This volume collects the foundation papers in the discipline of Geriatric medicine. The book begins with a chapter on those papers that established the field. It then goes on to provide a long overdue review of the important "classic" papers in geriatric medicine and includes information on the development of health systems which support the care of older patients. Each chapter begins with a commentary by a faculty member with special interest or expertise in that area.

For centuries people have puzzled over the inevitability of human aging. At the end of the 20th century a remarkable scientific discovery emerged, based on a series of important interconnected insights over quite a long period of time. The aim of this book is to dispel ignorance by explaining in non-technical language what are the reasons for aging and the myth of excessive prolongation of life.

Aging is an almost universal process within biological systems, one which leads to a decline in functional capacity, disease onset, and eventually death. There has been much interest in recent years to elucidate the molecular mec- nisms that underlie the aging process. Many theories have been proposed since the last century that aim to explain the causes of aging. There is no one theory that completely satisfies the phenotype of aging, but genetics and environm- tal factors play an important role in the etiology of age-related pathologies and the aging process. However, there is still much to be learned about the aging process which has been termed one of the last great frontiers in biology. De- graphic changes worldwide are leading to increased average life expectancies within our populations. These changes in population characteristics will impact upon the economies of the supporting society, with increasing healthcare and infrastructural costs arising from the prevalence of age-related pathologies and other physical disabilities associated with advancing years. Many researchers worldwide are working in the attempt to identify key cellular processes through which it might one day be possible to slow down the aging process and thus increase the health span of humans. Numerous research projects-from the cellular through to tissue, organ, and whole organism studies-are currently underway to investigate the mul- factorial aging process.

Social differences in health and mortality constitute a persistent finding in epidemiological, demographic, and sociological research. It is a topic that is much discussed in the current political debate and it is among the most urgent public health issues. However, we still do not know whether socioeconomic mortality differences increase or decrease with age.

This book provides a comprehensive, critical discussion of all aspects involved in the relationship between socioeconomic status, health and mortality. It synthesizes the sociological theory of social inequality and an empirical study of mortality differences that has been conducted by the Max Planck Institute for Demographic Research (Rostock, Germany). This study is the most comprehensive analysis of socioeconomic mortality differences in the literature, both in terms of quantity and quality of data, and in terms of the statistical method used: that of event-history modeling.

In comparison to Husserl and Heidegger, Max Scheler's philosophy of time as first presented here, is considerably wider in scope. Using posthumous manuscripts, Frings shows that Scheler conceived the origin of time in the self-activating center of individual and universal life as threefold "absolute" time of a four-dimensional expanse. This serves as a basis for establishing the phenomenon of objective time in multiple steps of constitutionality, including the physical field theory and theory of relativity.
For Scheler, objective time, even though anchored in absolute time, deserves "maximum attention" in a technological society. Frings focuses here with Scheler on time experience of values and among social groups, time experiences in the mind-set of capitalism, in politics and morals, in population dynamics, and time experiences in the process of aging, all of which were signposts in Scheler's thought before his early demise.

Late life is characterized by great diversity in memory and other cognitive functions. Although a substantial proportion of older adults suffer from Alzheimer's disease or another form of dementia, a majority retain a high level of cognitive skills throughout the life span. Identifying factors that sustain and enhance cognitive well-being is a growing area of original and translational research. In 2009, there are as many as 5.2 million Americans living with Alzheimer's disease, and that figure is expected to grow to as many as 16 million by 2050. One in six women and one in 10 men who live to be at least age 55 will develop Alzheimer's disease in their remaining lifetime. Approximately 10 million of the 78 million baby boomers who were alive in 2008 can expect to develop Alzheimer's disease. Seventy percent of people with Alzheimer's disease live at home, cared for by family and friends. In 2008, 9.8 million family members, friends, and neighbors provided unpaid care for someone with Alzheimer's disease or another form of dementia. The direct costs to Medicare and Medicaid for care of people with Alzheimer's disease amount to more than $148 billion annually (from Alzheimer's Association, 2008 Alzheimer's Disease Facts and Figures). This book will highlight the research foundations behind brain fitness interventions as well as showcase innovative community-based programs to maintain and promote mental fitness and intervene with adults with cognitive impairment. The emphasis is on illustrating the nuts and bolts of setting up and utilizing cognitive health programs in the community, not just the laboratory.

