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Chronic illness in the middle years

Tim Usherwood
Med J Aust 2003; 179 (5): . || doi: 10.5694/j.1326-5377.2003.tb05527.x
Published online: 1 September 2003

Middle age is when the accumulated interactions of genetic predisposition, environment and lifestyle commonly start to impact on health. Ischaemic heart disease and chronic obstructive pulmonary disease, for example, often become symptomatic in these years. The World Health Organization predicts that by 2020 these two conditions will be among the five leading causes of disease burden globally. Ischaemic heart disease is already the leading cause of disability in Australia and is the most common cause of death among Indigenous Australians.


  • Discipline of General Practice, University of Sydney at Westmead Hospital, Sydney, NSW.


Correspondence: 

  • 1. Scottish Intercollegiate Guidelines Network (SIGN). Secondary prevention of coronary heart disease following myocardial infarction. Edinburgh: SIGN, 2000.
  • 2. MacNee W, Calverley PM. Management of COPD. Thorax 2003; 58: 261-265.
  • 3. Wagner EH, Austin BT, Von Korff M. Organizing care for patients with chronic illness. Milbank Quarterly 1996; 74: 511-544.
  • 4. Vermeire B, Hearnshaw H, Van Royen P, Denekens J. Patient adherence to treatment: three decades of research. J Clin Pharm Therapeutics 2001; 26: 331-342.
  • 5. Ring IT, Brown N. Indigenous health: chronically inadequate responses to damning statistics. Med J Aust 2002; 177: 629-631. <MJA full text>
  • 6. Standing Committee on Aboriginal and Torres Strait Islander Health. Aboriginal and Torres Strait Islander Health Workforce National Strategic Framework. Canberra: Australian Health Ministers’ Advisory Council (AHMAC), 2002.

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