Reduced production of DHEA associated with the diseases that accompany aging has led to its use as a nutritional supplement for antiaging, metabolic support, and other purposes. While animal studies have clearly shown substantial benefits of DHEA in combating various disease states, the effect of low levels of DHEA in humans is less established, and the mechanisms of action and potential involvement in illnesses remain unclear. DHEA in Human Health and Aging reviews the past ten years of research into this hormone and explores its potential for future study.

With contributions from a cadre of international experts, this volume examines:

• The biology of DHEA relevant to health in humans
• Areas of potential clinical importance concerning low levels of DHEA related to age or physiological change
• Prevention as well as treatment of various human disease states by changing DHEA levels
• The use of DHEA levels in predicting the risk of disease
• The role of DHEA in diabetes, fitness, infectious disease, cancer, AIDS, bone health, cardiovascular diseases, autism, and mental health
• Animal models and their relation to studies done on humans
• The effects of loss of adrenal gland function, the subsequent reduction in DHEA production, and its replacement as therapy
• Adverse effects in DHEA-supplemented women
• Mechanisms of action of DHEA in prostate and ovarian health, vascular modification, stress, memory, aggression, and Alzheimer's disease

Covering a wide range of topics, the book is compiled from contributions of experts who have each studied some aspect of DHEA and human or animal health or disease. Every chapter is self-contained, allowing for focused study on individual topics. Edited by one of the leading experts in the field of nutrition, the book presents a compelling view of the state of the science in DHEA.

This issue of Clinics in Geriatric Medicine, Guest Edited by James Watson, MD, will feature such article topics as: Frailty and Late Life Decline; The Epidemiology of Frailty and Late Life Vulnerability; The Physiology of Frailty; Frailty and Muscle Mass Decline; Frailty and Anemia; Immune System Alterations in Frailty; CMV/ Viral Infections and Frailty; Frailty and Chronic Disease; Aging Biology and Frailty; Genetic Precursors to Frailty; Frailty Interventions: Exercise; Nutritional Interventions: Vitamin D.

The book covers topics ranging from basic sciences (developmental changes in neuroanatomy and neurophysiology and effects of neuropharmacology) to special situations such as brain death, ethical issues and palliative care. It discusses various neurological surgical problems and their challenges along with common problems such as Alzheimer's and Parkinson's disease. A section on Pain covers all possible modalities for relieving pain in this patient population followed by the important issue of palliative care. The book addresses the issue of cognition decline, common in this group. The fact that basic sciences are included along with clinical sciences makes it a unique read for the audience.

This issue of Clinics in Geriatric Medicine, Guest Edited by Laurence Rubenstein, MD, MPH, and David Ganz, MD, PhD, will feature such article topics as: Epidemiology of Falls in Older Adults; Exercise for Fall Prevention; Cardiac Causes of Falls and their Treatment; Medications and Falls; Vision and Fall Prevention; Preventing Falls in the Hospital, and Public Health Approach to Falls on a State and National Level.

New trends in mental healthcare practice and a rapid increase in the aged population are causing an explosion in the fields of clinical gerontology and geropsychology today. This comprehensivesecond editionhandbook offers clinicians and graduate students clear guidelines and reliable tools for assessing general mental health, cognitive functioning, functional age, psychosocial health, comorbidity, behavior deficits, and more. Psychopathology, behavioral disorders, changes in cognition, and changes in everyday functioning are addressed in full, and a wide range of conditions and disorders common to this patient population are covered. Each chapter provides an empirical review of assessment instruments, assessment scales in their totality, a review of how these instruments are used with and adapted for different cultural groups, illustration of assessments through case studies, and information on how to utilize ongoing assessment in treatment and/or treatment planning. This combination of elements will make the volume the definitive assessment source for clinicians working with elderly patients.
*The most comprehensive source of up-to-date data on gerontological assessment, with review articles covering: psychopathology, behavioral disorders, changes in cognition, and changes in everyday functioning
*Consolidates broadly distributed literature into single source, saving researchers and clinicians time in obtaining and translating information and improving the level of further research and care they can provide
*Chapters directly address the range of conditions and disorders most common for this patient population - i.e. driving ability, mental competency, sleep, nutrition, sexual functioning, demntias, elder abuse, depression, anxiety disorders, etc
*Fully informs readers regarding conditions most commonly encountered in real world treatment of an elderly patient population
*Each chapter cites case studies to illustrate assessment techniques
*Exposes reader to real-world application of each assessment discussed"