In this volume the authors examine some of the medical social and psychological conditions which affect the way we die. Important topics covered include attitudes toward death; suicide, assisted suicide and euthanasia; hospice and pain management. This volume will be of interest to all who work with terminally ill patients.

Whereas chronic stress has well known harmful effects, recent research shows that intermittent exposure of cells and organisms to mild stress can improve various biological parameters. This book brings together some of the world leaders in this area of research who present a critical analysis of the ongoing research with respect to the effects and mechanisms of action of various types of mild stress. Novel approaches to improving health and longevity are introduced.

This textbook addresses the best way of evaluating patients with rectal prolapse, the underlying pathophysiology, the different surgical approaches, the expected functional results after surgery and the management of complex clinical conditions associated with this condition. It is an essential book that attempts to draw together material that could be of vital importance to surgeons around the world. The pathophysiology of rectal prolapse is still uncertain and its clinical and instrumental diagnostic assessment needs to be clarified.

This book arises from a conference held in November 1996 designed to examine how competence can be improved in the different stages ofthe lifespan. To this end, we brought together eminent researchers in different areas of human development-infancy, childhood, and adulthood, including the late adult years. The conference was based on the premise that discussion arising from the interfaces of research and practice would increase our knowledge of and stimulate the further application of effective interventions designed to improve competence. The editors wish to acknowledge the contributions of Concordia University and the Fonds pour la Formation de Chercheurs et l'Aide a la Recherche (FCAR) in providing funding and other assistance toward the conference "Improving Competence Across the Lifespan" and toward the publication of this book. Finally, we wish to express our gratitude to the numerous students associated with our Centre for their help and to Gail Pitts and Lesley Husband of the Centre for Research in Human Development for their assistance. We are especially grateful to Donna Craven, Centre for Research in Human Development, for her heroic work on both the conference and the present volume. We could not have met our goals without you.

Presents both current and future aspects of diagnosis and treatment.

Presents evidence-based knowledge of pressure ulcer aetiology.

Contains over 90 illustrations.

Explores the possiblities of tissue repair using new tissue engineering strategies.

This book analyzes the challenges, benefits, coping strategies, problems, and accomplishments associated with the midlife experience of women. Ten chapters present the state of research (and correct longstanding myths) regarding significant aspects of middle-aged women's lives. The book bridges a major knowledge gap in the feminist-psychology literature. It balances optimism and realism about older women 's lives and younger women 's futures.

This excellent new work confronts two important oral health policy concerns in the United States: the disparities in the oral disease burden and the inability of certain segments of the population to access oral health care. The book examines in depth this crucial yet frequently overlooked indicator of seniors' quality of life. It provides an invaluable set of recommendations to the clinical, research, and administrative communities that will serve the elderly population.

The molecular and cellular approaches to the relationship of joint and bone problems distinguish this from other books on the topic. Advances in bone and joint biology enable practitioners to approach clinical problems more comprehensively. Emphasis on genetics and on newer viewpoints and approaches, exemplified by the possible effect of subchondral bone on osteoarthritis, gives a wider viewpoint to the reader and may enable novel approaches to solving a clinical problem.

It is with great pride that the Psychologists in Long Term Care (PLTC) have sponsored The Professional Educational Long-Term Care Training Manual, and now its second iteration, Geropsychology and Long Term Care: A Practitioner's Guide. Education of psychologists working in long-term care settings is consistent with PLTC's mission to assure the provision of high-quality psychological services for a neglected sector of the population, i.e., residents in nursing homes and assisted-living communities. To this end, direct training of generalist psychologists in the nuances of psychological care delivery in long-term care settings has been a major priority. It is a tribute to the accelerating nature of research in long-term care settings that a revision is now necessary. After all, the Professional Educational Training Manual's initial publication date was only in 2001. However, in the intervening years, much progress has been made in addressing assessment and intervention strategies tailored to the needs of this frail but quite diverse population. It is so gratifying to be able to say that there is now a corpus of scientific knowledge to guide long-term care service delivery in long-term care settings.

