The dramatic changes in the demographics will increase the number of elderly people from today's 10 % to 20% of the population in 2050, which is considered of one of the biggest challenge for our society. Geriatric therapeutic care is a multidisciplinary task that starts early on in the therapy of older adults and involves all stakeholders, including the patient, clinicians, physician, pharmacist, nurse, pharmaceutical industry and sciences and health care providers and policy makers [1]. When chronic diseases develop along with the increasing age and people start to take regularly medicines. With other diseases or symptoms occuring additional medications are given in the best intend of curing. Various physiological, biological, physical and social functions are changing with age too, leading to an increasingly heterogeneous patient group of the people 65 years and older. With 30-50% of all prescription drugs elderly patients represent the majority of drug users; however, their needs are poorly recognized in drug products development as well as their perception on medicines and their individual goals in drug prescription and therapy. Changes in the physiological and functional capacities, declining cognitive functions, impaired vision [2], increasing motoric limitations [3], an increasing difficulty of swallowing [4] and an increasing number of chronic diseases occurs with age. Within our drug product development programs the needs of special patient populations like elderly have to be taken into consideration. Age related changes need to be better understood and integrated into an overall therapeutic care plan that reflects the patient expectations and goals in the therapy as well as the patient life style to be executable. The author would like to thank all members of the 'Geriatric Medicines Society' for the contributions to this paper. [1] Stegemann S, Ecker F, Maio M, Kraahs P, Wohlfart R, Breitkreutz J, Zimmer A, Bar-Shalom D, Hettrich P, Broegmann B. Geriatric drug therapy: Neglecting the inevitable majority. Ageing Res Rev. of visual impairment in people aged 75 years and older in Britain: results from the MRC trial of assessment and management of older people in the community. Br J Ophthalmol. 2002; 86, 795-800. doi:10.1136/bjo.86.7.795 [3] Atkin PA, Finnegan TP, Ogle SJ, Shenfield GM. Functional ability of patients to manage medication packaging: A survey of geriatric inpatients.

The Singer-Blom tracheoesophageal puncture procedure for surgical-prosthetic voice restoration has proved to be a viable option for alaryngeal speech rehabilitation. Following tracheoesophageal puncture, occlusion of the tracheostoma shunts pulmonary air through the Blom-Singer prosthesis into the cervical esophagus. The pulmonary air passing through the cervical esophagus and into the hypopharynx causes a portion of the upper alimentary tract to vibrate in a manner similar to that of the pharyngoesophageal segment during the production of esophageal speech. To study the location and shape of the vibratory segment in tracheoesophageal speakers, videofluoroscopy and simultaneous voice recording were performed with 16 patients. To analyze the vibratory segment(s), photographs were made of the videotaped image while it was stopped during the patients' production of the /a/ sound. The most frequent location of the vibratory segment was in the lower third of the neck, which corresponds to cervical vertebrae C5 through C7. Five of the subjects had two separate vibratory segments and two other subjects had long vibratory segments. The vibratory segment(s) in tracheoesophageal speakers was found to be similar to the vibratory segment(s) in esophageal speakers.

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