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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)."
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.
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."
Among the various theories proposed to account for the process of aging, the free radical theory is of practical interest since it includes the possibility of retarding this process by administrating natural or synthetic antioxidants and free radical scavengers. The book "Free Radicals and Aging" summarizes knowledge accumulated during recent years in 42 reviews written by experts in the field. Aspects of free radical involvement in the intrinsic aging process and in age-related diseases, as well as the importance of the pro-antioxidant balance throughout life are discussed. Epidemiological studies from several European countries are reported showing correlations between low plasma levels of essential antioxidants and the occurence of coronary heart disease, cancer and cataract formation. Appropriate nutrition as well as prophylactic and therapeutic use of antioxidants are considered. This book represents a milestone in the field of age-related free radical biology and medicine. With contributions by: A. Azzi, B. Chance, R.G. Cutler, H. Esterbauer, P.H. Evans, F. Gey, C. Guarneri, D. Harman, N.I. Krinsky, M. Meydani, J. Miquel, A. Mori, L. Packer, C. Rice-Evans, M. Simic, A. Taylor, T. Yoshikawa.
The three of us, working in different institutions but in the same city, were very aware of the differences between our diverse approaches to the biology of aging and our perceptions of the sub ject matter. However, three years ago we began to hold informal meetings to discuss our research. These meetings eventually be came more frequent and, with this association, we became increas ingly cognizant of the commonality of our research problems de spite our separate perspectives. The idea for this symposium, therefore, grew from our aware ness that the underlying problem of the biological basis for aging was a common denominator in our research. The papers presented here represent three areas of active investigation: cell divi sion, biological membranes and hormonal regulation. They are sub mitted with the expectations that a greater understanding of the role of each of these separate approaches will help clarify, not only the interrelationships between our fields of research, but more importantly, the biology of aging itself. ACKNOWLEDGEMENTS We would like to extend our sincere thanks for the interest and contributions of the companies listed below: Abbott Laboratories Hoffman-LaRoche Arthur D. Little McNeil Laboratories Bristol Laboratories Mead Johnson & Company Burroughs H'ellcome Co. Merck Sharp & Dohme Research Labs. Charles River Breeding Labs. Rom-Amer Pharmaceuticals Dow Chemical Co. Sandoz Pharmaceuticals E.R. Squibb & Sons, Inc. Schering Corp. Eli Lilly Research Laboratories Smith Kline Corp."
These Proceedings emanate from the Second Tarbox Parkinson's Disease Symposium held February 2-4, 1978, at the SouthPark Inn in Lubbock, Texas. The Symposium was sponsored by the Tarbox Parkin son's Disease Institute and the Department of Pharmacology and Therapeutics of the Texas Tech University School of Medicine at Lubbock. The First Symposium took place in October, 1976. The Second Tarbox Parkinson's Disease Symposium boldly brought together investigators at the cutting edge of aging and neuroendo crine research and attempted to relate them to Parkinson's disease. Credit for the concept must go to the Program Chairman, Dr. David E. Potter. Once the plan was conceived the organizers relied heavily on the advice of Dr. Caleb E. Finch, whose counsel in developing the program was invaluable. The final verdict on the success of this daring venture must await the outcome of the publication of this Volume. Nevertheless, those in attendance could not fail but note the enthusiasm and excitement of the participants as their findings from the diverse disciplines of the neurological, aging, and endo crine sciences converged. This in itself is testimony that the Sym posium accomplished some degree of success. The Tarbox Parkinson's Disease Institute was established in 1973 with funds appropriated by the State of Texas and is dedicated to research, patient care, and education in Parkinson's disease and related neurological disorders. The Institute is named after Mr.
The central nervous system controls vital functions by ef?ciently coordinating peripheral and central cascades of signals and networks in an orchestrated manner. Historically, the brain was considered to be insulin independent. These earlier views have been challenged by ?ndings demonstrating that insulin exerts multiple actions in the brain, regulating vital biological processes such as life span, neuronal survival, cognition, reproduction, feeding behavior, energy balance, and glucose and fat metabolism, and that inef?cient central action of insulin contributes to the development of severe pathologies (Banks et al. 2000; Gerozissis 2003, 2004, 2008; Lustman and Clouse 2005; Okamoto et al. 2001; Park 2002; Perrin et al. 2004; Pocai et al. 2005; Reger et al. 2008; Schwartz and Porte, 2005; Schubert et al. 2004; van der Heide et al. 2005; Woods et al. 1979; Wrighten et al. 2008). Insulin and speci?c insulin receptors are widely distributed in the networks of the central nervous system related mainly to feeding or cognition (Baskin et al. 1983; Bruning et al. 2000; Gerozissis 2003, 2008; Havrankova et al. 1978a, b; Schechter et al. 1996; Schulingkamp et al. 2000; Schwartz et al. 1992; Zhao et al. 2004). Insulin receptors located in the synapses of neurons and in astrocytes are present in high concentrations in the cerebral cortex, olfactory bulb, hippocampus, amygdala, cerebellum and hypothalamus (Abbott et al., 1999; Havrankova et al.
