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Handbook of Non-Motor Symptoms in Parkinson's Disease is designed to provide practical tips and emphasize key priorities for treatment of non-motor aspects of the disorder. The quick-reference handbook format, with key points highlighted by the use of figures and tables, will provide the reader with high-value practical information.
The survival of the human species has improved significantly in modern times. During the last century, the mean survival of human populations in developed countries has increased more than during the preceding 5000 years. This improvement in survival was accompanied by an increase in the number of active years. In other words, the increase in mean life span was accompanied by an increase in health span. This is now accentuated by progress in medicine reducing the impact of physiologic events such as menopause and of patho logical processes such as atherosclerosis. Up to now, research on aging, whether theoretical or experimental, has not contributed to improvement in human survival. Actually, there is a striking contrast between these significant modifications in survival and the present knowledge of the mechanisms of human aging. Revealed by this state of affairs are the profound disagreements between gerontologists in regard to the way oflooking at the aging process. The definition of aging itself is difficult to begin with because of the variability of how it occurs in different organisms."
Assisting someone with Alzheimer s disease or another illness that causes dementia is incredibly demanding and stressful for the family. Like many disabling conditions, Alzheimer s disease leads to difficulty or inability to carry out common activities of daily life, and so family members take over a variety of tasks ranging from managing the person s finances to helping with intimate activities such as bathing and dressing.
Key coverage in "Caregiving for Alzheimer s Disease and Related Disorders" includes:
Early diagnosis and family dynamics
"Caregiving for Alzheimer s Disease and Related Disorders" 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."
1h The 5 International Conference on the Progress in Alzheimer's Disease and Parkinson's 51 1 Disease took place from March 31 to April 5 \ 2001 in Kroto, Japan. This international 1 conference was organized as a joint Congress with the 9 International Catecholamine Symposium. A total of 1258 clinicians and researchers participated in this joint congress 1h from 38 countries in the world. This book represents the proceedings of the 5 Conference on Alzheimer's and Parkinson's disease. The International Conference on the Progress in Alzheimer's and Parkinson's disease was first launched by Professor Abraham Fisher of Israel and Professor Israel Hanin of USA. The first conference was held in Eilat, Israel in 1985. The second conference was organized in Kyoto, Japan in 1989; the third one in Chicago, USA, in 1993, and the fourth one in Eilat, Israel in 1997. The International Catecholamine Symposium (ICS) is an international meeting devoted to the development of basic as well as clinical research on catecholamines. The first Catecholamine Symposium was held in Bethesda, USA in 1958. Since then this symposium has occurred every 5 years. Professor Toshiharu Nagatsu was appointed as 1h the president of the 9 International Catecholamine Symposium, which was to be held in 200 I also in Japan. Therefore, we decided to organize a joint congress of the two meetings, because there is much overlap in research between Alzheimer's disease, Parkinson's disease, and catecholamines. We thank Professor Nagatsu very much for agreeing to organizing this joint congress.
This concise practical guide is designed to facilitate the clinical decision-making process by reviewing a number of cases and defining the various diagnostic and management decisions open to clinicians. It is richly illustrated and diverse in scope, enabling the reader to obtain relevant information regarding both standard and unusual cases in a rapid, easy to digest format. The first in the series will be on Geriatric Dermatology and will be prepared within one month of acceptance and include photos. Each case will also include a narrative description and patient management tips
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.
The master tool of logic is the syllogism. If A> Band B> C, then it must follow as the night the day that A > C. If the major and minor premises are true or scientifically correct by current knowledge, the conclusion is true or at least scientifically correct by current knowledge. The demographer of today beams a clear message, which if not true is at least scientifically correct by current knowledge. In the first 80 years of the Twentieth Century, the 'over-65' population of Americans increased eight fold. By century's end it will have increased 12-fold and shortly thereafter will include one in five Americans. While initially a fact of the developed world, the pace of similar graying is accelerating even more rapidly in the Second and Third Worlds. This gray delta constitutes about 35 million living Americans, who may use one-half or more of the health care resources. A would have to be a lot more foolish than B if they failed to recognize that in the coming decade the causation, case-mix, and area of the gray delta demands a change from early, mid-or even later-century medicine. If Homer Smith was right in saying, "We are what we are because we have the kind of kidneys we have" and "The kidneys make the stuff of philosophy", then the who, what, where, when, and why the gray delta will be cared for must focus on the stuff of geriatric nephrology.
