The 1990s have been characterized by a reappraisal of allocating expenditure for health care interventions. Coronary artery bypass in the elderly has emerged as an example of burgeoning expensive surgery whose appropriateness is under challenge. This book comprises the proceedings of an international symposium where leading experts in aspects such as health economics, ethics, clinical cardiology, cardiac surgery, epidemiology and health-care policy discussed the need and outcome of the operation in old and very old patients. Clinical issues and operative results complement national costs and quantitated benefits in terms of quality of life as a justification of surgery. The book is addressed to cardiologists, geriatricians, cardiac surgeons, psychiatrists, rehabilitation physicians and public health-care administrators.

The book describes the major degenerative processes and pathologies exacerbated by senescence and how they can be alleviated through retardation of cellular aging. Topics discussed include neurodegenerative disease, protein oxidation, cerebrovascular disease, particle-induced inflammation and cardiovascular disease, Alzheimer's disease, ovarian aging, dietary and endogenous anti-oxidants in management of Parkinson's disease, and effects of exercise on oxidation and inflammation. The nineteen expertly authored chapters are organized into three sections in order to present a complete picture to the reader: Age Related Cellular Events, Role of Inflammatory and Oxidative Processes in Age-Related Diseases, and Retardation of Cellular Aging. Inflammation, Oxidative Stress and Age-Related Disease draws from a variety of international perspectives and provides a comprehensive overview of the relationship between disease, cell aging, and oxidative stress, as well as potential for preventing or slowing these processes. This installment of Springer's Oxidative Stress in Applied Basic Research and Clinical Practice is ideal for researchers, clinicians, and advanced graduate students in the fields of cardiology, neuroscience, biogerontolgy, and cell biology.

This book provides a comprehensive overview of the field of developmental programming of ageing phenotypes. Although gerontological research has traditionally focused on later stages of the life cycle, growing evidence indicates that both the rate of ageing-associated functional declines, and the risks of later-life chronic pathological conditions, can be traced to origins early in life. While other books in the field concentrate on the developmental origin of particular disorders, this volume offers a detailed guide to all important aspects of the role of early-life conditions in programming both chronic pathological conditions and the ageing process. Interest in the study of ageing and longevity had its beginnings in research on the fetal origins of adult disease. This has evolved into a hypothesis on the Developmental Origins of Adult Health and Disease (DOHaD), which postulates that adverse environmental exposures during critical in-utero and early postnatal stages of development may permanently change physiological responses and cause functional impairments and disorders in adult life. In this book, the contributing authors and leading experts from around the world, describe research on mechanisms underlying the developmental programming phenomenon, as well as interventional strategies aimed at restoring developmentally disrupted epigenetic patterns. Early Life Origins of Ageing and Longevity benefits a wide audience of working scientists, clinicians, and advanced students, and will also interest scientifically curious general readers who wish to know more about current research in this rapidly evolving field.

This volume provides insight into the pivotal roles of stem cells, exosomes and other microvesicles in biofunction and molecular mechanisms and their therapeutic potential in translational nanomedicine. It further highlights evidence from recent studies as to how stem cell derived exosomes and microRNAs may restore and maintain tissue homeostasis, enable cells to recover critical cellular functions and begin repair regeneration. These early studies in animal models of aging also show evidence of improved immune, cardiovascular and cognitive functions as well as improved health span and life span. The use of exosomes from body fluids to define specific biomarkers for various tumors may also clear the path to patient-targeted treatments by developing exosome-derived microRNA based cancer therapeutics. It is essential reading for graduate students, research fellow and biomedical researchers in academia or the pharmaceutical or biotech industries.

As the American population ages, health care for the elderly grows in importance. This bibliography overviews the most significant books and journal articles on the ethical issues related to health care for older Americans. The topics covered are of interest to practitioners and the general public alike, as well as to professionals from a wide range of fields. The author has provided more than five hundred bibliographic citations. These entries are arranged in eleven topical chapters to facilitate use by the reader. Each citation is accompanied by an annotation that concisely summarizes and assesses the contents of the work. The volume begins with an informative introductory essay on the ethical issues pertinent to health care for older adults. The chapters that follow are devoted to broad topics, such as financial considerations, treatment for the terminally ill, and decision-making by and for the impaired elderly. The work concludes with author and subject indexes that add to its utility. Researchers and practitioners from all fields will find this work an indispensable guide to the wealth of literature on the ethical aspects of health care for older Americans.