The problem of senescence, as reflected in the history of reli gion and philosophy, has long been one of the greatest concerns of humankind. In contrast, gerontology as a branch of science is still comparatively young. During the past decade, concomitant with rapid progress in our understanding of the basic life sciences, vast stores of knowledge about biological aging have been accumulated. This knowledge, however, arising from many scientific disciplines and focused on varying levels of biologic organization, seems almost random and covers everything from molecules to human societies. Theories advanced to interpret the facts and to understand the mech anisms involved in senescence have remained in individual, rather than general, territories. It has long been felt by some gerontologists that it was time for the various specialists to step back and take a generalist view of gerontology, to reconsider and reevaluate the fruits of their analyt ical pursuits at different levels within a broader context. Some others may think it still premature. It seemed, however, that the majority of those who gathered in Tokyo on the occasion of the XIth International Congress of Gerontology were of the opinion that there was much to be gained in looking for interrelationships among the facts and theories originated in the different levels of investiga tion in an attempt to observe and appreciate the biological drama of senescence as an entity.
The focus of this book is on the aging male, though I suspect the significant other will be most interested as well. It is a collection of anecdotes, advice and reminisences gathered over 50 years of medical care. You will not find any astounding revelations here. The content, though known, wasn't appreciated as much til the author entered the hallowed halls of old farthood himself. He is an avuncular storyteller and had a lot of fun in the writing of these very readable pages.
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.
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 volume is the third in the Contemporary Geriatric Medicine series. As in previous volumes, information is presented in the form of easy-to read essays to bring the reader up to date on state-of-the-art develop ments in the area of geriatric medicine. Once again, a system approach is utilized. In addition, several new topics-including alcoholism, throm boembolic disease, and decubitus ulcer management-have been intro duced to enhance this volume's usefulness to the busy clinician and student. Each chapter is not meant to be an exhaustive review of all topics in the field, but rather to focus on issues currently receiving a great deal of attention. Our goal continues to be to create an exciting approach to contemporary issues in geriatric medicine. The editors are once again appreciative for having been given the opportunity to develop this series. Appreciation is also expressed to our professional colleagues, families, and administrative assistants, who have enabled this volume to reach fruition. As in the past, we thank, most of all, our elderly patients for providing the inspiration and impetus to improve our knowledge and understanding of the health care needs of the elderly. Steven R. Gambert, M.D. V alhalla, New York ix Contents Chapter 1 Geriatric Cardiology and Blood Pressure 1 Edmund H. Duthie, Jr., and Michael H. Keelan, Jr."
It has been estimated that there are at least 2,500,000 adults, 10% of the population above age 65, who are currently in need of some sort of mental health services (Kramer, Taube, and Redick, 1973). Other estimates are even higher (e. g., Pfeiffer, 1977). It is expected that this number will increase as the number of older adults increases over the next 40 years. Probably less than 400 clinical psychologists are now provid ing services to this age group. The number of elderly patients actually seen by these psychologists is very, very small. One national survey found that of 353 psychologists who reported that they had older clients, only 495 individuals were seen for psycho logical testing and 1423 for psychotherapy in the one month just prior to the response (Dye, in press). Assuming that the same in dividuals were not seen for both testing and therapy within the one month period--a questionable assumption--approximately . 08% of the at least two-and-one-half million older adults in need of psychological services are now being supplied with these services in some form or another. Thus, the need for increased involvement of clinical psychology with the aged is undeniable. However, few resources currently exist which will serve to increase the number of clinical psychologists trained to meet this need. Probably less than 100 clinical psychologists living today have received any kind of formal graduate training in the clinical psychology of the aging (Storandt, 1977)."
This volume marks the first of a new series, Contemporary Geriatric Medicine, joining the ever growing "Contemporary" family. As with the other "Contem porary" volumes, our goal is to assist the reader in maintaining currency in a rapidly changing field. Perhaps no field has shown such major advances in such a short time as geriatrics. Over the last several years, the "demographic impera tive" has become a source of concern for many, including clinicians, scientists, econ omists, and health planners. Our geriatric knowledge base continues to grow, often making it difficult to keep abreast of advances and current therapeutic modalities. Contemporary Ger iatric Medicine presents the state-of-the-art thinking regarding a variety of topics all of major concern to the health practitioner caring for the elderly person. The authors, for the most part serving as members of a stable editorial board, have chosen topics that should have immediate interest to the readership. By having a stable editorial board, continuity is ensured in successive volumes. Every two years, a subsequent issue will either address new thoughts on already presented topics or focus on new topics of current interest. As with the other "Contempo rary" series volumes, the every other year interval is intended to allow new find ings to develop and be tested. It also provides the authors with time to provide the highest quality of work."
