Das Thema Alter und Altern mit seinen vielfaltigen Aspekten, von der kontinuierlichen Zunahme der mittleren Lebenserwartung seit 1850 um etwa 3 Monate pro Jahr und der erheblichen Abnahme der Fortpflanzungshaufigkeit bis zur Gefahrdung des Generationenvertrags und der Altersversorgung jungerer Jahrgange, wird seit einigen Jahren, wenn auch mit beachtlicher Verspatung, in der Offentlichkeit und Politik wahrgenommen.

Die daruber kursierenden Vorstellungen entbehren nicht einer gewissen, mitunter erheblichen Einseitigkeit.

Die Heidelberger Akademie der Wissenschaften hat mit der Natur- und Geisteswissenschaften ubergreifenden Kompetenz ihrer Mitglieder und mit Forderung durch die Robert-Bosch-Stiftung, die auf dem Gebiet der Altersforschung und fursorge umfangreich und erfolgreich tatig ist, das Thema aufgegriffen. Der grundlegende Ansatz, die Frage nach Ursprung, Wesen, Folgen und Bewaltigung des Alterns aus dem Blickwinkel aller relevanten Wissenschaften analysieren zu lassen, von der Molekularbiologie und Medizin uber die Politik- und Wirtschaftswissenschaften "

This is the third edition of the foremost medical reference on hereditary hearing loss. Chapters on epidemiology, embryology, non-syndromic hearing loss, and syndromic forms of hearing loss have all been updated with particular attention to the vast amount of new information on molecular mechanisms, and chapters on clinical and molecular diagnosis and on genetic susceptibility to ototoxic factors have been added. As in previous editions, the syndromes are grouped by system (visual, metabolic, cardiologic, neurologic, musculoskeletal, endocrine, etc.), with each chapter written by a recognized expert in the field. Written for practicing clinicians, this volume is an excellent reference for physicians, audiologists, and other professionals working with individuals with hearing loss and their families, and can also serve as a text for clinical training programs and for researchers in the hearing sciences.

This book contains a comprehensive review of the current research advances in late life mood disorders. This detailed review reflects the new understanding of neurobiology and psychosocial origins of geriatric mood disorders in the first decade of the 21st Century and is provided by the international group of leading experts in the field. The review of the latest developments and "gold standards" of care or methodologies in geriatric mood disorders is complemented by the anticipated future directions of research and translation into clinical practice. Our volume targets a broad audience of clinical researchers and clinicians. The content of the book will increase clinicians' and researcher's competency in recent research findings, and broaden their diagnostic and therapeutic perspectives and power of observation that will prepare them to deal with the challenges of finding appropriate effective treatments for older adults with mood disorders. The discussion of the data is presented in a textbook format and can be used for training of students of geriatric mental health. Individual chapters can be used as references on a particular topic for interested individuals, and obtained online. Clinicians and researchers who are dedicated to the treatment and study of mood disorders in older people might consider this volume an essential part of their library.

The Oxford Specialist Handbooks series provides readers with clear, concise information on all that is needed to successfully train in the medical sub-specialties. Each book gives an overview of clearly defined procedures, skills, guidelines, and technologies and provides practical tips and case studies to supplement hands-on experience. Where appropriate, each book complements the revised curriculum as developed by the Specialist Advisory Committees.
Dementia is a growing issue, exacerbated by improvements in health care which have led to an ageing population; currently three quarters of a million people suffer from dementia in the UK, and this is expected to rise to 1.8 million by 2050. This book concentrates on advanced disease and addresses issues such as pain management, decision-making, spiritual needs, communication, the Mental Health Capacity Act, dementia in the younger patient, and the carer's perspective.
Written by specialists, this book will be invaluable for doctors and nurses involved in palliative medicine, geriatrics, and old-age psychiatry, and the generalist who treats the patient with dementia.

