This issue of Medical Clinics, guest edited by Dr. Danelle Cayea, is devoted to Geriatrics. Articles in this important issue include: Thoughtful prescribing and deprescribing, Identifying goals of care, Overview of brief, high yield geriatrics assessment for clinic and hospital, Fall prevention, evaluation, and treatment, Cognitive impairment evaluation and management, Urinary and bowel symptoms, Sadness and worry in older adults, Chronic pain syndromes in older adults, Osteoporosis, Evaluation and management of difficult symptoms of older adults primary care, Perioperative assessment and management, Challenges related to safety and independence, and much more.

The average age of the world's population is increasing at an unprecedented rate and this increase is changing the world. This "Silver tsunami" emphasizes the need to provide advanced training in epidemiology and increase the cadre of experts in the study of aging. This book is designed to summarize unique methodological issues relevant to the study of aging, biomarkers of aging and the biology/physiology of aging and in-depth discussions of the etiology and epidemiology of common geriatric syndromes and diseases. Contributing authors in the book represent many disciplines, not only epidemiology and clinical geriatrics, but also demography, health services, research, cardiovascular disease, diabetes, psychiatry, neurology, social services, musculoskeletal diseases and cancer. The aim of the book is to provide a broad multidisciplinary background for any student/researcher interested in aging. The material in the book is organized and comprehensive. It represents the most up-to-date information on the scientific issues in aging research written by academics who specialize in research and training in the broad field of aging. The structure and organization of the book reflects our course series in the Epidemiology of Aging starting with the broad issues of demography and methodology, and then addressing specific health conditions and geriatric conditions common to older persons.

This book aims to clarify the potential association between frailty and cardiovascular disease in older people. Covering the biological as well as the clinical point of view, it allows researchers and clinicians to discover the significance of this topic. The contributions cover the most important aspects in the potential relationship between frailty and cardiovascular disease. In particular, authoritative authors in this field have clarified the definition and the epidemiology of frailty and cardiovascular disease in older people. A large part of the volume is dedicated to the biological mechanisms of frailty and cardiovascular disease, trying to find those in common between these two conditions. Since this book is dedicated to both researchers and clinicians, we have proposed some chapters to the importance of comprehensive geriatric assessment in the evaluation and treatment of cardiovascular diseases and frailty. In this regard, the importance of geriatric evaluation in cardiac surgery for older people is well covered. Finally, the importance of cardiac rehabilitation and physical exercise is summarized, being, actually, the most important treatments for both frailty and cardiovascular disease. Written by many well-known and widely published experts in their respective fields, this book will appeal to a wide readership such as researchers in the field and clinicians, especially suited in geriatric medicine and cardiology who, every day, face frail older patients.

This book examines the concepts of preventive care and health promotion specifically in the context of the elderly. It adopts a broad concept of health and defines a number of goals around this theme. Thereafter it provides a succinct, up-to-the-minute critique of the worth, risks and costs of preventive care and health promotional strategies for older people. A broad range of such strategies are considered including cancer prevention, the prevention of non-cancer health problems and strategies aimed at enhancing functional status and strengthening the social support network. Principles for tailoring these strategies to the varied needs and wishes of elderly people are outlined. Likewise, practical measures are discussed for integrating these preventive strategies into the existing health care system. In particular, the role of screening, case-finding and targeting strategies in primary care are reviewed in detail. The book concludes with a wider look at the cost implications of preventive care for the purchasers of health and health care services.

BACE inhibitors and their use in the treatment of Alzheimer's Disease

BACE (β-site of APP cleaving enzyme) is a critical component in Alzheimer's Disease (AD), and the development of BACE inhibitors shows great potential as a therapy for the disease. "BACE: Lead Target for Orchestrated Therapy of Alzheimer's Disease" covers virtually all aspects of BACE from initial identification, discovery of inhibitors, and challenges in clinical development, while providing a global understanding essential for productive and successful drug discovery.