Immunosenescence is a unique, multi-disciplinary approach to the understanding of immune aging. It addresses the topic from the biological, as well as the psychological, social and behavioral perspectives. It is, thus, a valuable and timely addition to the literature in this area. Contributors include experts in the field, reviewing the state of the art in research.
nly two things are certain in life, one is that all of us will inevita Obly grow older, the other is that at some point during or at the end of this process we shall die. Inherent to the passage of time is a deterio ration in the structural and functional integrity of our bodies, this pro gressing to such an extent that one or more organ systems will eventu ally begin to fail with the continued health and well-being of the individual coming under threat. Age-associated deficiencies in the musculo-skeletal, cardiovascular, or endocrine systems producing arthri tis, hypertension, stroke or diabetes are all too apparent in our elderly population yet internally caused failures in the function of the nervous system provide the common, and mostly intractable, problems of memory and intellect or locomotion that face and frustrate clinicians. Perhaps the most important factor which can decide the outcome of research studies professing to examine the effects of the passage of time (i. e. the 'process of aging') on the function of the nervous system, or indeed any other organ system, is the selection of appropriate or repre sentative subjects for investigation. The heart of this problem lies in defining what might be considered as 'normal' aging as distinct from age-associated disease; setting the 'goal posts of normality' continues to 1 be a matter of considerable debate.
''Full of valuable definitions, descriptions, discussion and succinct summaries....the volume forms an interesting, up-to-date reservoir of information on 'preparation for aging'. As a source of specific insights and alternative perspectives it is a welcome addition to the literature.'' -Aging and Society
Primer of Geriatric Urology provides a review of the demographics of our aging urologic population and their unique needs. Chapters review alterations that must be considered in the initial evaluation of the aging patient, and follow with practical suggestions for development of the management plan, whether by counseling, medication, invasive procedure or foregoing procedures. Complications, especially likely in the elderly, are also discussed. The volume also provides a review of the use of necessary adjunctive services such as home care or hospice in the context of Medicare in the USA. An important chapter provides hints on urology practice in a nursing home. The volume concludes with analysis of specific geriatric entities seen in urology practice. Primer of Geriatric Urology will be of great value to urologists, residents, fellows and allied health professionals including physician's assistants and nurse practitioners who treat urologic patients. Additionally, this book will also be of interest to primary care providers who treat elderly patients with urologic problems.
For more than 35 years the Swiss Society of Neuropathology has organiseditstraditionalInternationalWinterMeeting.Themainaimofthis venue is to bring together neuropathologists and clinicians as well as neuroscientistsinterestedindiseasemechanisms.TheXVIIIthInternational WinterMeeting washeld inMarch 2000 in St. Moritz, Switzerland. The topicofthe2000Meetingwas"NeuropathologyandGeneticsofDementia." Aprogrammeofinvitedplenarylecturesofhigheducationalvalueaswellas platform andposterpresentations given by manyparticipantscoveredthe broadspectrumofdementingdisorders.Encouragedbythehighstandardof the meeting, and probably also influenced by the advent of a new Millenniumwedecided, togetherwithKluwerAcademiclPlenumPublishers, topublishtheProceedingsofthe2000Meetinginthepresentbook. The increaseofthe agedpopulation challenges social and health care systemsinindustrializedsocieties.Maintenanceofhealthandautonomyinto oldage isakeyfactor, andtheautonomyandindependenceofoldpersons crucially depend on mental health. However, neurodegenerative disorders accompanied bydementiaaffect 5-10%ofindividualsoverthe ageof65, and for the age group between 65 and 95 the prevalence of cognitive dysfunction doubles every 5 years. With this challenge in mind, Rossor discusses the clinical syndrome of dementia which encompasses an enormousvarietyofunderlyingdisorders. Over the last few years it has become apparent that many neurodegenerative disorders are characterised by protein misfolding and aberrant polymerization and may therefore be viewed as "aggregation proteopathies." Among them a substantial subsetofdementing disorders, either with or without motor dysfunction, are characterised by abundant v VI Preface neuronaland/orglialaccumulationofhyperphosphorylatedtauprotein.The molecular parametersofthese "tauopathies" are reviewed by Delacourte. Therecentdiscoverythatmutationsofthetaugenearecausativeforfamilial formsoffrontotemporaldementiaandParkinsonism(FTDP-17)broughtthe "taupathway"and the"tauopathies"tothecentrestage.Thisextraordinary breakthroughwillbecoveredbySpillantiniandGoedert.Thereisincreasing evidence that argyrophilic grain disease is much more frequent in older patients than previously thought. Tolnay et al. are reviewing recent contributionstothepathologyofthislate-onsetdementingdisorderinwhich ofamyloidbetadeposits, isalmost taupathology, inthealmosttotalabsence exclusivelyrestricted to the limbic lobe and the amygdala. Schultzet al. report an intriguing age-related progression of neuronal and glial tau pathologyinbaboonsthusrenderingthe baboonapotentialprimatemodel forage-relatedhuman"tauopathies." Gotzetal. introducetransgenicmice expressingmutated human tau as valuable animal models for reproducing formationofneuro-andglialfibrillarylesions.