Das Buch untersucht die inhaltlichen und strukturellen Herausforderungen, vor der unsere Gesellschaft angesichts einer stetig steigenden Lebenserwartung und einer zunehmenden Vielfalt unterschiedlicher Lebensentwurfe steht. Sind wir vorbereitet auf die Bedurfnisse einer alternden Bevoelkerung? Wie sollen wir auf den demografischen Wandel reagieren, um ein wurdevolles Altern sicherzustellen? Wie mussen wir die unterschiedlichen Lebensbereiche wie Arbeitswelt, Gesundheitsversorgung, Wohnen und Kultur gestalten und anpassen, um den veranderten Lebenslaufen gerecht zu werden? Entlang der Dimensionen Alterung, Diversitat und Technisierung widmen sich in diesem Band Experten aus Medizin, Ethik, Recht, Sozialwissenschaften, Padagogik, Kunstgeschichte und Gerontologie Moeglichkeiten und Bedingungen des 'guten Alterns' in einer Gesellschaft des langen Lebens.

This book is a collection of work on aging and development from authors from the global south. Aging is steadily evolving as a public health and social crisis for which countries of the global south are ill-prepared. The forces of development and improved public health services have ensured that human being live longer. But there is enough evidence that such longevity do not commensurate with good health. As such, many countries of the global south are seeing a booming population who are aging in poor health, without the necessary safety net to ensure quality of life. This book discusses work from Asia, Africa, and South America to explore the challenges facing older adults. Topics include: aging in institutions, living arrangements of older adults, food insecurity, social isolation, end of life migration, and policy papers. This is the first book to bring together varied perspectives on the situation of older adults, and the challenges and opportunities that lie in developing innovative, sustainable programs to support elderly care services.

This book contains chapters from experts in the fields of brain imaging, clinical neuroscience, and cognitive neuroscience who have studied the aging brain. Topics covered include technical factors in brain imaging, pathological basis of age-related structural and functional changes, neurochemistry and genetics of brain imaging in aging, and the use of imaging techniques in diagnosis, longitudinal testing, drug development and testing, and presymptomatic detection. The book is intended to be both a detailed review of the current status of brain imaging and aging and to serve as an introduction to the field for those who may be starting investigations using imaging techniques of PET, structural MRI, and functional MRI. It covers basic science approaches such as using fMRI to probe networks, as well as recent developments like amyloid imaging and the use of imaging as a biomarker in clinical trials.

Handbook of Counseling and Psychotherapy with Older Adults

Older adults are the fastest-growing segment of society and are entering therapy at an unprecedented rate. Editor Michael Duffy has brought together leading experts in geropsychology and older adult counseling to discuss and offer practice strategies appropriate for this diverse population. The Handbook covers new research findings for clinical treatment, coverage of multiple treatment modalities, and clinical problems confronting older clients, including:

• Adjusting to role loss, leisure in late life, and retirement
• Developmental issues in psychotherapy with older men
• Existential issues of hope and meaning in late life therapy
• Developing and enhancing the therapeutic alliance with older clients
• The impact of cultural differences in psychotherapy with older clients
• Using reminiscence and life review as natural therapeutic strategies in groups
• Integrated group approaches with early stage Alzheimer's and their families
• Family disruption after nursing home placement of onset of dementia patients: systemic dynamics and treatment
• Realizing power in intergenerational family hierarchies: when older adults decline

Dieses Buch vermittelt einen kompetenten und facherubergreifenden Uberblick uber das aktuelle Wissen auf dem Gebiet der Parkinson-Krankheit. Es ist im deutschsprachigen Raum das einzige Buch, das umfassend neurobiologische Grundlagen, experimentelle Modelle, Klinik und Therapie der Parkinson-Krankheit beschreibt und einen kompakten Uberblick zur Pharmakologie und den Wirkmechanismen der Anti-Parkinson-Medikamente gibt. Das Buch besticht durch seine klare Systematik und die komprimierte Darstellung mit vielen Tabellen, Schemata und Abbildungen. Das Buch ist Lehrbuch, Nachschlagewerk und Leitfaden fur Studenten, Arzte und Wissenschaftler. Daruber hinaus werden auch dem interessierten Patienten und Laien wichtige Informationen geboten.

Neu in der 4. Auflage: Alle neuen Medikamente; Neueste Entwicklungen in der Genetik, Pathogenese- und Therapieforschung; Aktuelle Ubersicht uber Modelle der Parkinson-Krankheit; Gegenwartiger Stand der klinischen Studien zur symptomatischen Therapie und Neuroprotektion."