This issue of Clinics in Geriatric Medicine is devoted to Palliative Care. Guest Editors Thomas Smith, MD and Madeline Leong, MD have assembled a group of expert authors to review the following topics: Palliative Care in the Era of Healthcare Redesign; Communications to Patients; Communications by Professionals; International Palliative Care; Public Health and Palliative Care; Culturally Relevant Palliative Care; Spirituality, Religion, and Healing in Palliative Care; Alternative, Complementary and Mainstream Therapies in Palliative Care; Symptom Management in the Older Adult; Interaction of Palliative Care and Primary Care; Palliative Care in the Ambulatory Geriatric Practice; Choosing Cancer Therapy Based on Geriatric Assessment; and Emergency Medicine and Palliative Care.

Human aging is perhaps the most complex and important subject that will be facing science and societies in the next century. People seem to be living longer and remaining more active than their parents and grandparents, caused by to social and demographic shifts that must be accommodated by society. On the other hand it presents perplexing questions about the underlying processes and determinants of healthy aging. This book gives a design for research that will increase our understanding of the factors that influence healthy aging and can lead to improvements in reducing the levels of disability in the population. Its focus is on bio-behavioural and psychological factors contributing to healthy aging. Since human aging is determined by many interacting conditions inside and outside of the organism, research should concentrate on ecological relationships between the human organism and its social and physical environment. Not only individual characteristics associated with aging are discussed in this book, but also their impacts on society. The information presented in 'Aging in Europe' has not been available in any single source before. In many ways this book provides a model of gaining knowledge through cooperation that should guide us in the next century and beyond.

This issue of Clinics in Geriatric Medicine, guest edited by Dr. Soo Borson, is devoted to Geriatric Psychiatry. Articles in this issue include: Diagnosis; Providing high quality care for dementia patients and family caregivers; Common psychiatric problems in cognitively impaired patients - causes and management; Partnering with family caregivers; Palliation and end of life care; Geriatric depression; Treatment for depression and evaluating response; Post-traumatic stress in older adults; Sleep disorders; Substance Abuse; Suicide; and Mental Health Services for Older Adults.

This issue of Medical Clinics of North America, edited by Drs. Jeffrey Wallace and Susan Merel, is devoted to Gerontology. Articles in this issue include: Preventative care in geriatrics; Geriatric syndromes and assessment in the outpatient setting; Assessment and management of fall risk; Drug interactions and side effects; Evaluation and management of elderly patients presenting with cognitive complaints; Pain management in the elderly; Diabetes management in the elderly; Hypertension in the elderly; End-of-life care; Urinary incontinence; Nutrition in the elderly; Anti-thrombotic management in the elderly; and Sleep problems in the elderly.

How do individuals perceive the experience of aging? Can this perception predict such developmental outcomes as functional health or mortality? The 35th volume of ARGG encompasses the most current and fruitful research findings about the subjective experience of aging and describes how they fit within a theoretical framework. It reflects a new and advanced stage of development in the discipline of subjective aging and will be a building block for future theoretical and empirical work in this area of study. The book integrates presentations from a series of recent workshops attended by an international cadre of subjective aging researchers, the results of several longitudinal studies from across the globe, and theoretical propositions from studies that are ongoing. Chapters-reviewed by independent scholars for ""quality control""-- address major conceptual approaches and key challenges to subjective aging research; research designs, empirical findings, and methodological issues; and the implications of subjective aging research on interventions, society, and the changing contexts of aging. Key Topics: Subjective aging and awareness of aging Connections between research on subjective aging and age stereotypes and stigma Linking subjective aging to changing social meanings of age and the life course Psychological and social resources and subjective aging across the adult life span Experimental research on age stereotypes Domain-specific approaches and implications for addressing issues of developmental regulation Subjective aging as a predictor of major endpoints of aging and development Exploring new contexts and connections for subjective aging measures Changing negative views of aging Subjective aging research from a cross-cultural perspective Subjective aging research and gerontological practice Future directions for subjective aging research

Caring for the Geriatric Surgical Patient is covered extensively in this important Surgical Clinics of North America issue. Articles include: Changing Demographics of the American Population; Effect of Aging on Cardiac Function plus Monitoring and Support; Effect of Aging on Vascular System plus Monitoring and Support; Effect of Aging on Pulmonary Function plus Monitoring and Support; Effect of Aging on Renal Function plus Monitoring and Support; Management of the Gastrointestinal Tract and Nutrition in the Geriatric Surgical Patient; Management of Skin/Soft Tissue/Pressure Sores in the Geriatric Surgical Patient; Hematologic Issues in the Geriatric Surgical Patient; Healthcare-Economic Impact of Caring for the Elderly; Operative Risk Stratification in the Geriatric Surgical Patient; Management of Fractures in the Geriatric Surgical Patient; Pharmacology for the Geriatric Surgical Patient; Rehabilitation of the Geriatric Surgical Patient; End-of-Life Care of the Geriatric Surgical Patient, and more.

