Book Review: Essential Geriatrics (Fourth Edition) by Henry J Woodford

Shane O’Hanlon is a Consultant Geriatrician in St Vincent’s University Hospital Dublin. He tweets @drohanlon

Reflecting on my education over the last few years, I think I may have learned most from Twitter. There is a seriously erudite group of geriatricians dropping pearls of wisdom there, of which Dr Henry Woodford is just one. I’ve seen clear answers to questions such as “What is the value (or not) of a dipstick?”, “How do I approach a DNACPR discussion?” and “How do I select appropriate bone protection medication”, with evidence and clinical experience added into the mix. I’ve often thought that it would be great to have all these mini-tutorials condensed into a textbook, but aren’t textbooks a thing of the past now?

Essential Geriatrics is an excellent counter-argument to this proposition. I previously reviewed the 3rd edition back in 2016 and gave it a 5 star rating. I boldly stated “I couldn’t be more impressed”, but reader: I was wrong!

Somehow that fantastic work has been bettered. Woodford has combed through his elegant textbook and updated the evidence base, while adding in new content including Covid-19, acute coronary syndromes and improved statistical explanations – something that I always feared, but this book makes accessible. The same logical structure has been carried over, with the major topics of Brain, Bladder & Bowel, Falls, Cardiovascular & Respiratory comprising the main sections. These are augmented by what feels like “bonus content” of common issues including but not limited to leg ulcers, arthritis, anaemia, cancer and epilepsy. Pick a topic, you’ll find it.

Readers new to geriatric medicine will appreciate the first section, which introduces ageing, frailty, CGA, care approaches for older people and medications. This means that medical students and trainees who have not yet had exposure to the area can rapidly get up to speed. For trainees with some experience, they can consolidate their clinical learning with the detailed information here. I dare say that fully qualified geriatricians would be hard-pressed not to find something new. For a book to suit so many potential readers is unique, but Woodford writes with clarity and a passion that holds the reader’s attention. For consultant colleagues who are not geriatricians, his voice makes our specialty approachable and engaging.

The comprehensive nature of the book means that every common condition is covered: stroke, dementia, Parkinson’s, delirium, incontinence, constipation, falls. Other conditions, which often challenge us to achieve a diagnosis (but are so important to consider) are also well described: progressive supranuclear palsy, posterior circulation stroke, frontotemporal dementia, mesenteric ischaemia. Of course, geriatric medicine is far more than just about a long list of illnesses and how to manage each one. In his introduction, Woodford states that “improved well-being is more than an absence of disease”. With that in mind, he also deals with mental health, health promotion, rehabilitation and palliation.

You can test your ability to digest all this knowledge by trying out the 200 single best answer multiple choice questions – a nifty addition for anyone sitting the SCE soon (but probably a good idea for all of us!). These are high-quality questions that relate to modern topics and have been freshly written – not simply rehashed from an old database.

Any textbook of almost 500 pages can feel off-putting, but this one has been plucked from my shelf on an almost-daily basis over the past 2 months since its release. I actively like dipping in when I have a spare 5 minutes, and this is made easy by the useful “Key Points” boxes at the end of each chapter. None of my questions have remained unanswered after browsing Essential Geriatrics.

To conclude, the fourth edition is a must-buy – and if you only ever buy one book this is it. It’s like having a Professor of Geriatric Medicine on your shelf; one you’d like to retweet constantly…

Rating: *****