It 's a core issue at the heart of elder care: while best-practice data exist for long-term care, quality of life as a concept, measure and standard for care outcomes remains elusive. The result of an ambitious European research initiative, the Care Keys Project addresses quality of life issues among frail, care-dependent seniors, taking their social as well as health needs into account. This resulting volume explains the theory behind Care Keys, its methodology, empirical findings, and practical considerations in promoting effective, efficient elder care aimed at social and emotional well-being and including disabled and cognitively impaired patients.

This book offers a broad-ranging assessment of current efforts of the molecular, cellular, hormonal, nutritional and lifestyle strategies being tested and applied by biogerontologists in the search for effective means of intervention, prevention and treatment of age-related diseases, and for achieving healthy old age. Employing a semi-academic style, the book presents data from experimental systems, while focusing primarily on their applications to humans in the prevention and treatment of age-related impairments.

Geriatric anesthesia is a rapidly growing and evolving field. The last few years have seen significant advancements in and important new modalities for addressing the needs of an aging population. The editors of Geriatric Anesthesiology's second edition are uniquely situated to put together a text highlighting both essential knowledge and recent breakthroughs of importance to any who work with the elderly. For the second edition, the editors have introduced a streamlined chapter format and have assembled a selection of chapters intended to deepen the understanding of anesthesic management of the geriatric patient.

Covers the whole range of potential complications of PCI

Only book exclusively dedicated to the risks of PCI

Complements available texts that detail interventional cardiology

Supports physicians in improving care by anticipating or recognizing problems

Appeals to cardiologists or interventional radiologists

Addresses cardiac arrest, legal matters and adverse event reporting

Essential information is easily accessible in useful tables

Text is logically organized and richly illustrated with 184 illustrations on 210 pages

Medication use is the predominant form of health intervention in our society. And as we age, the likelihood of medication use increases dramatically, with more than 80 percent of those over age 65 using one or more medications. Along with that, the potential for medication errors also increases. Indeed adverse drug reactions (ADRs) and adverse drug events (ADEs) are a significant problem in older adults. Written in a practical format by contributors from Australia and the United States, Medication Management in Older Adults: A Concise Guide for Clinicians presents the available evidence on research interventions designed to reduce the incidence of medication errors in older adults, with a focus on acute, subacute, and residential (long-term) care settings. Because medication errors can occur at all stages in the medication process, from prescription by physicians to delivery of medication to the patient by nurses, and in any site in the health system, it is essential that interventions be targeted at all aspects of medication delivery. Chapters cover the principles of medical ethics in relation to medication management; common medication errors in the acute care sector; medication management in long-term care settings; nutrition and medications; the outcomes of a systematic review; dose form alterations; Electronic Health Records (EHR), Computerized Order Entry (COE), Beers criteria; and pharmacokinetics and pharmacodynamics. For those clinicians especially concerned with providing the best possible outcomes for their older adult patients, Medication Management in Older Adults: A Concise Guide for Clinicians is an invaluable resource and a significant contribution to the burgeoning literature on medication errors.

One of the most pressing questions facing society today is how to care for its burgeoning elderly population. By the year 2050, experts predict that one-third of the world's population will be over 60 years old. Health promotion for the elderly is therefore becoming an increasingly important topic in public policy and planning. This book examines the challenges presented by an ageing global population, our varying expectations of healthy ageing, and the importance of exercise and physical activity for the elderly. Drawing on empirical research from around the world, it considers the factors that influence health and well-being in later life and compares practices and policies designed to promote healthy ageing. It presents case studies from 15 countries spanning Europe, North and South America, Africa and Asia, and sheds light on how attitudes to physical activity differ across nations, regions and cultures. Ageing, Physical Activity and Health: International Perspectives is important reading for all students, researchers and practitioners with an interest in physical activity, public health, exercise science or gerontology.