This book details the story of the discovery of BACE and its role in AD and comprehensively discusses:

The development of BACE inhibitors as therapeutics for Alzheimer's disease

The research that led to the identification of BACE

New BACE inhibitors currently being clinically tested

ADME (absorption, distribution, metabolism, excretion) and clinical trial design--topics not addressed in current field literature

Cutting-edge technology such as high-throughput screening, structure-based drug design, and QSAR in context of BACE inhibitors and Alzheimer's drug discovery

Other approaches to BACE inhibition based on interaction with the precursor protein APP

By enhancing the reader's understanding of the various aspects of the BACE drug-discovery process, this much-needed reference will serve as a key resource for all scientists involved in Alzheimer's research--and inspire new approaches to treatment of AD.

Evidence pertaining to continual violence throughout the life cycle coupled with the experience of growing old in a life permeated by intimate violence is scarce. And the focus is usually on the victims usually, the older, battered women and seldom on their aging partners or adult children who were part and parcel of the violent dynamics in the family system. With the increase in longevity and the older population s subsequent growth in size, the number of elderly couples living and aging in long-lasting conflictive relationships is on the rise.

The relatively intense preoccupation with elder abuse in the gerontological literature in recent years has not specifically addressed long-term intimate violence among the old adults and its lasting consequences. Similarly, the literature on intimate intergenerational relationships in old age has usually focused on normative exchanges between partners and their extended family, including their adult children. Therefore, conflictive relationships, and particularly violent ones, have also fallen outside the scope of this body of research. This volume describes and analyzes the various perspectives of family members concerning life, and particularly old age, in the shadow of long-term intimate violence. It explores how people make sense out of living and aging in violence, how interpersonal, familial and cross-generational relationships are perceived and reconstructed and how we-ness is achieved, if at all, in such families."

This fortieth volume of Annual Review of Gerontology and Geriatrics focuses on economic inequality in later life. Cutting-edge chapters discuss the complex factors that can lead to advancing our understanding of economic inequalities. The volume includes perspectives on the changing pathways in later life, retirement income and security, race and associated advantages and disadvantages, and social rights for the elderly. The contributions in this volume discuss state-of-the-art research and keen insights into this increasingly important topic.Key Topics: Reconstructing Work and Retirement: Changing Pathways and Inequalities in Late Life Neoliberalism and the Future of Retirement Security Families in Later Life: A Consequence and Engine of Social Inequalities Increasing Risks, Costs, and Retirement Income Inequality Intentionality, Power, and Systemic Processes: Race and the Study of Cumulative Dis/Advantage Social Rights of the Elderly as Part of the New Human Rights Agenda: Non-contributory Pensions in Civil Society in Mexico

Assisted Living Administration and Management: Effective Practices and Model Programs in Elder Care 2nd Edition provides students and healthcare professionals with the most up to date and essential knowledge on assisted living and residential care. This comprehensive text empowers current and future assisted living administrators to employ effective practices, understand model programs, and learn the necessary tools and tips to maximize the overall health, safety, and comfort of residents in their care. Organized by domains of practice, it also covers content information required to prepare for state-based Residential Care and Assisted Living (RC/AL) administrator certification or licensure exams.The textbook is structured in five parts which instruct on how to build and manage effective assisted living and residential care communities, beginning with Organizational Management and progressing through Human Resources, Business and Financial Management, Environmental Management, and Resident Care Management. The second edition includes six new chapters on evolving topics, such as interprofessional practice, home and community-based services (HCBS) as alternatives to assisted living, information and communication technology (ICT), LGBT issues, memory care units, and palliative and hospice care. Chapters feature learning objectives, case studies, effective practices, and more enabling students and healthcare professionals to evaluate, analyze, and synthetize information on how to best operate, manage, and lead assisted living communities. Useful for any long-term care and health management professional or student in the fields of gerontology, health administration, and long-term care administration, this comprehensive book covers the most crucial aspects of assisted living and residential care management the most abundant and fastest growing senior living line of service in the United States. Key Features: Describes real-life situations and challenges associated with Assisted Living Administration with pragmatic solutions which highlight the most effective practices and model programs in elder care Contains new chapters on interprofessional practice, home and community-based services (HCBS) as an alternative to assisted living, information and communication technology (ICT), LGBT issues, memory care units, palliative and hospice care Highlights useful details on business and financial management, including guidelines for marketing facilities and services, important legal issues and terms, and evolving public policy issues Incorporates chapters on environmental management, with information on accessibility, fire safety, disaster preparedness, universal design and aging in place, and much more Emphasizes the importance of holistic, resident care management by examining the biological, psychological, and social aspects of aging Prepares students to qualify and sit for the state certification or licensure examination as Assisted Living Administrators Includes access to the fully downloadable eBook and instructor resources including a test bank