What are the fundamental mechanisms of decision making, processing speed, memory and cognitive control? How do these give rise to individual differences, and how do they change as people age? How are these mechanisms implemented in neural unctions, in particular the functions of the frontal lobe? How do they relate to the demands of everyday, 'real life' behaviour? Over almost five decades, Pat Rabbitt has been among the most distinguished of British cognitive psychologists. His work has been widely influential in theories of mental speed, cognitive control and aging, influencing research in experimental psychology, neuropsychology and individual differences. This volume, dedicated to Pat Rabbitt, brings together a distinguished group of 16 contributors actively pursuing research in the fields of speed, memory, and control, and the application of these fields to individual differences and aging. With the latest work from senior figures in the field, and a focus on fundamental topics in both teaching and research, the book will be valuable to students and scientists in experimental psychology and cognitive neuroscience.

In an ageing world, the delivery of psychogeriatric services in an effective and efficient manner is an increasing concern for health service providers and administrators in both developed and developing countries. Despite awareness of the anticipated mental health needs of the ageing population, services for older people have been slow to develop in many places, and in some places do not exist at all. This volume brings together the theory and practice of psychogeriatric service delivery from an international perspective. It examines the range of different service models, perspectives and ideas with the evidence-base for each, providing a unique resource for those planning and administering psychogeriatric services. The first section of the book discusses the theory behind psychogeriatric service delivery, including its history, service delivery principles, needs analysis, population-based service planning, economics and funding, and evidence-based service delivery. Section two concentrates on practice, describing examples of service delivery from a number of European, American, African, Asian and Australasian settings. The third section focuses on solutions, evaluating the range of delivery settings and considering the needs of both consumers and carers.

We live in an aging world. Illnesses that are prevalent and cause significant morbidity and mortality in older people will consume an increasing share of health care resources. One such illness is depression. This illness has a particularly devastating impact in the elderly because it is often undiagnosed or inadequately treated. Depression not only has a profound impact on quality of life but it is associated with an increased risk of mortality from suicide and vascular disease. In fact for every medical illness studied, e.g. heart disease, diabetes, cancer, individuals who are depressed have a worse prognosis. Research has illuminated the physiological and behavioral effects of depression that accounts for these poor outcomes. The deleterious relationship between depression and other illnesses has changed the concept of late-life depression from a "psychiatric disorder" that is diagnosed and treated by a psychiatrist to a common and serious disorder that is the responsibility of all physicians who care for patients over the age of 60.
This is the first volume devoted to the epidemiology, phenomenology, psychobiology, treatment and consequences of late-life depression. Although much has been written about depressive disorders, the focus has been primarily on the illness as experienced in younger adults. The effects of aging on the brain, the physiological and behavioral consequences of recurrent depression, and the impact of other diseases common in the elderly, make late-life depression a distinct entity. There is a compelling need for a separate research program, specialized treatments, and a book dedicated to this disorder. This book will be invaluable to psychiatrists, gerontologists, clinical psychologists, social workers, students, trainees, and others who care for individuals over the age of sixty.

With an ever increasing population of aging people in the western world, it is more crucial than ever that we try to understand how and why cognitive competence breaks down with advancing age. Why do some people follow normal patterns of cognitive change, while others follow a path of progressive decline, becoming stricken with neurodegenerative diseases such as Alheimer's. What can be done to prevent cognitive decline-or to avoid neurodegenerative diseases? The answers, if they come, will not emerge from research within one discipline, but from work being done across a range of scientific and medical specialities.
This volume brings together leading experts from a range of fields studying cognitive aging, including neuroscience, pharmacology, health, genetics, sensory biology, and epidemiology. Unlike other books in this area, this book is more about "new frontiers" than past research and accomplishments. Recently cognitive aging research has taken several new directions, linking with, and benefiting from, rapid technological and theoretical advances in these neighboring disciplines. This book provides unique interdisciplinary coverage of the topic. With each chapter including commentaries from other specialists in related fields, the book provides integrative study of the topic. For those within the fields of psychology, cognitive neuroscience, and geriatrics, this volume will make an important contribution in furthering our understanding of a problem that affects all of us.