Coronary artery bypass surgery in the elderly: Too often or too seldom? It is a testimony to scientific advances that raising a simple inquiry today, such as whether coronary artery bypass surgery is done too often or too seldom in elderlypatients, requiresanexplorationofwhatviewsonemightholdonseveral medical as well as non-medical issues. Unlike earlier years when doctors were clinically free to decide what should be done with a patient, health has become an expensive human right, decisions about which also involve the patient, the epidemiologist, the health policy administrator, politicians, the exchequer, and the philosopher. In its broadest definition health has come to mean the core of well-being and, therefore, the goal ofany socio-economic system. Until only a decade ago, medical opinion regarding how often coronary artery bypass surgery (CABG) was indicated or useful was unclear. Becauseof multi-organ senescence, the elderly were expected to have a higher rate operative morbidity and mortality and, having crossed an advanced life span, might not live very long after the operation. Decision making on medical grounds first depends on knowing if a patient can survive an operation compared to how long they would survive without it, i. e.
Geriatric Notes is an essential quick reference for the advanced practice provider (APP) who provides care to elders in the outpatient setting, such as nursing homes, family practice, or home health. With a practical, accessible, and concise approach, it offers an easy to understand overview of the most common diagnoses, topics, and symptoms encountered in the aging population. Designed to offer access to the basics, this guide provides tables and bullet points for easy reference. Sections include health promotion, neurology and psychiatry, cardiovascular, pulmonary, gastroenterology, genitourinary, rheumatology, dermatology, endocrinology, labs, Beers list, and common presentations.
This book aims to provide an up-to-date review of the literature in each of the major areas relating to the management of older urological cancer patients, and makes recommendations for best practice and future research. The authors come from a broad geographic spread including the UK, mainland Europe and North America to ensure a worldwide relevance.
With the aging of the baby boomers and medical advances that promote longevity, older adults are rapidly becoming the fastest growing segment of the population. As the population ages, so does the incidence of age related disorders. Many predict that 15% - 20% of the baby-boomer generation will develop some form of cognitive decline over the course of their lifetime, with estimates escalating to up to 50% in those achieving advanced age. Although much attention has been directed at Alzheimer's disease, the most common form of dementia, it is estimated that nearly one third of those cases of cognitive decline result from other neuropathological mechanisms. In fact, many patients diagnosed with Alzheimer's disease likely have co-morbid disorders that can also influence cognition (i.e., vascular cognitive impairment), suggesting mixed dementias are grossly under diagnosed. The Clinical Handbook on the Neuropsychology of Aging and Dementia is a unique work that provides clinicians with expert guidance and a hands-on approach to neuropsychological practice with older adults. The book will be divided into two sections, the first addressing special considerations for the evaluation of older adults, and the second half focusing on common referral questions likely to be encountered when working with this age group. The authors of the chapters are experts and are recognized by their peers as opinion leaders in their chosen chapter topics. The field of neuropsychology has played a critical role in developing methods for early identification of late life cognitive disorders as well as the differential diagnosis of dementia. Neuropsychological assessment provides valuable clinical information regarding the nature and severity of cognitive symptoms associated with dementia. Each chapter will reinforce the notion that neuropsychological measures provide the clinician with sensitive tools to differentiate normal age-related cognitive decline from disease-associated impairment, aid in differential diagnosis of cognitive dysfunction in older adults, as well as identify cognitive deficits most likely to translate into functional impairments in everyday life.