This issue of Clinics in Geriatric Medicine, guest edited by Dr. Susan Friedman, is devoted to Healthy Aging. Articles in this issue include: Healthy Aging Across the Stages of Old Age, How Geriatric Principles Inform Healthy Aging, Multimorbidity, Function and Cognition in Aging, Preserving Cognition, Preventing Dementia, Preserving Engagement, Nurturing Resilience, The Frailty Cycle: Reducing frailty to promote healthy aging, Addressing Obesity to Promote Healthy Aging, Lifestyle (Medicine) and Healthy Aging, Nutrition and Healthy Aging, Physical Activity and Healthy Aging, Mindfulness, Stress, and Aging, The Role of Prevention in Healthy Aging, Best Practices for Promoting Healthy Aging, Getting from Here to There: Motivational Interviewing and Other Techniques to Promote Healthy Aging, and more.

This unique, concise ready reference for daily use collates for the first time the most useful, practical and simple assessment scales used in geriatric settings. It provides tools to identify clinical conditions and health outcomes objectively and reliably. It is essential as a clinical primer and everyday reference guide for all practising and training members of multidisciplinary teams, including consultants and doctors in specialist training, career grade doctors and general practitioners, and medical students; nurses, health visitors, dieticians, and social workers; allied health professionals such as physiotherapists, occupational therapists, speech and language therapists; and managers of elderly care services.'Assessment is central to the practice of Geriatric Medicine. All members of the multidisciplinary team require a sound knowledge of the basic principles of measurement scales. We need to be competent in using and selecting appropriate scales, understanding which scales are valid and fit for purpose. Unfortunately, up to now, this has been a difficult task often requiring reference to original papers. Dr Gupta's scholarship has come to the rescue. He has trawled through the many hundreds of scales available selecting those most useful for the specialty.This book will be valuable to all members of the multidisciplinary team. Dr Gupta has done an excellent job outlining the theory and practice of measurement scales. He has put together an extremely useful compendium of scales. I congratulate him and wish his publication every success. I can foresee this publication becoming an essential text for every unit library and valuable book for individual clinicians.' - Dr Jeremy Playfer in his Foreword. 'This book summarises the most commonly used validated assessment scales which can be used by medical students, postgraduate trainees, consultants and the multi-disciplinary team members. I hope a copy of this book will be kept on every ward, outpatient department and GP practice for daily use and reference' - Professor Bim Bhowmick OBE in his Foreword.

This book illustrates the imperative for late-life depression prevention, introducing a broad range of approaches to prevention and provides detailed examples of clinical applications of late-life depression prevention - all with consideration of medical and scientific, social, economic and global health perspectives. Clear guidelines are delineated for assessing, treating and preventing such conditions as depression and anxiety, dementia, psychosis and mania, sleep disturbances and personality disorders. Written by experts in the field, this text considers the complicating conditions that depression may incur higher costs and create during the course and treatment of comorbid major medical conditions that are also highly prevalent in older adults - including diabetes, hypertension and heart disease. Prevention of Late-Life Depression: Current Clinical Challenges and Priorities is an important new volume that will be useful to all providers that are concerned with the mental health of our rapidly expanding aged population.