This issue examines what is a healthy aging brain and covers preventive measures for succesful cognitive aging. Topics covered include: A road map to healthy aging brain; Cardiovascular risk factors, cerebrovascular disease burden and healthy aging brain; Healthy aging brain: Impact of head injury, alcohol and environmental toxins; Healthy aging brain: What has sleep go to do with it?; Endocrine aspects of healthy aging brain; Healthy aging brain: Role of exercise and physically active lifestyle; Healthy aging brain: Role of nutrition and nutritional supplements; Healthy aging brain: Role of cognitive reserve, cognitive stimulation and cognitive exercises; Healthy aging brain: Impact of positive and negative emotions; Dementia risk predictor. Are we there yet?; Potential future neuroprotective therapies for neurodegenerative disorders and stroke; Healthy aging brain: Importance of promoting resilience and creativity.

Articles in this issue include: Aging Male: Demographics and Unique Aspects; Sexuality and Aging Male; Late Life Onset Hypogonadism; Erectile Dysfunction; Benign Prostate Hypertrophy; Prostate Cancer; Lower Urinary Tract Symptomatology; Diabetes and Metabolic Syndrome; Frailty; Nutritional Aspects; Osteoporosis in Older Males; ip Fracture in Older Men; Sarcopenia.

Articles in this issue include: A Biopsychosocial Perspective; Aging with a Physical Disability: Maintainance and Transition in Employment, Benefits, and Insurance; Psychological Functioning; Exercise and Physical Activity; Communication Issues; Pain, Fatigue, and Sleep Dysruption; Assistive Technology; Mobility and Falls Cognitions; Aging and Disabilties: Conceptual Issues; Aging with a Physical Disability: Bridging the Aging and Disability Nexus; Aging with Spinal Cord Injury; Aging with Multiple Sclerosis; Aging with Post-Polio Syndrome and Muscular Dystrophy; Aging with Cerebral Palsy.

Health policy emphasises the role of primary and community-based services in achieving strategic change throughout the NHS. However, despite lead roles assigned to social service departments and residential and nursing home care services, difficulties remain in achieving closer working relationships. This book is a concise guide to the new initiatives in this area, including models and practical examples. It covers the recent developments encouraging partnerships between health and social care services, and is essential reading for all those involved in primary care and the social services, especially those with an interest in the care of older people. The National Primary Care Research and Development Centre series provides policy makers, commissioners, managers, primary care professionals and user organisations with up-to-date multi-disciplinary research on important issues that inform future decision-making for primary care development.