As the global geriatric population continues to grow, an increasing proportion of people reporting to emergency departments are elderly. The work-up of these patients uses more time and resources than that of younger patients, and is complicated by the fact that acute disease often presents more subtly, without the outward manifestations typically seen in younger patients. This volume focuses on the unique pathophysiology of the elderly, presenting guidelines for resuscitation, evaluation and management. The first section discusses general principles including demographics, pharmacology and pain management. The following sections cover high-risk chief presenting complaints and review geriatric emergencies. Finally, topics of particular relevance in the geriatric population are discussed, including functional assessment, end-of-life care, financial considerations and abuse. This book provides a comprehensive, practical framework for community and academic emergency medicine practitioners, as well as emergency department administrators striving to improve delivery of care to this vulnerable, growing population.

Zur Einordnung der einzelnen Wirkstoffe wird auch die PRISCUS-Liste berücksichtigt. Die A-Z Struktur, in der die Psychopharmaka-Profile aufgelistet sind, ermöglicht eine gezielte Suche und schnelles Finden der gwünschten Information. Die Listen geordnet nach Handelsnamen und nach Wirkstoffen unterstützt ebenfalls das schnelle Nachschlagen. Ein praktisches Taschenbuch zum schnellen Nachschlagen für Pflegefachkräfte in stationären und ambulanten Pflegeeinrichtungen. Aber auch Krankenpflegekräfte, Hausärzte und Medizinische Fachangestellte können von diesem übersichtlichen Nachschlagewerk profitieren. Für einen verantwortungsvollen und bewussten Umgang mit Psychopharmaka in der Betreuung älterer Menschen. Erhebungen zeigen, dass oft zu schnell und zu viele Psychopharmaka an ältere Menschen verabreicht werden. Insbesondere pflegebedürftige Menschen haben unter den Folgeerscheinungen wie z.B. Desorientierung, erhöhte Sturzgefahr, Immobilität zu leiden. Diese Einschränkungen zeigen sich im Alltag und können meist nur durch beobachtende Pflegekräfte erkannt und an den Arzt weitergetragen werden. Dieses praktische Taschenbuch vereint wichtiges Basiswissen häufiger Psychopharmaka und deren Wirkung bzw. unerwünschten Nebenwirkungen bei älteren Menschen. Der Fokus liegt auf den Fakten, die in der Pflege und Betreuung relevant sind, wie z.B. ... Durch das Wissen können Veränderungen bzw. Verschlechterungen des Gesundheitszustandes Pflegebedürftiger besser eingeschätzt und als mögliche Wechselwirkung oder Folgeerscheinung eines Medikaments erkannt werden. Dieses Wissen befähigt Pflegekräfte in der Kommunikation mit dem Arzt, besser auf negative Wechselwirkungen und Folgeerscheinungen einer eingestellten Medikation aufmerksam zu machen und nach einer Optimierung der Dosierung und Einstellung im Sinne des Senioren zu suchen. Neben der Aufklärung über Wirkung und Nebenwirkung einzelner Medikamente werden alternative Angebote aus z.B. der Basalen Stimulation, Seelsorge, Physiotherapie, Ergotherapie, Aromatherapie vorgestellt, mit denen Therapieziele ebenso erreicht werden können. Durch das fundierte Hintergrundwissen aus diesem Buch gelingt es Pflegekräften auf Augenhöhe mit dem Arzt zu kommunizieren, negative Wechselwirkungen schneller zu erkennen und somit dazu beizutragen, dass diese reduziert werden und weniger Psychopharmaka verabreicht werden, was immer die Lebensqualität der betroffenen Senioren erhöht.

Vascular dementia, caused by multiple small strokes, is the second commonest cause of dementia behind Alzheimer's disease. In recent years there has been a radical reappraisal of the concept of vascular dementia and a move away from an Alzheimer-based diagnostic paradigm towards one more appropriately tailored for vascular disease. Vascular Cognitive Impairment presents a new definition for this class of cerebrovascular process with an emphasis on early detection, prompt treatment and the prevention of disease progression.