In keeping with the traditions of deve1opmenta1 bio1ogy and geronto1ogy, there was a long incubation period before fu11 expres sion of the plans for an International Conference on the Werner Syndrome and the pub1ication of the present monograph based upon the proceedings of that conference. The initial concept emerged at the Xlth International Congress. of Geronto1ogy, which took p1ace in Tokyo in 1978. Drs. G.M. Martin, Y. Fujiwara and Y. Mitsui met on that occasion to discuss ways of acce1erating the pace of research on this important disorder, inc1uding banking and sharing of ce11 cu1tures, establishment of patient registries, and p1anning of joint conferences and pub1ications. In November 1979, under the auspices of the Geronto1ogica1 Society of America and a conference grant from the National Institute on Aging of the U.S. National Institutes of Hea1th, a group of Japanese investigators (Drs. Fujiwara, Mitsui, M. Goto, T. Ishii, K. Oota and .T. Matsumura) met with Drs. Martin, D. Sa1k and W. Ted Brown to deve10p plans to implement the goals discussed at the initial Tokyo meeting. A workshop focused on the needs of ce11 banking and 1ed to an accumu1ation of research materials both in Japan (main1y under the leadership of T. Matsumura) and in the U.S.A. (with the cooperation of Dr. Arthur Greene of the Institute of Medica1 Research)."
This CD has been especially compiled from the BBC Sound Archives and contains excerpts of famous radio programme theme tunes from the 1940s and 1950s. Designed to be used as a trigger for reminiscence work with older people, this CD provides a valuable stimulus for conversation. It can also be used for group or individual quiz sessions. These packs provide memorable listening material covering the 1940s and 1950s. Ideal for work on a one-to-one basis, as a starting point for discussion groups and with those with visual disability. Each pack contains a CD and notes for guidance in a storage wallet.
Between longer life expectancies and declining birth rates, Europe's elder population is growing into a sizable minority with considerable impact on nations, health systems, and economies-in other words, global implications as well as local and regional ones. Those investing in the health of older adults need a double perspective: the social and clinical complexity of aging and the larger forces shaping these experiences.
"Aging in European Societies" examines aging trends across the continent, analyzing individual and collective variables that affect the lives of older adults, and drawing salient comparisons with other parts of the world. An interdisciplinary panel of experts provides theory, research, and empirical findings (with examples from the UK, Cyprus, Sweden, and others) in key areas such as family and social supports, physical and cognitive changes, dependence and autonomy issues, and living arrangements. The book's wide-net approach offers insights into not only aging, but aging well. And of particular importance, it details approaches to defining and measuring the elusive but crucial concept, quality of life. Included in the coverage:
The potential for technology to improve elders' quality of life.Dementia and quality of life issues.Changes in functional ability with aging and over time.Family networks and supports in older age.Factors influencing inequalities in quality of life.Late-life learning in the E.U.
Gerontologists, sociologists, health and cross-cultural psychologists, and public health policymakers will welcome "Aging in European Societies "as a springboard toward continued discussion, new directions for research, and improvements in policy and practice."
Measurement of Wound Healing will update the knowledge base and promote the use of measurements in order to improve both understanding of wounds and their management. This book will feature well used vascular measurements, pathological measurements, imaging measurements and so on. There will be chapters on techniques/measurements that have much promise.
This book is led by 3 experienced clinician scientists from different backgrounds who have successfully worked together on projects.
Managing Geriatric Health Services provides an overview of the many disciplines related to geriatric health administration as well as specialty topics in long-term care. Ideal for students studying geriatric health services administration, as well as active professionals currently working in the field, Managing Geriatric Health Services thoroughly examines core topics such as administration, nursing, and rehabilitative therapies. It also covers specialty topics, including spirituality, dementia, quality assurance, oral history, and ethical issues. This text examines the various jobs within the continuum of care from an administrative and management standpoint, and also looks at the various roles or disciplines within long-term care and the specific challenges to each. With contributions from experienced professionals in the field, this book includes an entire section of interdisciplinary case study examples and reflection exercises. Individual chapters include learning objectives, key terms, chapter-specific case studies, and chapter summaries, Key Features: * Discussion questions in each chapter engage the reader in learning and understanding the topics presented. * Interdisciplinary case studies allow the reader to see the practical application of the concepts presented. * Chapters are supported by current research from prominent experts in the field. * A unique chapter on Oral Histories explores the aging process and the value of reminiscing. Instructor Resources: PowerPoint LEcture Slides, Test Bank
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.
