Guide to Fitness After Fifty presents basic and applied research data, authoritative advice and tested techniques for professional workers who want to learn more about physical exercise, fitness and health for aging people and for all who seek to become more physically and mentally fit. The editors and contributors believe that physical activity and exercise following the pri ciples and practices utlined in this inter disciplinary volume can improve the health and quality of life by increasing en durance and cardiovascular fitness, strengthening the musculoskeletal system, im proving mobility, posture and appearance, and relaxing emotional tensions. Evidence at hand and discussed in this book demonstrates that properly prescribed physical activity or exercise can raise the level of physical fitness and health, both physical and mental, at any age, delay the ravages of aging, and prevent or reduce disability from musculoskeletal and circulatory disorders. Section I, Perspectives on Exercise and Aging, surveys the fundamental problems and relationships of exercise to aging and health and provides historical insights and philosophic perspectives on the significance and importance of physical fitness and exercise through the centuries and in contemporary society. Section II, Evaluation and Physiology of Exercise, presents objective scientific and medical evidence that reasonable improvement in fitness and other bodily func tions may be achieved by people of all ages who follow well designed exercise and relaxation routines for at least 30 minutes three or more times weekly."

The aim of these short notes is to provide the newcomer to the speciality of geriatrics with a wide though not exhaustive differential diagnosis of most of the commonly encountered symptoms in the elderly, and to draw particular attention tothe common and important disorders. The common causes of symptoms and the common dis eases as well as certain features which have special importance to the medicine of the elderly are emphasized. A final section on investigations (with short notes) which one may employ in the practice of geriatric medicine is included along with an appendix of normal values for the elderly. In our view this book does not show how geriatric medicine is practised but it does provide an outline of clinical aspects of medicine (geriatrics), knowledge of which is essential to the practice of ger iatrics. G.S.R. V.P. Foreword I take the view that if vitality is reduced to the extent that it interferes with life as the old person would wish to live it, then a proper medical assessment should be made as part of the overall appraisal of that person's problems. The provision of a home help or the meals on wheels service cannot be expected to revitalize the person suffering from hypothroidism or pernicious anaemia In the event both medical treatment and social support may be needed and to provide one without the other would be half measures."

The mammalian central nervous system is a remarkable structure which has attracted many new investigators, as evidenced by the dramatic increase in scientific publications dealing with neurobiology. Every day basic scientists conduct new and exciting experiments, resulting in remarkable discoveries des tined to help mankind. Unfortunately many of these new findings are slow to be accepted by the clinical world. This is especially true in the area of brain trauma, where the present prognosis is usually very poor. We have known for quite some time that the mammalian central nervous system is capable of compensating for severe damage in many different ways, and under some circumstances behav ioral compensation can be observed. However, much is still to be learned about the various factors and events that lead to functional recovery and those condi tions that do not. It is this challenge that originally excited a number of the contributors to this volume to explore the subject of recovery from brain damage. One factor in particular that is known to change the prognosis of recovery is the age of the organism at the time of the damage. This book is an attempt to explore this important variable. Most of the literature concerning aging deals with widespread degenerative changes and paints a grim picture for the aging central nervous system in terms of recovery of function following trauma."

Events in anyone day of the aged consist of the functions of daily living modified or enhanced for each individual according to his or her capability. It is the constant aim of the medical professions to enhance the individual's quality of life and to try to avoid what is preventable. Among some of the hazards of the geriatric day are fits, faints and falls. It is the fall which often highlights the first two and the consequences may be serious for an old person. Perhaps one day an easy way to circumvent the 'forces of gravity' or drugs to counteract impaired sensory input will be found. The importance of the study of gait has been increasingly recognized by physicians working in this field of medicine for the elderly; writings by geriatricians on the subject are numerous. Bernard Isaacs in his gait research laboratory in Birmingham is studying the subject. In this book the experience of the contributors is brought together, inevitably with some overlap, which has in the main been avoided by restructuring, modification and crosschecking of articles.

The year was 1943. As a third-year medical student at Stanford, I was about to witness the beginning of a medical miracle. Dr. Arthur Bloomfield, Professor of Medicine, had selected my patient, a middle aged man, who was dying of acute pneumococcal pneumonia, as one of the first patients to receive miniscule doses (by today's standards) of his meagre supply of a new drug - penicillin. The patient's response amazed everyone especially this impressionable medical student. The rest of the story is history. With one stroke, the introduction of penicillin removed from the medical scene the 'friend of the aged' - lobar pneumonia. The consequences, which no one could have imagined at the time, are still becoming manifest as other 'miracles' such as respirators, artificial kidneys and many potent new antibiotics have come upon the scene. All of us are aware that these miracles have created a variety of new challenges around the states of dying and near dying. We have no easy answers for these problems. Nevertheless as dialysis techniques, especially CAPD, are applied more widely to the treatment of the elderly, the task of helping the patient meet death with dignity becomes increasingly important and vexing because once begun, dialysis is difficult to terminate.

Distinguished physicians critically review the clinical consequences of the endocrinological changes that occur with aging-in both men and women-and examine the use of hormonal therapy to reduce them. Topics range from bone disease and water balance in all older people, to androgen deficiency in aging males, gynecomastia, and menopause. The authors also discuss Type II diabetes in persons over 65, emphasizing the cognitive benefits of good glycemia control, and the interaction of nutrition and metabolism, focusing on hypocholesterolemia, obesity, the anorexia of aging, trace elements, and vitamins. The aging of the sympathetic nervous system and its impact on hypertension in the elderly is also covered. Timely and authoritative, Endocrinology of Aging offers endocrinologists, geriatricians, and primary care physicians critical insight into the endocrine problems of our rapidly growing elderly population.