This major reference is a substantially revised edition of Palmore's "International Handbook on Aging," which was voted Choice Outstanding Academic Book of 1980. The reference collects and summarizes information on programs and research in gerontology in most countries where significant work is taking place. The chapters are arranged alphabetically, with each chapter devoted to a particular country. The countries selected represent a wide range of social, political, geographic, and economic conditions, and ten new countries are included in this edition.

Each chapter provides current information on the unique features of the country profiled; the roles and status of the aged; problems of the elderly; programs for older adults; research in biomedical, psychological, and sociological aspects of aging; and sources of additional information. Each chapter closes with a list of works for further consultation, and the handbook concludes with an appendix of gerontological associations and a bibliography. Gerontologists, social scientists, and policymakers will find this reference a valuable and current guide to developments and research on aging around the world.

Poliomyelitis, better known as polio, thoroughly stumped the medical science community. Polio's impact remained highly visible and sometimes lingered, exacting a priceless physical toll on its young victims and their families as well as transforming their social worlds. This social history of infantile paralysis is plugged into the rich and dynamic developments of the United States during the first half of the twentieth century. Children became epidemic refugees because of anachronistic public health policies and practices. They entered the emerging, clinical world of the hospital, rupturing physical and emotional connections with their parents and siblings. As they underwent rehabilitation, they created ward cultures. They returned home to occasionally find hostile environments and always discover changed relationships due to their disabilities. The changing concept of the child, from an economic asset to an emotional commitment, medical advances, and improved sanitation policies led to significant improvements in child health and welfare. This study, relying on published autobiographies, memoirs, and oral histories, captures the impact of this disease on children's personal lives, encompassing public-health policies, hospitalization, philanthropic and organizational responses, physical therapy, family life, and schooling. It captures the anger, frustration, and terror not only among children but parents, neighbors, and medical professionals alike.

The articles appearing in this geriatrics-focused issue are consistent with the collaborative and translational concepts held by a life course perspective. Each supports interprofessional collaboration and some are either authored or coauthored by interdisciplinary colleagues. Three goals are reflected in these articles: keeping community-dwelling older adults safe, sensible, and secure with solutions that will enable them to stay healthy, wise, and aware. Topics include maintaining physical functions, benefits and consequences of weight-bearing exercise on foot health; cancer prevention; managing nocturia's effect on sleep quality and safety; protection from financial exploitation; and providing safe and affordable living environments. Several articles address physical or cognitive challenges that include monitoring medication adherence, threat of anxiety and stigma in dementia, and approaches to managing self-care in the home for persons with dementia. These evidence-based articles address emerging and best practices to support targeted interventions for persons in community-dwelling home settings. They provide a frame-work of person-centered approaches that foster good health in older age, a central tenet of aging in place and the global response to population aging.

This issue of Clinics in Geriatric Medicine is centered on the management of the geriatric fragility fracture patient. This issue features expert clinical reviews on topics such as Principles of comanagement, Lean business model and implementation of a Geriatric Fracture Center, Preoperative optimization and risk assessment, Preoperative reversal and management of anticoagulation and antiplatelet agents, Classification and surgical approach to hip fractures for non-surgeons, Special anesthetic consideration for the fragility fracture patient, Non-surgical management and palliation of fragility fractures, and Management of post-operative complications including Delerium, Anemia, Venous thromboembolism, and Cardiovascular disease and volume management. Also included are articles on Transitions in care and rehabilitation, Osteoporosis related secondary fracture prevention, Post-operative assessment of falls risk and prevention, and Fragility fractures requiring special consideration.

The rapidity of scientific progress over the last few years guarantees the utility of a new collection of state-of-the-art reviews on the immunology of ageing. The aim of this authoritative book is to summarize current knowledge on the cellular and molecular aspects of the ageing immune system and their clinical relevance. The book is a result of extensive collaboration of more than sixty of the greatest thinkers and scholars in the field, in cooperation with a number of junior colleagues. Immunology of Aging presents the most up-to-date information on the scientific issues addressed by research into ageing of the immune system, providing insights into the effects of this process on susceptibilities to those diseases which are most common among elders. The retrieval strategies used to slow down the decline in the immune system in the elderly are another subject detailed extensively. By providing a broad overview of immunosenescence and its consequences, as well as their potential modulation, this book will fill a gap in a timely manner. It will be of value to all immunologists, whether novice or experienced, as well as geriatricians and epidemiologists.