Most scholars do not consider the long-term nature of caregiving, but rather focus on a specific developmental period (e.g., old age) or a specific disability (e.g., cancer). Yet the most important lessons about caregiving may occur at any age, regardless of disabilities or other limitations. Caregiving is a lifelong process. It begins in a mother's womb, continues throughout the lifespan, and ends after death. Caregiving Across the Lifespan emphasizes caregiving as a process that occurs throughout one's life. It discusses infant care, the developmental needs of children and adolescents, the many caregiving issues in adulthood and mid-life, and finally end-of-life care and bereavement. Key coverage includes: Examining caregiving issues across a developmental perspective. Caregiving from infancy through early childhood through end of life. Mid-life and multigenerational bonds and responsibilities. Caregiver identity in older adults. Family caregiving at the end of life. This must-have volume offers a wealth of insights and ideas for researchers, practitioners, and graduate students across the caregiving fields, including psychology, social work, public health, geriatrics and gerontology, and medicine as well as public and education policy makers.

Although textbooks on the subject of Osteopathy have been in print for over 100 years, there is little material specifically addressing the treatment of adults over the age of 50, in spite of the increase in this demographic group. This book is intended to provide a study of the biomechanics and physiology of somatic dysfunction as it relates to individuals over the age of 50. Practitioners require information about the diagnosis of somatic dysfunction and application of osteopathic manipulative treatment specifically as it relates to this age group - and this is where this book is invaluable. - The main body of the text considers the relevance of somatic function and dysfunction in multiple clinical areas including cardiology, pulmonology, gastroenterology, urology, neurology and rheumatology. - The diagnostic approach to the patient over the age of 50 and osteopathic manipulative treatment is thoroughly described. This book provides information on the biomechanics and physiology of somatic dysfunction for the osteopathic treatment of older adults in a thorough, yet easy to approach, fashion for practitioners of osteopathy and osteopathic medicine.

The Health Services Executive (HSE (TM)): Tools for Leading Long-Term Care and Senior Living Organizations serves as a contemporary and comprehensive resource that addresses each of the core professional domains of practice and leadership essentials for long-term care administration students and professionals. With sections dedicated to post-acute care settings, operations, leadership and management, this textbook covers information pertinent to the spectrum of senior living service lines - from inpatient rehab facilities, long term acute care hospitals, nursing homes, assisted living and residential care communities to home-and-community-based services. It is a practical reference for both undergraduate and graduate students preparing to enter the field of long-term care administration and leadership, for professionals transitioning to another line of post-acute service. The textbook begins with a thorough history of the field, including the development of senior services in the United States. Section I then describes the components of customer care, supports, and services before transitioning into Section II, which addresses operations, including the core practice domains of effectively managing human resources, finances, and the environment. Section III offers a framework for leadership, covering strategic thinking and innovation, marketing and public relations, critical thinking and operation practice, working with people throughout the long-term care team, customer service, and personal development. Case examples, discussion questions, leadership essentials, high-impact practices, key points, and NAB domain competencies conclude each chapter. Written by two highly experienced long-term care administrators, this textbook is intended for those preparing for the examinations administered by the National Association of Long-Term Care Administrator Boards (NAB) for the HSE (TM) qualification or licensure for individual lines of service, such as for Nursing Home Administration (NHA), Residential Care and Assisted Living (RC/AL) and Home-and-Community-based Services (HCBS). Key Features: Provides best practices for leadership and management across the continuum of long-term care and senior living services Covers all five NAB professional practice domains - Customer Care, Supports and Services, Human Resources, Finance, Environment, and Leadership and Management Includes case problems, discussion questions and more to foster critical thinking and decision-making skills Offers coverage of the most unique differences among service lines that are part of the HSE (TM) initiative Insightful quotes from industry leaders woven throughout chapters for practical tips and words of wisdom Comes with access to a fully downloadable eBook, as well as a full suite of instructor resources including PowerPoint slides and a test bank

Geriatric urology represents one of the largest overall sectors of care provided within the specialty of urology. As the incidence and prevalence of many clinical urologic conditions increase significantly in older adults, the practice of urology involves a need for advanced knowledge of the basic principles of geriatrics. Geriatric Urology outlines important topics in the care of elderly urology patients. The first section covers the biology of aging, changes in the genitourinary system, and common diseases including urologic conditions that may serve as warning signs of other disorders. Section two covers geriatric syndromes and implications for urologic care including frailty, polypharmacy, dementia, and wound healing. Urologic conditions in older adults are explored in detail including urinary incontinence, pelvic organ prolapse, urinary tract infection, nocturia, and benign prostate diseases. Other topics covered include obtaining informed consent, development of advance directives, palliative medicine and care of the dying patient. Geriatric Urology is of great value to urologists, geriatricians, internists, residents and family practitioners.