Because aging is accompanied by a steady decline in resistance to infectious diseases, the diagnosis and treatment of these diseases in the elderly is not only much more complex, but also often quite different from that for younger patients.

In the second edition of Infectious Disease in the Aging: A Clinical Handbook, a panel of well known and highly experienced geriatric physicians and infectious disease experts review the most important common infections affecting the elderly and delineate their well-proven diagnostic, therapeutic, and preventive techniques. Among the illnesses discussed are urinary tract infections, pneumonia, ocular infections, tuberculosis, and fungal and viral infections. In addition, there are detailed discussions of sepsis, infective endocarditis, intraabdominal infections, bacterial meningitis, osteomyelitis and septic arthritis, and prosthetic device infections.

The second edition of the Handbook of Pain Relief in Older Adults: An Evidence-Based Approach expands on the first edition by providing a number of timely new features. Most important of these are the revised recommendations from the American Geriatrics Society on prescribing that reflect the many new agents available since the last guidelines were released in 2001. Additionally, concepts such as synergy in prescribing for older adults have been better delineated in this edition. The most salient features of the original edition have been retained and updated, including the full range of approaches for pain assessment and prevention, interventional strategies, guidance on pharmacotherapy and nonpharmacologic pain relief strategies for seniors, preventive analgesia, the role of rehabilitation in sound pain treatment, legal and public policy issues in pain care for seniors, pain management in long-term care, and even the issue of spirituality as an adjunct to pain management. The second edition also includes a new chapter on resources, which includes organizations, internet websites, and guidance on acquiring additional consultation for pain intervention. Of particular interest is an updated discussion of the effect that electronic medical records and internet-based personal health records will have on pain relief in older adults and a new chapter that serves as a resource guide for patients and caregivers trying to navigate the waters of pain relief assistance. This issue has not been addressed substantively in the pain management literature and the ramifications for older adults are particularly poignant. Comprehensive and practical, the Handbook of Pain Relief in Older Adults: An Evidence-Based Approach (Second Edition) is a comprehensive resource with targeted, practical information that will be of vital importance for all clinicians who provide care for seniors.

Building upon the strengths of the popular reference, Cancer in the Elderly, this guide outlines novel approaches in the identification and management of cancer in geriatric populations by world-renowned experts on the topic. Presenting new trends and strategies in surgery, radiation therapy, and chemotherapy, this source presents a multidisciplinary and best-practices approach to the optimization of cancer care for the elderly and collects the most recent findings gleaned from prevention, adjuvant, neo-adjuvant, and treatment research.

Features that characterize the aging process include the gradual accumulation of cell damage after prolonged exposure to oxidative and inflammatory events over a lifetime. In addition to the accretion of lesions, the intrinsic levels of pro-oxidant and aberrant immune responses are elevated with age. These adverse events are often further enhanced by the chronic and slow progressing diseases that characterize the senescent brain and cardiovascular system. The incidence of some disorders such as Alzheimer's disease and vascular diseases are sufficiently prevalent in the extreme elderly that these disorders can arguably be considered "normal." Aging and Aging-Related Disorders examines the interface between normal and pathological aging, and illustrates how this border can sometimes be diffuse. It explores and illustrates the processes underlying the means by which aging becomes increasingly associated with inappropriate levels of free radical activity and how this can serve as a platform for the progression of age-related diseases. The book provides chapters that examine the interactive relationship between systems in the body that can enhance or sometimes even limit cellular longevity. In addition, specific redox mechanisms in cells are discussed. Another important aspect for aging discussed here is the close relationship between the systems of the body and exposure to environmental influences of oxidative stress that can affect both cellular senescence and a cell's nuclear DNA. What may be even more interesting to note is that these external stressors are not simply confined to illnesses usually associated with aging, but can be evident in maturing and young individuals. A broad range of internationally recognized experts have contributed to this book. Their aim is to successfully highlight emerging knowledge and therapy for the understanding of the basis and development of aging related disorders.