This book outlines the state of the art program for the prevention and treatment of Alzheimer's dementia (AD), memory loss and mild cognitive impairment (MCI or pre-Alzheimer's). At the Leonardi Institute, Drs. Leonardi and Daley have focused their entire careers on the enhancement of vitality and the prevention of age related disease for men and women over the age of 40. After developing programs effective for preventing cancer and cardiovascular disease they then looked at what their patients would face next if spared our two biggest killers. The answer, AD, prompted a concentrated investigation into the biochemistry behind Alzheimer's and how that biochemistry can be attacked using a combination of lifestyle alteration, optimal nutrition, bioidentical hormone replacement and nutritional supplements that specifically target AD pathology. While drug companies languish in finding a "patentable pharmaceutical cure," the authors uncovered approximately 30 natural elements with real disease-altering potency and organized them into a succinct 6 step program. With 281 scientific articles cited, every element adopted into this program is backed by the latest science. Whether you have Alzheimer's or want to prevent it, this is where you need to focus your attention. We urge you to read the evidence and start this program now
Having limited face time with their doctor during their brief medical office or clinic visit, most people (but particularly the elderly) will find their questions, frustrations, and medical problems inadequately answered. This book was inspired by actual issues which confused, confounded, and frustrated older patients, and for which they, and their caregivers repeatedly sought answers and explanations: issues dealing with aging, health and disease, health care, hospitalization, emergency care, insurance, medical billing, medications, laboratory testing, interactions with doctors, and much more. Inspired by their need for answers, this book was written to fill many of the gaps in the average senior's knowledge, and help them understand what's happening in their bodies and in their medical life. This book confronts the complexity of health care for the elderly, and offers guidance for a longer and happier life. It is what you need to know if you are an older health care consumer.
Elderly people are the main drug consumers in Western societies, as multimorbidity seems to justify a high load of drugs to be supplied to them. People above 65 years of age take an average of five drugs, and this figure increases to almost ten drugs at the age of 75. Serious adverse events (SAE) related to drug use are considered to lead to 100,000 deaths per year in the United States. The primary motivation of doctors resulting in polypharmacy is the treatment of all diagnoses according to the guidelines which recommend three drugs per disease, on average. The mean number of diagnoses at age 80+ is 3.3, leading to ten drugs prescribed to each elderly patient.
As this multimorbidity/polypharmacy challenge apparently leads to therapies which are costly, ineffective and potentially harmful, there is a need to structure drug load reduction approaches. This must be coupled with the enormous and contradictory challenge of undertreated diseases. The DETECT study on the prevalence of hypertension in the Western world, for example, shows that 75% of 75-year-old patients required antihypertensive treatment, but only 20% were sufficiently treated.
The solution is rooted in the skills and experiences which lead medicine in the pre-EBM era. Though the strengths of EBM are indisputable, without evidence-based guidelines applicable to the elderly, careful reasoninig, patient assessment, treatment observation, and integration are the keys to success. "Drug Therapy for the Elderly" provides the practitioner with:
- Background information on the elderly population regarding their needs for particular drugs (with an eye to frailty, co-morbidity patterns, and special sensitivities regarding drug metabolism and excretion)
- Practical advice about drug treatment surveillance paramters in the elderly
- In-depth discussion of drugs in relation to the elderly with specific diagnoses
- Integration of multimorbidity/polypharmacy situations into prioritization schems
- A plan for how to deal with the complexity of polypharmacy situations in a five-minute consultation
An original classification of drugs is proposed by the editor which relates the power of effects, prognostic data, and tolerability to a prioritization scoring with labels ranging from A (indispensible, clear-cut benefit for efficacy/safety ration proven even in elderly patients for a given indiacation, unanimous morbidity and/or mortality data) to D (avoid in elderly, delete first). Whereas current lists intend to eliminate unsafe drugs for the elderly, this novel approach underlines both indispensable and dispensable elements of drug therapy. This approach is the first to not only provide a negative liesting, but also integrates positive data into an overall assessment for drugs fit for the aged.
The demographic revolution of an aging society will lead to increased pressure to come to a rationalistic and age-tailored process of diagnosing and treating increasingly complex situations in the elderly. "Drug Therapy for the Elderly" is focused on the most important treatment modality in medicine and serves as a timely reference for a wide array of physicians.
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