Written by an experienced clinician and researcher in the field, this reference provides practical information on the clinical recording techniques, physiologic origins, and applications of electroretinogram (ERG), electro-oculogram (EOG), and visual evoked potential (VEP) tests.

Geriatric Rehabilitation addresses the fact that this is an age in which individuals have increasing longevity, better health care, education and expectations of health care which present new, increasing and even radical challenges to health care providers. The care of our older patients in rehabilitation settings demands the broad understanding of the key differences in strategies to care for older adults. The combined skills embraced in rehabilitation and geriatrics are presenting unprecedented opportunities for both fields to make substantive and even ground-breaking improvements in the lives of millions of older adults who entrust their lives to us. Rarely in one's medical career are such opportunities so evident and achievable. Geriatric Rehabilitation edited by Dr. K. Rao Poduri, MD. FAAPMR draws on a distinguished group of authors who are the front-line providers of care to the older adults. This book presents the full spectrum of the unique care needs of older patients who need the combined skills of physical medicine and geriatrics. It provides an easily accessible means of acquiring and improving these new skills for all those involved in geriatric care.

This book critically explores the world of older prisoners to provide a more nuanced understanding of imprisonment at old age. Through an ethnographical study of male and female older prisoners in two Belgian prison settings, one in which older prisoners are integrated and one in which they are segregated, it informs debates and seeks to recognise ageist discourse, attitudes, practices in prison. The Older Prisoner seeks to situate the older prisoner from both a penological and gerontological perspective, organised around the following broad themes: the construction of the older prisoner, the physical prison world, the social prison world, surviving prison and giving meaning. The book allows readers to navigate between contrasting perspectives and voices rather than reinforcing traditional narratives and prevailing discourses on the older prisoner. In doing so, it hopes to open up a broader dialogue on ageing and punishment. It also offers insights into the concept of meaning in life as an analytical tool to study prisoners.

This issue of Clinics in Geriatric Medicine, guest edited by Dr. Daniel E. Forman, is devoted to Cardiac Rehabilitation. Articles in this outstanding issue include: Cardiac Rehabilitation: No Such Thing As 'Too Old'; Evaluating and Treating Frailty in Cardiac Rehabilitation; Utility of Home-based Cardiac Rehabilitation for Older Adults; Benefits of Smart devices, Wearables, and Other Telehealth Options to Enhance Cardiac Rehab; Resistance Training in Cardiac Rehabilitation for Older Adults; High Intensity Interval Training (HIIT) in Cardiac Rehabilitation for Older Adults; Pre-habilitation: The right medicine for older frail adults anticipating TAVR, CABG, and other cardiovascular care; Using Cardiac Rehabilitation to Adjust Medications in Older Adults: Aggressive Prevention and Deprescribing as 2 Sides of the Same Coin; Gender Disparities in Cardiac Rehabilitation Among Older Women: Key opportunities to improve care; Cardiac Rehabilitation for TAVR; Cardiac Rehabilitation for Heart Failure in Older Adults; Cardiac Rehabilitation for Peripheral Arterial Disease (PAD) in Older Adults; Cardiac Rehabilitation as Part of Management in Post-acute Care (PAC): Opportunities for improving care; and Tailoring Assessments in Cardiac Rehabilitation for Older Adults: The relevance of geriatric domains.

Opening with a clear overview of the biology and demographics of aging, this text authoritatively summarizes the most recent knowledge on disorders of the ears, nose, paranasal sinuses, oral cavity, larynx, voice, throat, and neck in the geriatric population. With chapters by prominent leaders in the discipline, this reference serves as an invaluable source of guidance on perioperative assessment, operative procedures and outcomes, and new strategies for reconstructive and cosmetic surgery.