This updated and expanded second edition of Resilience in Aging offers a comprehensive description of the current state of knowledge with regard to resilience from physiological (including genetic), psychological (including cognitive and creative), cultural, and economic perspectives. In addition, the book considers the impact of resilience on many critical aspects of life for older adults including policy issues, economic, cognitive and physiological challenges, spirituality, chronic illness, and motivation. The only book devoted solely to the importance and development of resilience in quality of life among older adults, Resilience in Aging, 2nd Edition continues to offer evidence-based theory, clinical guidelines, and new and updated case examples and real-world interventions so professional readers can make the best use of this powerful tool. The critical insights in this volume are concluded with a discussion of future directions on optimizing resilience and the importance of a lifespan approach to the critical component of aging. The book's coverage extends across disciplines and domains, including: Resilience and personality disorders in older age. Cultural and ethnic perspectives on enhancing resilience in aging Sustained by the sacred: religious and spiritual factors for resilience in adulthood and aging. Building resilience in persons with early-stage dementia and their care partners. Interdisciplinary geriatric mental health resilience interventions. Developing resilience in the aged and dementia care workforce. Using technology to enhance resilience among older adults. This wide-ranging and updated lifespan approach gives Resilience in Aging, 2nd Edition particular relevance to the gamut of practitioners in gerontology and geriatrics, including health psychologists, neuropsychologists, clinical psychologists, psychiatrists, social workers, geriatricians, family physicians, nurses, occupational and physical therapists, among others.

This issue of Clinics in Geriatric Medicine features expert clinical reviews on Mild Cognitive Impairment which includes current information on topics such as Overview of Mild Cognitive Impairment, Aging and Cognition, Classification and Epidemiology of Mild Cognitive Impairment, Neuropsychiatric Symptoms of Mild Cognitive Impairment, Clinical Evaluation of Early Cognitive Symptoms, Emerging Biomarkers Relating to Cognition, Imaging Modalities in Evaluation of Cognition, Current Management Decisions in Mild Cognitive Impairment, Risk Factors for Progression to Dementia, Dealing with Mild Cognitive Impairment: Help for Patients and Caregivers.

This book provides a comprehensive view of rational suicide in the elderly, a group that has nearly twice the rate of suicide when chronically ill than any other demographic. Its frame of reference does not endorse a single point-of-view about the legitimacy of rational suicide, which is evolving across societies with little guidance for geriatric mental health professionals. Instead, it serves as a resource for both those clinicians who agree that older people may rationally commit suicide and those who believe that this wish may require further assessment and treatment. The first chapters of the book provides an overview of rational suicide in the elderly, examining it through history and across cultures also addressing the special case of baby boomers. This book takes an ethical and philosophical look at whether suicide can truly be rational and whether the nearness of death in late-life adults means that suicide should be considered differently than in younger adults. Clinical criteria for rational suicide in the elderly are proposed in this book for the first time, as well as a guidelines for the psychosocial profile of an older adult who wants to commit rational suicide. Unlike any other book, this text examines the existential, psychological, and psychodynamic perspectives. A chapter on terminal mental illness and a consideration of suicide in that context and proposed interventions even without a diagnosable mental illness also plays a vital role in this book as these are key issues in within the question of suicide among the elderly. This book is the first to consider all preventative measures, including the spiritual as well as the psychotherapeutic, and pharmacologic. A commentary on modern society, aging, and rational suicide that ties all of these elements together, making this the ultimate guide for addressing suicide among the elderly. Rational Suicide in the Elderly is an excellent resource for all medical professionals with potentially suicidal patients, including geriatricians, geriatric and general psychiatrists, geriatric nurses, social workers, and public health officials.

In this deeply considered meditation on aging in Western culture, Jan Baars argues that, in today's world, living longer does not necessarily mean living better. He contends that there has been an overall loss of respect for aging, to the point that understanding and "dealing with" aging people has become a process focused on the decline of potential and the advance of disease rather than on the accumulation of wisdom and the creation of new skills.