Vascular Cognitive Impairment: Preventable Dementia presents an overview of the current state of our knowledge in this field. It reviews the historical background, prevalence, risk factors and economic consequences of the condition. In addition, the book summarises our knowledge of the pathological process, describing insight derived from genetic and imaging studies, before examining opportunities for early diagnosis, prevention and the options for management, both now, and as a result of ongoing clinical trials.

With contributions from an expert team of international contributors, this book provides a comprehensive summary of the state-of-the-art in this field, providing a framework for a new understanding of a complex, disabling but Preventable condition.

In our society, the overwhelming majority of people die in later life. They typically die slowly of chronic diseases, with multiple co-existing problems over long periods of time. They spend the majority of their final years at home, but many will die in hospitals or care homes. This book explores the possibilities for improving the care of older people dying in residential care and nursing homes. It argues that there are aspects of palliative care that, given the right circumstances, are transferable to dying people in settings that are not domestic or hospice based.

End of Life in Care Homes describes what happens in nursing and residential care homes when a resident is dying, how carers cope, and the practical, health and emotional challenges that carers face on top of their day-to-day work. Based on detailed research from both the UK and US, the book shows how the situation can be improved.

Delirium is a cognitive disorder consisting of deficits of attention, arousal, consciousness, memory, orientation, perception, speech and language. It represents the most frequent complication of hospitalisation in the older population. Despite its importance in terms of clinical, economic and social considerations, and despite considerable advances in the past decade, it remains a relatively misunderstood and mis-diagnosed condition.

This book provides a state-of-the-art update of delirium research, covering its history, conceptualisation, measurement, epidemiology, pathophysiology, assessment, diagnosis, causes, prevention and management. The final chapter takes a look to the future, highlighting the importance of ongoing interdisciplinary research.

As well as being important as a clinical syndrome in its own right, the study of delirium provides a valuable opportunity to understand brain functioning at a fundamental level, and as it is a preventable condition, it is also now being used as a marker to measure the quality of hospital care provided for older people.

This volume will serve as a catalyst to revive interest and progress in delirium research and clinical care, and should be read by psychiatrists, neurologists, geriatricians and all those involved in working with the elderly in hospitals or in the community.

Most physical illness effects people at the extremes of life, particularly in late life. A significant proportion of hospitalized older patients will experience some mental health problems, and medical units lacking specialist old age psychiatric services must rely on adult psychiatric and consultation liaison services for support. These generalists assume the role of old age psychiatrists by default. A key aim of the book is to provide guidelines for the appropriate treatment of psychiatric disorders in older people when medical illness complicates the picture. The book is divided into five sections. The first two sections cover the nature of the problem and initial assessment procedures. Section three focuses on specific disorders, including, amongst others, the most common reasons for referral - dementia, depression and delirium. Section four provides guidelines for treatment including pharmacological therapies, psychotherapeutic interventions and the use of ECT. The book concludes with short section considering the ethical and legal issues involved. This book covers the theoretical and practical knowledge required by psychiatrists in training, those seeking to specialize in consultation liaison or old age psychiatry, geriatricians and general practitioners. It will also be of interest to all other members of the healthcare team responsible for the medical management of older patients.

This book aims to be a single point of reference for advances in the care of geriatric populations across medical and surgical specialties. The aging population is a unique demographic with its own health challenges. Geriatricians are specifically trained to address these challenges but few medical students or residents enter geriatrics, even as the demand for geriatric expertise increases. The practices of many medical and surgical specialists are dominated by older patients who may themselves see many specialists but rarely visit geriatricians. This updated edition elucidates the most common medical conditions seen in aging patients and translates approaches to those conditions for physicians across specialties. Divided into three sections that assemble crosscutting issues, medical specialties, and surgical and related specialties, this book serves as a guide for clinicians of all backgrounds who will work with older patients as the demographic ages further. This second edition of Geriatrics for Specialists expands the number of specialist chapters to reflect growth in research in aging and clinical care for older people in dermatology, plastic surgery, and behavioral neurology. All original chapters from the first edition are extensively revised and updated to reflect the rapid growth of new knowledge in the field.

