Neurotransmitter changes taking place in the brain of patients with dementia disorders, mainly Alzheimer type dementia, are reported. Their role in the pathogenesis of Alzheimer's disease is discussed; and the neurochemical changes are considered as a base for formulating treatment strategies. By studying markers in the cerebrospinal fluid, diagnostic methods may be achieved that will aid in diagnosing subgroups of dememtia.

This volume presents a clear, concise overview of the current state of knowledge about the biology of aging - serving as both an invaluable graduate-level text and a key reference for practicing professionals. Over a dozen distinguished contributors probe the latest developments in our knowledge of why people age and how the process works. These authoritative chapters are not just written for biologists - but for gerontologists in general. Marks the tenth anniversary of the Annual Review of Gerontology and Geriatrics.

Traditional methods in the clinical practice of neurology have dominated clinical teaching in this specialty for about 100 years. Essentially these methods involve meticulous attention to detail and the recording of clinical facts. Thus the clinical history must be recorded chronologically, preferably in the patient's own words, and of the nervous sys followed by a carefully structured examination tem set out in such a way as to allow the precise localisation of the lesion or system involved. Clinical neurology taught and practised in this way has bred generations of neurologists throughout the world and raised the standards in the specialty to a level where clinical skills are probably unexcelled in any other specialty. With increasing availability and reliance upon non-invasive imaging techniques, the need for these skills in large areas of neurological practice has diminished. But perhaps more importantly, the classical clinical methods in neurology were developed when the elderly population was much smaller and when the specialty of geriatrics did not exist. As a result, much of the methodology is irrelevant or unreliable in of geriatrics will frequently the elderly population and the student find himself searching in vain in the textbooks of neurology for help in assessing an elderly patient with an atypical presentation (for example disturbance of balance or recurrent confusional episodes) of some common neurological disorder."

The number of diabetics in the elderly population is increasing rapidly, not merely because of the increasing size of the elderly population itself. In elderly people diabetes is often poorly diagnosed and occurs as a consequence of, or in addition to, some other condition. Although diabetes may manifest itself less dramatically in the elderly there is evidence to suggest that diabetes-related complications do arise more rapidly in this group. It is therefore extremely important that doctors and health professionals can spot the symptoms of diabetes at an early stage. This book provides a concise description of diabetes in the elderly as well as discussing related complications and should be useful to all health workers dealing with elderly people.;This book should be of interest to all health professionals working with elderly people.

The study of "the end of life" has become a major focus on medicine, the social sciences, ethics, and religion. This volume brings together the latest research on issues around death and dying, life's attributes as it nears death, planning and preparation for death, and care and intervetion-related issues. This evidence-based finding of this volume will help shape how we approach the topic for years to come.

While modern Americans strive to control nearly every aspect of their lives, many of us abandon control of life's final passage. But the realities of twenty-first-century medicine will allow most of us to have a say in how, when, and where we die, so we need to make decisions here, too. Through compelling real-life stories and practical guidance, this book helps readers navigate end-of-life care for themselves and their loved ones.

"The Better End" is about hope, empowerment, and inspiration. What we choose for our end-of-life care depends on accurate information and on our personal values. We need not only to understand new medical advances but also to appreciate the wisdom of humanity's past and present.

Dan Morhaim, a practicing physician and Maryland state legislator, guides readers through the medical and legal maze of end-of-life care. He details the care choices available to patients and explains why living wills and advance directives are a necessity for every American. He tells readers where to find free and readily available living wills and advance directives and why it is so important for everyone--young and old--to complete them.

Dr. Morhaim helps readers keep decisions in their own hands and spare their families the uncertainty and trauma of guessing about their end-of-life wishes. With this book, he breaks down the barriers to a difficult but essential topic, helping readers to open this often avoided discussion with their loved ones and providing the information and guidance needed to ensure that deeply held values are reflected and honored.

Illness in old age is characterised by vague and atypical presenting features which are often missed and wrongly attributed to the ageing process. This is particularly true of endocrine disorders where hypothyroidism may mas querade as dementia, where electrolyte imbalance may cause lassitude, and where diabetes mellitus may produce a wide range of complications com monly associated with ageing. It is our intention that our book provide straightforward practical guidance in this difficult area by delineating the effects of ageing on endocrine function and the clinical consequences of these; and by describing in detail the wide range of presenting clinical fea tures of endocrine disease in the elderly. Physicians are also often baffled and misled by the effects of ageing and disease on laboratory tests used in the investigation of endocrine disease. Our book describes these changes in detail, and gives guidance on which tests are most appropriate. Ageing and disease also produce subtle changes in the response of patients to drugs and replacement, and this is also dis cussed in detail. Subjects included separately and in depth include thyroid disease, the clinical features and treatment of diabetes, postmenopausal changes, bone disease, fluid and electrolyte imbalance, energy imbalance, and drugs caus ing endocrine and metabolic disorders. These have been chosen because we consider that they present problems which are particularly relevant to the elderly. Many other issues are covered in general textbooks of endocrin ology and have been omitted."