To make his case, Baars compares and contrasts the works of such modern-era thinkers as Foucault, Heidegger, and Husserl with the thought of Plato, Aristotle, Sophocles, Cicero, and other Ancient and Stoic philosophers. He shows how people in the classical period--less able to control health hazards--had a far better sense of the provisional nature of living, which led to a philosophical and religious emphasis on cultivating the art of living and the idea of wisdom. This is not to say that modern society's assessments of aging are insignificant, but they do need to balance an emphasis on the measuring of age with the concept of "living in time."

Gerontologists, philosophers, and students will find Baars' discussion to be a powerful, perceptive conversation starter.

This issue of Clinics in Geriatric Medicine features expert clinical reviews on Renal Disease in Older Adults which includes current information on topics such as Anatomic/ Physiological Changes with Aging, Acute Kidney Injury in Older Adults, Electrolyte Problems in Older Adults, Glomerular Disease in Older Adults, Hypertension in Older Adults, Chronic Kidney Disease in Older Adults, End-stage Renal Disease in Older Adults, Decision Making in the Older Adult Patient with Advanced Kidney Disease, Obstructive Uropathy in Older Adults, Drug Dosing, Transplantation in Older Adults, and Slowing the Aging Process.

Caring for the ill, disabled, very old, or very young requires a labor-intensive commitment that is not only essential to the well-being of individuals and to society as a whole, but also fraught with physical, financial, and psychological risks. And despite the critical nature of their job, caregivers rarely have avenues of support. The Challenges of Mental Health Caregiving addresses the complexities of the situation with uncommon depth and breadth. Suited to researchers, scientist-practitioners and clinicians, and students seeking a rounded understanding of the field, it examines how caregiving affects the lives, work, and mental health of family and professional caregivers. Chapters explore developmental, cultural, and spiritual contexts of care, addressing ongoing concerns about care in relation to larger health systems and emphasizing the need for care to be viewed as a community, rather than an individual or family experience. Further, the book's conclusion strongly advocates for more effective and efficient uses for available funds and resources while offering workable proposals for service improvements at the policy level. Key areas of coverage: The impact of caregiving on physical and mental health. Integrating mental health and primary care. The promotion of positive mental health outcomes in children and youth. Mid-life concerns and caregiver experience. Loss, grief, bereavement and the implications for mental health caregiving. Policy issues in caregiving and mental health. The Challenges of Mental Health Caregiving is a clear-sighted reference for researchers, clinicians and scientist-practitioners, and graduate students in the caregiving fields, including clinical psychology, social work, public health/medicine, geriatrics/gerontology, public policy, and educational policy.

An encouraging and compassionate guide for dementia caregivers. Caring for someone with dementia means devotedly and patiently doing a hundred little things each day. But few care providers are trained to meet the challenges of dementia-despite the fact that millions of people will struggle with it as they grow older. In A Loving Approach to Dementia Care, Laura Wayman, who is known professionally as the Dementia Whisperer, offers practical, compassionate advice on overcoming caregiving obstacles and maintaining meaningful relationships with loved ones who have dementia and memory loss. In this thoroughly revised third edition, Wayman includes * answers to common caregiver questions, such as "What is dementia?" * a detailed explanation of how to cope with and care for a spouse with dementia symptoms, including advice about communication * a new chapter on caring for someone who has dementia along with other health problems * recommendations about how to handle challenging situations and behaviors * dementia-aware activities that work for both family caregivers and professional care staff * fresh caregiving insights that emphasize the importance of taking time to care for oneself Each chapter contains two sections-"Lessons Learned" and "Perceptions and Approaches"-which provide details about how readers can apply lessons from the stories Wayman tells to their own caregiving practice. Providing support for the numerous difficulties and disruptions that all caregivers face along the way, A Loving Approach to Dementia Care is an empathetic guide filled with respect, calm, and creativity. It will leave readers feeling empowered and inspired.

This issue of Medical Clinics covers the important advances surrounding the early intervention of Alzheimer's Disease. Guest edited by world-renowned experts from around the world, the topics covered will include evaluation of new diagnostic criteria, CSF biomarkers, diagnostic imaging, neurocognitive approaches, breaking clinical trials and more.

This issue of Clinics in Geriatric Medicine features expert clinical reviews on Geriatric Dermatology which includes current information on topics such as diagnosis and management of bullous disease, common skin cancers in older adults, psoriasis, management of pressure ulcers, management of venous stasis disease, approach to diabetic and vascular ulcers, diagnosis and management of soft tissue infections, cutaneous fungal infections in older adults, mangagment of scabies and generalized pruritus, herpes zoster and other herpes infections, and adverse drug effects in aging skin.