This book addresses key questions about the need for palliative care, the current provision of services and the evidence for the effectiveness of a range of alternative models of organisation in palliative care. A broad approach is taken to include the needs of both cancer patients and patients with other terminal diseases and the relationship between palliative care and other aspects of health care services. The book is based on a comprehensive and detailed review of the international scientific literature on evaluation of palliative care, providing an essential evidence base for policy decisions.

This book aims to present the age-related alterations in redox signaling networks and their diagnostic biomarkers in aging cells using multidisciplinary approach. Establishing sensitive and specific biomarkers of dynamic redox homeostasis is crucially important in the development of effective antiaging and senolytic interventions. Recent years have seen tremendous advances in the understanding of redox signaling events which highlight the process of aging and age-related pathologies. A major challenge in biological aging research is developing reliable biomarkers to determine the consequences of disrupted redox signaling networks long before the clinical diagnosis of age-related diseases is made. Therefore, we have chosen to concentrate on aging-induced aberrant redox signaling networks, their biomarkers, and pathological consequences in this book. Although oxidation is a natural metabolic process, the imbalance in the level of oxidants and antioxidants causes oxidative stress and eventually leads to inflammatory conditions, diabetes, neurodegenerative diseases, and cancer. Novel redox-sensitive biomarkers for the evaluation of aging-induced proteinopathies such as amyloid ss and tau proteins in Alzheimer's disease, -synuclein in Parkinson's disease, and islet amyloid polypeptides in type 2 diabetes mellitus recently drew the attention of researchers. Inside this textbook, readers will find comprehensive perspectives on the association between redox homeostasis and the aging process both at the molecular and clinical levels. Due to the inherent relationship between impaired metabolic activities and oxidative stress, the temporal interaction between intermediary metabolism and disturbed redox status can lead to greater susceptibility to aging-induced diseases and disorders, such as cardiovascular diseases, hypertension, and diabetes. This knowledge could be a key to continued research toward improving medication regimens such as in cancer and cardiovascular therapies, and procedural outcomes for patients. This book brings together current research evidence and knowledge on redox signaling and biomarkers in aging in chapters written by leading global experts in this rapidly evolving field. We hope that this textbook is of interest to a wide group of researchers, advanced students, scientifically curious non-specialist readers and clinicians alike.

Organised services for those with memory disorders are growing. This growth is stimulated by an increase in the number of people with memory problems and by an increased appreciation of the complexity of the needs of such patients. Further growth is likely, especially now that we appear to have crossed the threshold of effective treatment for many patients with dementia. With these advances has come the recognition of the necessity for an interdisciplinary approach to management. Diagnosis and Management of Dementia: A Manual for Memory Disorders Teams is an edited volume covering all aspects of the operation of a memory disorders team. It is aimed at all those working in the dementia or memory disorders team, whether in a clinic or a community setting. The book is divided into three sections. Section one takes the reader through the practical details of setting up and organising a clinic, from timetabling, through managing information, to the assessments needed and the opportunities such a service provides. Section two deals with the diagnostic process; and section three addresses management issues, from carer support, pharmacological and physiological interventions, through managing common problems, to the role of the primary care physician. An Appendix contains the results of a survey to the memory disorder services. This survey provides the reader with examples of other services and demonstrates the wide variation in how these services operate. The Manual is unique in that it combines up to date thinking on diagnosis and management with practical and helpful ideas on how to run a dementia or memory disorders service.

When the first edition of this book (Terminal Care Support Teams: the hospital-hospice interface, 1990) was written, there were only a few advisory palliative care teams working in hospitals. Since then the number of teams has grown rapidly. The concept of these teams in now widely accepted but there is an increased need for information about setting up a team, how they work and how effective they are. This book looks at the need for hospital- based palliative care teams and the challenges of bringing palliative care into the acute hospital setting. It reviews the needs of patients, their families and their professional carers, and also looks at the theoretical and practical problems which may be encountered. For example there is practical advice on setting up hospital-based palliative care teams, the selection of team members as well as coverage of team dynamics, and the role of the pain clinic and palliation oncology.