[Geriatrics, a social medicine challenge]

The number of old people in our society is strongly increasing. In 1960 1.4 percent of the German population were older than 80 years, in 1993 this percentage was 3.8. 4000 persons older than 100 years are living in Germany today. A great number of these old people are ill and in need of help, often being multimorbid. It has to be the task of geriatrics to increase the number of symptom-free years and to relieve arising diseases.--Cardiovascular and cancer diseases--the leading diseases in our society--are for the most part caused and maintained by external factors. But genetic defects are also increasingly getting involved. About 5000 genetic defects in man have been described so far and results of the latest research suggest that every human being has four to eight pathologically changed genes. Which effects these genes have in the course of life is still the question. Environmental influences play an important role, also in genetically caused diseases.--The care insurance, recently established in Germany, involves considerable dangers. Most of the sick people who are in need of care are being nursed in families and households. These possibilities should be made use of also in the future. The number of people demanding care benefits will continuously rise in the coming years and the extent of necessary financial support is threatening to increase excessively. Bureaucratic selection procedures should be avoided. An important role will come up to the doctors in this field. It must be avoided letting the cultural evolution get out of control. This is also true for the field of geriatrics and gerontology.