The concept of dementia has itself been the subject of increasing refinement and precision in definition and diagnosis. Two important sub-types have been identified: Alzheimer's disease and multiple-infarct dementia. Alzheimer's disease or Senile Dementia of the Alzheimer Type (SDA T), arises out of changes in the brain which are as yet poorly understood and identifiable with certainty only at post mortem examination. This type of dementia has been named after Alois Alzheimer, who first identified these changes, in the earliest years of this century. Alzheimer's is the commonest type of identified dementia. The second commonest type is multi-infarct dementia (MID), which follows a stroke or strokes affecting the relevant part of the brain. Like SDA T, it can be diagnosed with certainty only after death, although Jorm (1987, Ch. 8) reviews progress in using various types of tests which can suggest, if not confirm, its presence during the sufferer's lifetime. As will be shown in Chapter 2, some populations appear to reverse the general picture and exhibit more MID than SDAT. Many dementia sufferers cannot, even after a post-mortem examination, be neatly categorized as one or the other of these sub-types. A considerable uncertain 'grey area' of dementia remains at present very poorly understood. Some elderly people develop dementia as a side-effect of known physical disease. Some of these conditions are curable. Care of the demented person has traditionally taken place in the community: hospitalization is a fairly recent innovation.

Elderly patients are major consumers of antidepressant drugs, yet this subject is under-researched. The elderly are particularly sensitive to the adverse affects of psychotrophic drugs, and they are often given a variety of drugs simultaneously. It is therefore vital that doctors should be well informed about this subject.;The aim of this book is to provide comprehensive guidance on the drug therapy for depression in old age to the clinicians involved in the health care of elderly people.;The book starts be discussing the epidemiology, presentations and assessments of depression in old age. The main part of the book deals with problems of antidepressant drug therapy, such as which antidepressant to prescribe, how to monitor side effects, what is the adequate dose, how long to treat a single episode of depression and who requires long-term medication.;This book should be useful reading for all doctors who care for elderly people.;This book should be of interest to general physicians, psychiatrists, psychopharmacologists and physicians in geriatric medicine.

In recent years, the literature on the topic of ethnic and racial issues in Alzheimer's disease and other dementias has increased dramatically. At the same time, the need for cultural competence in all of geriatric care, including dementia care, is increasingly being acknowledged. Dementia is a large societal problem affecting all communities, regardless of race or ethnicity, and understanding dementia for specific groups is tremendously important for both clinical knowledge and for health planning as a nation. This third edition of Ethnicity and the Dementias offers invaluable background information in this area, while also examining how those suffering from dementia and their family members respond or adapt to the challenges that follow. Thoroughly updated and revised throughout, the book features contributions from leading clinicians and researchers in the field, with particular attention given to genetic and cultural factors related to dementia, effective prevention and treatment strategies, and issues in caregiving and family support. Chapters offer specific recommendations for dementia care in eleven ethnic/racial groups, as well as suggestions for working effectively with LGBTQ families. Providing a truly comprehensive resource on ethnicity and dementia, and including reflections on emerging trends and the future of caregiving, this new edition is ideal reading for clinicians, educators, researchers, policy makers, and families, in search of the most current ethnogeriatric findings.

The study of "the end of life" has become a major focus on medicine, the social sciences, ethics, and religion. This volume brings together the latest research on issues around death and dying, life's attributes as it nears death, planning and preparation for death, and care and intervetion-related issues. This evidence-based finding of this volume will help shape how we approach the topic for years to come.

Incontinence is still a subject which is rarely discussed. But, since this very common condition can severely impair a person's lifestyle, information about it needs to be made more widely available, both to health professionals and to lay people.;This text describes the nature of incontinence, how it can be managed, and gives information about the aids, equipment and services available to help those affected by this problem. It is a revised version of a book originally published in 1977 under the title - "Incontinence: A Guide to Understanding and Management of a Very Common Complaint". Since the earlier publication the services available to people with incontinence have increased significantly. More doctors and Incontinence Advisers (usually nurses) have expertise in the field, and manufacturers have improved their products. Incontinence can severly affect a person's self-esteem, family relationships and mobility. It is hoped that this book will help educate lay and professional readers about incontinence and how sufferers can be helped.;This book should be of interest to health professionals (doctors, nurses, physiotherapists), social workers, volunteers working with disabled people, lay people.