"The Encyclopedia of Aging and Health is both a comprehensive reference of best practices across gerontology-related fields and a philosophical work that inspires its readers to embrace a loftier and more global view of aging beyond disability and medications." -Gerontologist As an ever increasing percentage of the population of western societies enters "old age," health issues grow in importance in terms of the well-being of this population, economic impact within the health-care system, impacts on families and family relationships, and so many other ways. The Encyclopedia of Health and Aging presents state-of-the-art research and ready-to-use facts on health and aging. This one-volume resource captures some of the excitement of the research in the field in terms of new findings as well as conceptual developments guiding research, practice, and policy. With more than 200 entries, it covers the biological, psychological, social, and economic aspects of health and aging and impacts within the health-care system. This Encyclopedia also focuses heavily on geriatrics with respect to geriatric syndromes and common diseases of aging. Key Features Addresses a full spectrum of topics, including acute illness, Alzheimer's disease, bereavement, economic dependency, health-care costs, health promotion, hospice care, long-term care, medications, nursing homes, optimal aging, public policy, quality of life, spousal care-giving, widowhood, and much more Discusses landmark studies such as (Duke Longitudinal Studies, the Established Populations for the Epidemiological Study of the Elderly, Health and Retirement Study, and the National Long Term Care Survey) as well as important programs (Social Security, Meals on Wheels, and Medicaid/Medicare, etc.) Offers cross-disciplinary coverage with contributions from the fields of gerontology, epidemiology, health psychology, biology, sociology, health and medicine, and public policy Provides health and aging issues from around the world including Mexico, Canada, Latin America, Europe, Asia, Africa, Australia, and New Zealand Includes a list of 45 online resources on health and aging Key Themes: Aging and the Brain Diseases and Medical Conditions Drug Related Issues Function and Syndromes Mental Health and Psychology Nutritional Issues Physical Status Prevention and Health Behaviors Sociodemographic and Cultural Issues Studies of Aging and Systems of Care The Encyclopedia of Health and Aging is a must-have reference for any academic, as it appeals to a broad audience such as scholars within programs of gerontology and health, graduate students, members of the media, policy makers and health-care advocates, and the general reader.

Health care and human service professionals often experience anxiety about potential adverse legal repercussions for actions taken or not taken in the course of caring for patients or clients.

In this volume, professionally distinguished and diverse authors discuss both the real and perceived legal liability context within which health and human service delivery to older persons takes place. The benefits and costs of litigious, legislative, and regulatory interventions on the quality of care and the quality of life for recipients of geriatric services is evaluated. Most important, chapters present suggestions for ways to effectively reduce or manage legal risks and anxieties while improving patient care. This volume fills a gap in the literature by providing careful and accurate analysis of legal issues rarely translated into practical and useful advice for health care and human service professionals.

With cardiovascular disease as the leading cause of death in the United States, the topic of preventive cardiology deserves intense examination. Michael Rich and George Mensah guest edit this issue, which explores important topics, such as the burden of cardiovascular disease, updates on hypertension, hyperlipidemia, and diabetes, all geared towards the elderly patient. This issue of Clinics in Geriatric Medicine also covers the effects of physical activity on cardiovascular and non-cardiovascular outcomes, impact of strength and resistance training on cardiovascular risk factors and outcomes, cellular mechanisms and the effects of caloric restriction, obesity and the obesity paradox, and the primary and secondary prevention of cardiovascular diseases in older adults.

This new issue of Clinics in Geriatric Medicine, guest edited by Edgar Lerma, examines critical aspects of renal disease from anatomic and physiologic changes in the aging kidney, to ethical issues in elderly with patients with renal disease. Authors from the United States and abroad cover topics in this issue such as: drug dosing and the elderly kidney, diabetic nephropathy, renal replacement therapy, glomerular diseases in the elderly, urinary tract infections, obstructive uropathy, and urinary incontinence.

Aging is associated with an increased prevalence of several GI disorders, including those induced by drugs (eg, gastrointestinal bleeding caused by nonsteroidal anti-inflammatory drugs), anorexia of aging, development of constipation, diarrhea or fecal incontinence, and postprandial hypotension. This issue addresses these disorders and discusses the current treatments for management of these patients. Specifically, articles focus on celiac disease, anorexia of aging, chronic constipation, fecal incontinence, neurogastrointestinal diseases, ischemic gut, and the pharmacology of commonly used GI drugs.

Recent studies show that more people than ever before are reaching old age in better health and enjoying that health for a longer time. This Handbook outlines the latest discoveries in the study of aging from bio-medicine, psychology, and socio-demography. It treats the study of aging as a multidisciplinary scientific subject, since it requires the interplay of broad disciplines, while offering high motivation, positive attitudes, and behaviors for aging well, and lifestyle changes that will help people to stay healthier across life span and in old age. Written by leading scholars from various academic disciplines, the chapters delve into the most topical aspects of aging today - including biological mechanisms of aging, aging with health, active and productive aging, aging with satisfaction, aging with respect, and aging with dignity. Aimed at health professionals as well as general readers, this Cambridge Handbook offers a new, positive approach to later life.

