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.

This book promotes an understanding of ageism, discrimination and mistreatment of older adult workers, incorporating an international human rights perspective. The impact of ageism on the mistreatment of older adult workers has not to date been examined in depth through the lens of international human rights instruments, nor has discrimination against older adults in the workplace been framed as a form of elder abuse for research and policy making purposes. This book presents a multi-disciplinary exploration of these themes as they affect work and retirement of older adults. It reflects the view that older people who choose to work into old age should be able to do so in enabling work environments that promote dignity and are free of abuse. The contributing authors come from many disciplines, including law, psychology, social work, business, and international affairs. Many are members of the International Network for the Prevention of Elder Abuse (INPEA), a non-governmental organization with consultative status at the United Nations, and have devoted their professional careers to increase awareness and understanding of elder abuse in order to prevent it. The editors hope that broadening the framework within which elder abuse in the workplace is understood will stimulate further research, policy and program development to address this troubling social problem.

Most scholars do not consider the long-term nature of caregiving, but rather focus on a specific developmental period (e.g., old age) or a specific disability (e.g., cancer). Yet the most important lessons about caregiving may occur at any age, regardless of disabilities or other limitations. Caregiving is a lifelong process. It begins in a mother's womb, continues throughout the lifespan, and ends after death. Caregiving Across the Lifespan emphasizes caregiving as a process that occurs throughout one's life. It discusses infant care, the developmental needs of children and adolescents, the many caregiving issues in adulthood and mid-life, and finally end-of-life care and bereavement. Key coverage includes: Examining caregiving issues across a developmental perspective. Caregiving from infancy through early childhood through end of life. Mid-life and multigenerational bonds and responsibilities. Caregiver identity in older adults. Family caregiving at the end of life. This must-have volume 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.

''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

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.

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.

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."

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.

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."

This volume presents the work of clinical health care teams and natural work groups, quality improvement teams, committees, and task forces made up of employees in health care settings. It discusses proven multidimensional instruments that measure team performance along with future needs for measuring team performance. It will be a resource for medical instructors and students, public health workers, and health administrators interested in team management.

The preparation of Aging, Immunity, and Infection has been a "labor of labor. " When we began, there existed a huge literature-but manage able, we thought, given our years of experience in the area often referred to as immunogerontology. However, in the time that we have been at work, the new relevant literature has increased at a prodigious rate. The more we read and tried to assimilate, the farther we fell behind. In order to have any hope of completing a book on this rapidly evolving topic, we have been forced to become increasingly selective in covering new and re cent publications. We dare to hope that many read ers will find the book useful and only a few will dweIl on the inevitable inadequacies. We consider the book a work in progress, and welcome suggestions for future editions. Five chapters cover several aspects of infection and the decline of immunity with age. The first chapter "Human Aging: Present and Future," is devoted to demographics and theories of senescence. Chap ter 2 outlines the gradual breakdown of resistance to infection in the aged individual. Chapters 3 and 4 cover changes in innate and acquired immunity. The final chapter, "Nutrition, Longevity, and Integrity of the Immune System," discusses such provocative ideas as life-span exten sion and nutritional intervention for the delay of immunosenescence.

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

"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.

In the elderly, the coexistence of various diseases, the presence of involutional and degenerative changes, and the occurrence of both physical and cognitive problems represent "the norm." It is therefore important to know how to distinguish the healthy elderly from those in need of treatment as a sound basis for avoiding overdiagnosis and overtreatment. This aspect is a central theme in Geriatric Imaging, which covers a wide range of applications of different imaging techniques and clearly explains both the potential and the limitations of diagnostic imaging in geriatric patients. Individual sections are devoted to each major region or system of the body, and a concluding section focuses specifically on interventional procedures. The book, written by recognized experts in the field, is superbly illustrated and will be an ideal resource for geriatricians, radiologists, and trainees.

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)."

Most of the DNA in the human genome does not encode proteins but is involved in regulatory functions. In addition, the human genome is characterized by an extensive array of structural DNA variants arising from de novo mutations plus accumulated structural variants transmitted through an individual's lineage. The result is that each person has a unique genome which is expressed as that person's unique phenotype. Ageing can be understood on both the species and individual level. Each species has a programmed ageing and mortality pattern, but within those broad species-specific boundaries there is considerable individual variation. At the individual level, ageing reflects the integrated effects of that individual's unique mix of DNA structural variants, unique experience-specific epigenetic marks and imperfectly repaired genomic and cellular damage. This book examines human "chronic degenerative" diseases which are not diseases, but rather variations of the ageing process across individuals.

This volume is the result of a lifetime of personal research into human wellness. It naturally considers all the implications of human illness as well. The chapters offer a kaleidoscope of training programs previously offered to thousands of healthcare professionals in hospitals, nursing homes and rehab centers in the New England Area. The topics range of nursing home placement to spirituality as life meaning, to depression and suicide in the elderly. It is meant to contribute to the modern challenge of longevity, living longer with greater meaning.

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.

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

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.

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.

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
Emotional needs of caregivers
Developmentally appropriate long-term care for people with Alzheimer s
Family caregivers as members of the Alzheimer s treatment Team
Legal and ethical issues for caregivers
Faith and spirituality
The economics of caring for individuals with Alzheimer s disease
Cultural, racial, ethnic, and socioeconomic issues of minority caregivers
Advances in Alzheimer s disease research

"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."

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 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."