[Advanced organ failure in the elderly. Some issues from a geriatrics, palliative medicine and bioethics perspectives].

Objective: To analyze the literature as regards the knowledge, skills and attitudes that these disciplines can provide in improving technical, ethical and human quality health care in the elderly with advanced organ failure, multimorbidity, frailty and progressive dementia.

Material And Methods: A comprehensive review focused on available references on the interrelationship between geriatric medicine and palliative medicine, education in bioethics, prognostic tools, functional status, and the humanization of health care.

Results: Advance care planning, comprehensive geriatric assessment, the study of the values of the patient and their introduction in decision-making process, as well as the need to promote moral, care, and healthcare organizational ethics, are essential elements to achieve this objective.

[Sexual dysfunction in the elderly. Pathophysiological and medical issues. Treatment of erectile dysfunction].

Erectile dysfunction (ED) is a very distressing condition that not only negatively affects the elderly man's sexual ability, but also his overall quality of life and that of his partner. Encouraging men, alone or as a couple, to seek professional help is a major educational challenge which needs to be met by medical, social and political initiatives. The exact pathogenesis of ED remains unknown, but is presumed to be multifactorial; vascular disease is the most frequent cause with endothelial dysfunction being the common denominator.

[Gait impairment and dysphagia due to a giant basilar aneurysm in a nonagenarian].

We describe the case of a 90-year-old woman with a giant fusiform cerebral aneurysm of the basilar artery who developed progressive ataxia and dysphagia. The interest of this case lies in the type, size, localization and clinical manifestations of the aneurysm. We analyze the case and review the main features of this entity.