As our population continues to age, health professionals are being called on to care for an ever-increasing number of elderly patients. A thorough understanding of what constitutes normal aging versus age-prevalent illness is essential. In addition, the atypical and nonspecific presentation of illness commonly encountered when caring for an older patient must be expected and watched for carefully. In recent years, the health professional has been exposed to an exponentially increasing number of publications attempting to teach geriatric principles. To date, few publications lend themselves to use by the busy practitioner, student, or nurse in search of immediate facts, flow sheets, and clinically applicable data. It was felt that the health professional would benefit greatly from a book based on the concept of a ready-reference "hand book," with chapters filled with tables, flow sheets, and listings similar in scope to those in a well-presented lecture series. Our goal was to create a geriatrics handbook that would have value at the bedside as well as in the classroom. It is to this end that the contributors dedicated their efforts."

For much of the developed world, health care for a surging elderly population looms as one of the most daunting problems of the coming decade. In this book, contributors from diverse disciplinary backgrounds and countries discuss resource allocation for the elderly and debate plans for the years ahead. Essays focus on five general issues: the meaning of old age, the goals of medicine and health care for the elderly, the balance between the needs of the young and old, the pressures of other social priorities, and the role of families, especially the burden on women, in long-term care.

In consideration of the difficult moral and practical issues involved, the editors conclude the volume with a special report containing policy recommendations from representatives of eight countries (the United States, Belgium, the Czech Republic, Germany, Hungary, the Netherlands, Sweden, and the United Kingdom). This important volume will be of interest to policymakers and a broad spectrum of health care professionals, as well as to anyone interested in the fate of the elderly or in coming health care challenges.

Increasingly, scholars from many disciplines have begun to incorporate various modalities from the humanities and arts - novels, films, artwork, and other forms of expression - to help connect students with the experience of aging in deeply meaningful and person-centered ways. This collection examines how these approaches are incorporated into gerontology and geriatrics education. Rather than focusing solely on measurable outcomes, such as changes in learning over time - which is the purview of empirical pedagogy - chapters focus on strategies for successfully incorporating a specific work into the classroom, descriptions of humanities and/or arts exercises with students or older adults, and other ways that explore how the humanities and arts can be applied successfully and meaningfully in educational settings. This book was originally published as a special issue of Geronotology & Geriatrics Education.

Neuroimmunoendocrine aspects of the pathophysiology of rheumatic diseases are presented in this volume, and new approaches to diagnosis and therapeutic intervention are suggested.

Topics presented include gene polymorphisms and the neuroendocrine immune system in rheumatic diseases, anti-TNF strategies and effects on neuroendocrine immune mechanisms in rheumatic diseases, new perspectives on therapeutic use of glucocorticoids, nerve fibers and rheumatoid arthritis, stimulation tests of the stress axes, and sex hormones and lipid metabolism in rheumatic diseases.

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The undisputed leader on the subject of geriatrics-updated to reflect the most recent advances in the field The leading text on the subject of geriatrics, this comprehensive guide combines gerontology principles with clinical geriatrics, offering unmatched coverage of this area of medicine. Anchored in evidence-based medicine and patient-centered practice, Hazzard's Geriatric Medicine and Gerontology presents the most up-to-date, medical information available. This updated eighth edition reflects the continued growth and increasing sophistication of geriatrics as a defined medical discipline. The book focuses on the implementation of key concepts and covers the foundation for geriatrics, as well as frequently encountered syndromes found in older adults. In addition, it provides valuable insights into the simultaneous management of multiple conditions, including psychological and social issues and their interactions, an intrinsic aspect of geriatric patient care. Features: A greater emphasize on the growing knowledge base for key topics in the field, including gerontology, geriatrics, geriatric conditions, and palliative medicine NEW chapters on: Social Determinants of Health, Health Disparities and Health Equity Age Friendly Care Geriatrics Around the World The Patient Perspective Substance Use and Disorders Applied Clinical Geroscience Managing the Care of Patients with Multiple Chronic Conditions UPDATED contributions from a respected and diverse team of geriatricians and subspecialists to reflect clinical breakthroughs and advances NEW: Extensive coverage of the COVID-19 pandemic and its impact on vulnerable older adults Updated Learning Objectives and Key Clinical Points Hundreds of full-color images A Doody's Core Title for 2022!