In a vicious cycle, poor nutritional health leads to acute and chronic disease, and disease states are catastrophic to nutritional health. The magnitude of nutritional depletion from any cause depends to a large extent on the nutritional reserves an individual has accumulated over time. In our increasingly older population, nutritional reserves are marginal and the magnitude of the effect on nutritional health is amplified. Strategies to improve nutritional health in older individuals require a unique approach and sensitivity to the individual's needs. Drawing from a group of outstanding experts in the field, Geriatric Nutrition is a state-of-the-art review of current nutritional thinking. Beginning with an overview of nutrition in older persons, the book addresses nutrition epidemiology, obesity, immunity, as well as molecular theories of aging. A detailed scientific review of nutritional requirements follows with chapters on energy balance, water metabolism, vitamin disorders, and trace elements. Techniques for the clinical assessment of nutrition in older adults include comparisons between US and European Union strategies and standards. The book includes a revealing section on the management of undernutrition in nursing homes and assisted living environments. It offers prescriptions for enteral and parenteral nutrition, as well as protein energy undernutrition. A significant portion of the book covers nutrition recommendations in specific disease states, including psychological issues such as dementia and depression, cancer, diabetes, anemia, and fracture risk. The book also considers multicultural and ethical issues relevant to the sensitive treatment of older individuals. Exploring exciting new ideas in normal, pathological, and optimal nutrition, Geriatric Nutrition ties basic research with clinical practiceto further the understanding of nutrition in older persons.

This edited volume is a compilation of 30 articles discussing what constitutes food for health and longevity. The aim is to provide up-to-date information, insights, and future tendencies in the ongoing scientific research about nutritional components, food habits and dietary patterns in different cultures. The health-sustaining and health-promoting effects of food are certainly founded in its overall composition of macronutrients and micronutrients. However, the consumption of these nutrients is normally in the form of raw or prepared food from the animal and plant sources. The book is divided into four parts and a conclusion, and successfully convenes the well-established information and knowledge, along with the personal views of a diversified group of researchers and academicians on the multifaceted aspects of nutrition, food and diet. The first part reviews the scientific information about proteins, carbohydrates, fats and oils, micronutrients, pro- and pre-biotics, and hormetins, along with a discussion of the evolutionary principles and constraints about what is optimal food, if any. The second part discusses various kinds of foods and food supplements with respect to their claimed benefits for general health and prevention of some diseases. The third part brings in the cultural aspects, such as what are the principles of healthy eating according to the traditional Chinese and Indian systems, what is the importance of mealing times and daily rhythms, and how different cultures have developed different folk wisdoms for eating for health, longevity and immortality. In the part four, various approaches which are either already in practice or are still in the testing and research phases are discussed and evaluated critically, for example intermittent fasting and calorie restriction, food-based short peptides, senolytics, Ayurvedic compounds, optimal food for old people, and food for the prevention of obesity and other metabolic disorders. The overreaching aim of this book is to inform, inspire and encourage students, researchers, educators and medical health professionals thinking about food and food habits in a holistic context of our habits, cultures and patterns. Food cannot be reduced to a pill of nutritional components. Eating food is a complex human behavior culturally evolved over thousands of years. Perhaps the old adage "we are what we eat" needs to be modified to "we eat what we are".

This book belongs to a long tradition at the Tavistock Clinic of work focused on the mental and emotional well-being of the elderly. It applies psychoanalytic thinking to areas that have generally attracted very little sustained attention over the years.

This book brings together a selection of classic psychoanalytical papers related to ageing, dying and death that have appeared in the renowned International Journal of Psychoanalysis (IJP). Two papers address the analysis of an elderly patient directly and bring the work and the challenges it brings vividly to life. Also explored are such issues as death and the midlife crisis, loneliness and the ageing process, ageing and psychopathology, fear of death, transference and countertransference issues, and the final stage of the dying process. 'The idea behind this monograph is to alert interested psychoanalysts, students and those working from an interdisciplinary standpoint to the possibility of a better understanding of the ageing process as well as a group of potential analysis that seem to exist in the shadow of our professional communications. 'Each stage of life has its own somatic and psychic normality as well as pathology.