This volume brings together noted scientists who study presbycusis from the perspective of complementary disciplines, for a review of the current state of knowledge on the aging auditory system. Age-related hearing loss (ARHL) is one of the top three most common chronic health conditions affecting individuals aged 65 years and older. The high prevalence of age-related hearing loss compels audiologists, otolaryngologists, and auditory neuroscientists alike to understand the neural, genetic and molecular mechanisms underlying this disorder. A comprehensive understanding of these factors is needed so that effective prevention, intervention, and rehabilitative strategies can be developed to ameliorate the myriad of behavioral manifestations.
Although thousands of articles and hundreds of books on aging have been published, only a small percentage of this material has dealt with anatomy, particularly at the fine structural level. It was with this in mind that Aging and Cell Structure was conceived. Volume 1 of Aging and Cell Structure was published in 1981 and represented a current compilation of information, concentrating at the electron microscopic level, on morphological changes which occur in cells and tissues as they age. The present volume completes the two-volume set. While Volume 1 highlighted structural changes occurring in the aging nervous system, Volume 2 centers its efforts on studies of in vitro aging. Chapters on other subjects are included as well. These include age-related changes seen in neuromuscular junctions, oral tissues, and the pancreas. Although these two volumes represent a very small part of the published infor mation on experimental gerontology, their approach is rather unique because they focus on anatomy, perhaps the most basic of all the biomedical sciences. Because many dif ferent tissue types are examined, we begin to see recurrent, definitive patterns in the aging cell which may not be fully apparent from studies taking one cell type at a time. This becomes even more evident in the present volume where changes seen in popula tions of cells grown in culture-isolated from hormones or nervous impulses from other body areas-are found to be similar to those changes found in vivo."
In the last two years, a wealth of new information has accumulated regarding both clinical and research aspects of health care for the elderly. Although many controversial issues have been resolved, many still remain. Volume 2 of Contemporary Geriatric Medicine is once again dedicated to the clinician who cares for the elderly on a continuing basis. Although, for the most part, general topics first introduced in Volume 1 have been retained, all infor mation in this volume is new and represents the current state of the art. In addi tion, several new topics-including falls, interpretation of laboratory data, and oral health care-have been introduced to enhance this volume's usefulness to the busy clinician. Through these easy-to-read essays, we attempt once again to keep the non geriatrician abreast of the current state of the art regarding the special needs and problems of the elderly. Each chapter is not meant to be an exhaustive review of all topics in the field, but rather to focus on issues receiving a great deal of atten tion. Our goal is to create an exciting approach to contemporary issues in gerIatric medicine."
Clinical trials are the most definitive tool for evaluation of the applica bility of clinical investigations. The main objective of clinical investiga tions is to assess the potential value of a therapeutic entity in the treat ment or prophylaxis of a disease or a condition. It is also deemed necessary at this stage to obtain information regarding the undesirable side effects, associated risks, and their interrelationship with clinical assessments. Most of these clinical investigations conform, in some form or fashion, to the guidelines adopted by the Food and Drug Administration (FDA) for a given class of compounds. Clinical investigations in the past have not included specific studies in special or subpopulations, e.g., the elderly. Because of an ever-increasing elderly population, newer policies for clinical investigations are now being debated with the recognition of enhanced drug sensitivity in this special population. This key research activity can lead not only to improved health care in the elderly but also to control of its costs."
Memory is essential for the retention of learning. In the presence of memory deficits, new learning is impaired and performance of previously learned habits deteriorates. What is the nature of memory? Where does it reside in the brain? What biological events are associated with the formation and retrieval of memory? These questions are explored in the first chapter of this volume. The answers are not final, but we have learned a great deal about memory processes during the past few decades. Memory is influenced by most of the pathological processes that influ ence the brain such as infection, trauma, cerebrovascular disorders, and met abolic and degenerative diseases. The nature and course of memory impairment are unique for each of the disorders and are fairly distinguishable. More than fifty conditions are known to cause dementia, which now affects several million Americans. In Alzheimer's disease, memory disorder predominates for two to three years before other intellectual functions are affected. Many neurological diseases, such as Huntington's disease, Friedreich's ataxia, and multiple sclerosis, are associated with progressive memory deficits. Forgetting is a problem that becomes progressively worse with age. Most individuals in their forties begin to experience some difficulty in quick recall of past events. By age sixty definite changes are evident in the process of registration, storage, and recall of memory. At this age the material that is to be remembered is processed more slowly, stored less firmly, and poorly recalled."
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