Ageing and Later Life reflects the diverse nature of the subject by taking a multidisciplinary approach including literary, historical, sociological, policy, psychological, philosophical and clinical perspectives. This lively and informative book features essays by major authors in the field and includes discussions of: cultural aspects of self-image and identity; current concerns relating to health and well-being; the reality of power and control in the care of older people; concepts and values which shape our understanding of ageing; issues of policy and politics; and historical perspectives on ageing and possibilities for the future. Ageing and Later Life is a set book for The Open University course K256 An Ageing Society.

Hypertension, an important and common concern in the elderly population, is examined in this new issue Guest Edited by Mahboob Rahman. Authors from around the country tackle such subjects as arterial compliance in the elderly, polypharmacy in the elderly, and hypertension and cognitive function in the elderly. This is a must-have resource for all clinicians dealing with the geriatric population.

This issue of Clinics in Geriatric Medicine focuses on the past, present, and future of home health care, a rapidly growing subspecialty of Geriatric Medicine. Guest Edited by Peter Boling, the issue describes the population in need (age range, numbers, projected growth), range of service needs, social vs. medical models of care, international and state-to-state comparisons to show the wide range of strategies that have been tried. It also includes a brief snapshot of the history of home care research, absence of integration of medical model home care and continuity of care for home-bound and function-limited persons in the US.

The need to sleep and obtain adequate rest is an essential bodily function from birth to death. Like eating and breathing, sleep is necessary for human survival. Sleep patterns evolve as one moves from infancy to childhood and into adulthood. It should be no surprise, then, that sleep parameters also evolve as the body enters the oldest decades of life. In this exciting new issue of Clinics in Geriatric Medicine, guest edited by Julie Gammack, a leader in her field, the spectrum of sleep-related changes and disease states is discussed. Evaluation of insomnia is summarized in the context of the elderly individual. Sleep disturbances are specifically reviewed in various care settings and disease states. Finally, this issue discusses both pharmacologic and nonpharmacologic management of sleep disorders to provide a multidimensional array of treatment options for the medical provider.

The number of elderly patients with diabetes is increasing at a significant rate. Responding to this growth, this source serves as a solid arsenal of information on the varying presentations and challenges associated with diabetes in the geriatric patient, and supplies clearly written sections on the screening, diagnosis, and treatment of diabetes in elderly populations. With contributions from renowned authorities from the national and international institutions, this reference will depict the role of specific co-morbidities, socioeconomic aspects, and caregiver issues on the effective management of diabetes in the older adult.

Detailed Review of Nutritional Therapies Used to Combat Elderly Health Issues The combination of the aging baby-boomer generation and their increased longevity has been fortunately met with increased research and greater understanding of health promotion and disease prevention in the elderly. Handbook of Nutrition in the Aged: Fourth Edition shares these groundbreaking insights and serves as a guide to better understand health problems that occur in aging adults and the nutritional therapies that are proven to fight and prevent them. Addresses Requirements for Optimum Health of Aging Physiological Systems This sharply focused work recognizes the special nutrition hurdles associated with the aged, particularly the decline of nutrient intake that compromises health. As a globally relevant text, this fourth edition is extensively revised, updated, and expanded to reflect the latest research in nutrition and aging. New chapters to this edition include information on: Arthritis Cognition Nutrition and the geriatric surgery patient Nutrition supplementation in fracture care Coffee and hypertension Asian medicine This book is a valuable tool not only for geriatricians and gerontologists, but also for dieticians, nutritionists, and aging researchers. It provides all the necessary information for assisting the growing aging population in maintaining a healthy quality of life.

