and nonselective beta-blockers) and statins in the 5 years before diagnosis were calculated by logistic regression, adjusted for a marker of socioeconomic position and number of drug types prescribed (as a measure of health service usage). RESULTS. Prevalence of oral beta-blocker use in the 5 years before diagnosis was lower in the cases (22.5%) than in the controls (23.6%), adjusted odds ratio (OR) 0.87 (95% confidence interval [CI], 0.80-0.94). This effect was presence with treatment with beta(1)-selective medications (OR, 0.81; 95% CI, 0.74-0.88) but not with nonselective medications (OR, 1.08; 95% CI, 0.94-1.24). The prevalence of thiazide use was higher among the glaucoma cases than among the controls (OR, 1.13; 95% CI, 1.04-1.23). Neither statins nor other antihypertensive treatments were associated with the risk of glaucoma. CONCLUSIONS. Oral beta(1) beta-blockers may protect against development of glaucoma. The current consensus on the relative importance of beta(2) receptor blockade in treating glaucoma may have to be reviewed. Changes in prescribing oral beta-blockers for cardiovascular disorders may affect the number of those who eventually have glaucoma. There is no evidence to suggest that statins have a preventive role in glaucoma.

Prescription of potentially inappropriate medication, particularly benzodiazepines, to older people remains at a high level in the UK. Levels were higher than those seen in published data from the Netherlands, however the low rate of co-proxamol prescribing in the Netherlands explains much, but not all, of the difference. Future international comparisons, based on more careful delineation of the criteria, may play a valuable role in pharmaco-vigilance and can identify areas where regulation of prescribing may reduce risks to older patients.

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