The Manual of Geriatric Anesthesia is a practical guide for physicians, residents, and students interested in the care of the elderly patient undergoing surgery. Although primarily written for anesthesiologists, other perioperative physicians and nurses will also find the information highly valuable. Highlights of the text include concise and clear discussions of preoperative assessment, anesthetic administration, the immediate postoperative care, as well as the more classic 'geriatric' topics such as the hip fracture patient, cataract surgery, postoperative delirium, dementia, ethics and end of life care. Clinical geriatric principles are woven into the text so that the reader can develop skills in geriatrics and develop a broader understanding of terminology and principles used in geriatric medicine.

"e of the reasons for all the F ASEB Societies to meet yearly is the possibility O to interrelate recent progress in diverse areas of research. The F ASEB Conferences have been organized to promote such interdisciplinary approaches. They center around a basic theme with the aim of discussing active research, in cluding widely divergent approaches, towards a better understanding of a general biological phenomenon. Because of the mounting interest in the subject of aging and development, this has been chosen as the theme for this year's symposia. We have necessarily been limited in the number of topics that could be covered. In our choice we have attempted to' select those facets of the main subject which at this time are gen erating active research interest among our membership. We have included invited speakers from abroad, such as Drs. Goldstein, Liew and Miller from Canada and Drs. Wolpert, Holliday and Williamson from England. I am sorry to say that the two speakers that we had invited from Russia, Dr. Frolkis, and from Czechoslovakia, Dr. Sterzl, were unable to attend.

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."

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 recent years ideas about the influence of psychological status on physical health have been elevated from intuition and clinical lore to a legitimate area of scientific study. Mechanisms of influence are, indubitably, diverse. Some of this influence is indirect, accounted for simply by the instrumental help that social engagement, associated with good mental health, affords people; for example, psychologically "healthy" people are probably more likely to comply with medication regimens and engage in other healthful behaviors to a greater extent than those who are socially withdrawn or psychologically unstable. But recent studies suggest that while the importance of these more obvious factors cannot be denied, the complete picture includes factors that are much more subtle and complex. A body of research is beginning to accumulate that suggests that all three major regulatory systems -- the central nervous system, the endocrine system, and the immune system -- are affected by cognitions, emotions and behavior. There is no doubt that a relationship between mental and physical health exists, but very little is known about the specific mechanisms by which such influence occurs. At least in part, empirical research in this area has been limited by the inherent need for an interdisciplinary approach and synthesis of collected data. Recently, a few researchers in a number of different disciplines have begun to study directly the linkage between psychological and emotional well being and health."

A distinguished team of contributors from the fields of medicine, philosophy and law address some of the issues which arise over the provision of care for dependent elderly patients. Some of the chapters are concerned with the challenge of achieving good quality medical care, the chronic inadequacies of policy making in the UK context, and the prospects for improvement in the medium term. Other chapters look at some of the threats to dependent elderly patients posed by longer-term social and ideological trends which find expression in proposals for age-limits to health care, advocacy of living wills and euthanasia, arguments for withdrawing tube-feeding from certain categories of patient, and certain proposals for resource allocation. This interdisciplinary volume will have a wide appeal to those involved in care of the dependent elderly, to health policy analysts and health care economists, and to bioethicists.

Throughout my clinical training and practice, I have been surprised by the number of times that sexual issues have emerged as an unexpectedly central feature in my work with older adults. I can vividly remember my own internal reaction on hearing one of my elderly female patients tell me that she was date raped a few years after the death of her elderly husband-when she was 68 years old. I can see in my mind's eye the blood splattered on the floor of an inpatient unit from an elderly man who smashed his arm through a window, furious that his antidepressant medication made it impossible to climax through masturbation. On a much less dramatic but equally important note, I think about the elderly amputee who told me softly about his fears of resuming sexual activity with his wife of 25 years. I also think about the elderly woman whose inability to take herself shopping to find fashionable, comfortable clothes to fit over her hunched shoulders and large breasts helped precipitate a serious depression. In sum, I learned early on that elderly sexuality is not just about how many times a week someone makes love. It is my hope that sharing these experiences and introducing the related theories, research, and interventions will assist other clinicians in dealing with these often challenging and clinically demanding situations. Without my patients, this text would not have been possible.

This volume brings together leading researchers on quality of life in old age to focus on one of the most important issues in both gerontology and quality of life studies. Quality of life is a holistic construct and assessed from many different perspectives and by many disciplines. Moreover, the concept of quality of life can be applied to practically all important domains of life. Thus, quality of life research has to include social, environmental, structural, and health related aspects and be approached from an interdisciplinary perspective. Recently research in gerontology has begun to systematically study quality of life - following the WHO dictum 'years have been added to life and now the challenge is to add life to years' - however there are very few texts available on this topic and none of an international and multi-disciplinary nature. Quality of life studies have neglected older people and, given the size and growth of this population, it is time to publish a volume on this topic that systematically pursues a comprehensive perspective and includes theoretical approaches and empirical findings with respect to the most important components of quality of life in old age. For these reasons and the high quality of the authors we have assembled, this will be a seminal text for both gerontology and quality of life researchers.

In this third volume on longevity Fondation Ipsen has again collected the most recent results in research on genes and diet in the evolution of human longevity, educational level and longevity, cognitive impairment and survival at older age and other contributions. The preponderance of relatively short - compared to long-lived organisms suggests that morphogenesis is easier to accomplish than is maintenace of soma, whereas the broad range of longevities of organisms demonstrates that maintaining soma for extended periods of time is possible. The underlying assumption of "disposable soma" theory of aging is that the expense of maintaining somatic cells depends on their contribution to the welfare of the germ cells.

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.

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.

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.

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.

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.

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.

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.

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.