"Parkinson's Disease in the Older Patient, Second Edition" has been fully revised, updated and expanded to include new treatments and entirely new chapters. This authoritative text is written by recognised national specialists in the field and provides accessible, easy-to-read information. The practical and versatile approach comprehensively covers all aspects of treatment, and although it focuses on the older patient, it is also highly relevant for younger patient groups with an emphasis on multidisciplinary assessment and management. Detailed information on the aetiology and pathogenesis of the condition, drug and surgical treatments, sleep disturbances, quality of life and careers is now included, along with the more prevalent older patient issues such as neuropsychiatric disturbances, speech and swallowing problems, balance and falls, and autonomic disturbances. The updates also include new advice on the management and services in primary care, linked to the recent NICE guidelines.With official endorsement from The Parkinson's Disease Academy of the British Geriatrics Society, this new edition is highly recommended for general practitioners, geriatricians, neurologists and psychiatrists. Physiotherapists, occupational therapists, speech therapists, dieticians, and psychologists will also find it invaluable. It is suitable for general and specialist nurses, and will be of great use to researchers with an interest in Parkinson's disease.

Learn how to ensure quality and safety for vulnerable older adults Transitional care is crucial to older adults with complex care needs who are moving between different locations or different levels of care. Charting a Course for High Quality Care Transitions addresses this problem by providing leading experts and leaders in the field discussing practical strategies that ensure care quality and safety for transitioning vulnerable older adults. This helpful resource comprehensively discusses current research, quality improvement, risk targeting, risk identification, patterns of care, care coordination, and performance assessment. Lowering the inherent risks for adverse events when moving patients can be challenging. Numerous unforeseen variables such as possible mismanagement of medication or staff shortages can often jeopardize patient safety. Charting a Course for High Quality Care Transitions offers practical approaches to address several of the main challenges encountered by health professionals. This book focuses on various ways to provide the highest quality patient-centered care through advancements in research, practice, and data measurement. This informative text is extensively referenced and contains numerous tables to clarify and illustrate important data. Topics in Charting a Course for High Quality Care Transitions include: a semantic framework for overcoming quality improvement issues stemming from inconsistent use of terms a tool for home health agencies to identify home health care patients at risk for hospital readmission medical and social factors that contribute to poor quality care transitions a successful Advanced Practice Nurse transitional care model that can improve outcomes to cognitively impaired older adults unrecognized needs of older adults living in residential care facilities patient-centered performance measurement early results of the Reducing Acute Care Hospitalization National Demonstration Collaborative gaps in research that need to be addressed in the future Charting a Course for High Quality Care Transitions is an important resource for home care professionals, hospital discharge planners, public health nurses, geriatric health services researchers, and health care professionals of all types.

Trauma in older people aged over 65 is a rapidly growing field within orthopaedics. Up to two thirds of fractures occur as a result of a fall and about one third of all fractures occur in the over-65 population. The aim of this comprehensive new text is to present the epidemiology and management of all musculoskeletal trauma that occurs in the elderly. The book deals with the assessment and treatment of medical comorbidities, complications, and the role of orthogeriatric care. The focus of the book is on the practical management of fractures although soft tissue injuries and dislocations are also discussed. Reflecting the multidisciplinary nature of the field, contributors are drawn from orthopaedics and orthogeriatrics on both sides of the Atlantic. The book is intended for all surgeons and physicians involved in the treatment of trauma in the elderly, and it will be relevant to trainees and as well as experienced practitioners.

This book makes an enquiry into policies surrounding old age and telecare. It contextualises telecare within the wider history of health and social care in England to build the case that there are grand narratives of old age embedded in policies. Divided into four sections, the book covers: * Connecting old age with telecare * A general review of old age and telecare * A critical enquiry into discourses and the identity of old age * Conclusions and future directions. The author highlights the manifestation of old age discourses in care policies, how they have been perpetuated yet also transformed in the context of telecare, and what this means about older people. The book will be of interest to students and academics in the fields of gerontology, sociology, old age studies, philosophy, social policy, health and social care policy, information systems, and critical theoreticians