With the aging of the baby boomers and medical advances that promote longevity, older adults are rapidly becoming the fastest growing segment of the population. As the population ages, so does the incidence of age related disorders. Many predict that 15% - 20% of the baby-boomer generation will develop some form of cognitive decline over the course of their lifetime, with estimates escalating to up to 50% in those achieving advanced age. Although much attention has been directed at Alzheimer's disease, the most common form of dementia, it is estimated that nearly one third of those cases of cognitive decline result from other neuropathological mechanisms. In fact, many patients diagnosed with Alzheimer's disease likely have co-morbid disorders that can also influence cognition (i.e., vascular cognitive impairment), suggesting mixed dementias are grossly under diagnosed. The Clinical Handbook on the Neuropsychology of Aging and Dementia is a unique work that provides clinicians with expert guidance and a hands-on approach to neuropsychological practice with older adults. The book will be divided into two sections, the first addressing special considerations for the evaluation of older adults, and the second half focusing on common referral questions likely to be encountered when working with this age group. The authors of the chapters are experts and are recognized by their peers as opinion leaders in their chosen chapter topics. The field of neuropsychology has played a critical role in developing methods for early identification of late life cognitive disorders as well as the differential diagnosis of dementia. Neuropsychological assessment provides valuable clinical information regarding the nature and severity of cognitive symptoms associated with dementia. Each chapter will reinforce the notion that neuropsychological measures provide the clinician with sensitive tools to differentiate normal age-related cognitive decline from disease-associated impairment, aid in differential diagnosis of cognitive dysfunction in older adults, as well as identify cognitive deficits most likely to translate into functional impairments in everyday life.

Susan Kemper A debate about the role of working memory in language processing has become center-most in psycholinguistics (Caplan & Waters, in press; Just & Carpenter, 1992; Just, Carpenter, & Keller, 1996; Waters & Caplan, 1996). This debate concerns which aspects of language processing are vulnerable to working memory limitations, how working memory is best measured, and whether compensatory processes can offset working memory limitations. Age-comparative studies are particularly relevant to this debate for several reasons: difficulties with language and communication are frequently mentioned by older adults and signal the onset of Alzheimer's dementia and other pathologies associated with age; older adults commonly experience working memory limitations that affect their ability to perform everyday activities; the rapid aging of the United States population has forced psychologists and gerontologists to examine the effects of aging on cognition, drawing many investigators to the study of cognitive aging. Older adults constitute ideal population for studying how working memory limitations affect cognitive performance, particularly language and communication. Age-comparative studies of cognitive processes have advanced our understanding of the temporal dynamics of cognition as well as the working memory demands of many types of tasks (Kliegl, Mayr, & Krampe, 1994; Mayr & Kliegl, 1993). The research findings reviewed in this volume have clear implications - for addressing the practical problems of older adults as consumers of leisure ti- reading, radio and television broadcasts, as targets of medical, legal, and financial documents, and as participants in a web of service agencies and volunteer activities.

Fractures in the Elderly: A Guide to Practical Management provides geriatricians and other medical specialists who provide care for older adults with the vital guidance and most current data and opinions regarding the treatment of elderly patients who sustain a variety of fractures. It also provides orthopedic surgeons with the necessary information and most current data and opinions regarding assessment and management of geriatric conditions that predispose the elderly to fracture, perioperative complications and subsequent functional decline. Each chapter is both readable and appealing not only to geriatricians and orthopedic surgeons but to all clinicians that have contact with elderly patients who have sustained or are at high risk of sustaining a fracture. Emphasis is placed on the fact that although in some cases pre- and post-operative care in elderly fracture patient may proceed as it does in younger individuals, often there are considerations owing to functional status, pre-existing conditions, and age-related physiological declines that require specialized knowledge and alternative approaches. Developed by a group of renowned experts, Fractures in the Elderly: A Guide to Practical Management is a major addition to the literature and provides a wealth of specialized knowledge and approaches to care. It is an essential reference for all clinicians who care for older adults as well as fellows and residents in training.

During our short time on earth, we all undergo the highly complex process of aging, and with it, we experience the many physiological symptoms. Studies of premature aging have produced a great deal of information that gives some aspects of aging a better understanding. This book explores Werner's syndrome. To some, Werner's syndrome is considered a caricature of aging, but others will find it fascinating that only one mutated human gene (WRN) can bring about a multitude of complicated phenotypes that are usually associated with aging.

Diet-Brain Connections fills a void between the fields of nutrition, behavior and cellular and molecular neurosciences by providing an integrated collection of articles that critically dissect the link between what we eat and how the brain develops and functions in health and disease.
Key topics covered in depth include:

-caloric restriction benefit the brain and retard aging;
-effects of dietary antioxidants on brain function and aging;
-developmental and function consequences of different dietary fatty acids;
-biochemical links between dietary folic acid and psychiatric and neurodegenerative disorders;
-effects of nutritional deficit during early development and behavior disorders later in life; -neurochemical basis of the benefits of widely used dietary supplements including creatine and Gingko biloba;
-contribution of dietary toxins such as metals and pesticides to neurological disorders.This book provides an unprecedented resource for scientists in academia and government labs as well as in the pharmaceutical, nutraceutical and food industries.

"The Common Sense Guide to Dementia for Clinicians and Caregivers" provides an easy-to-read, practical, and thoughtful approach to dementia care. Written by two specialists who have cared for thousands of patients with dementia and their families, this ground-breaking title unifies the perspectives of neurology and psychiatry to meet a variety of caregiver needs. It spotlights many real-world concerns not typically covered in standard textbooks, while simultaneously presenting a more detailed medical perspective than typical caregiver manuals.
This handy title offers expert guidance for the clinical management of dementia and compassionate support of patients and families. Designed to enhance the physician-caregiver interaction and liberally illustrated with case examples, "The Common Sense Guide" espouses general principles of dementia care that apply across the stages and spectrum of this illness, including non-Alzheimer's types of dementia, in addition to Alzheimer's disease.
Clinicians, family members, and other caregivers will find this volume useful from the moment that symptoms of dementia emerge. The authors place an emphasis on caring for the caregiver as well as the patient. Essential topics include how to find the right clinician, make the most of a doctor's visit, and avert a crisis - or manage one that can't be avoided. Sometimes difficult considerations, such as driving, financial management, legal matters, long-term placement, and end-of-life care, are faced head-on. Tried, true, and time-saving tips are explained in terms of what works - and what doesn't - with regard to clinical evaluation, medications, behavioral measures, and alternate therapies. Medical, nursing, and allied health care professionals will undoubtedly turn to this unique overview as a vital resource and mainstay of clinical dementia care, as well as a valuable recommendation for family caregivers.

DDDDDDDDDDDD Effective management logically follows accurate diagnosis. Such logic often is difficult to apply in practice. Absolute diagnostic accuracy may not be possible, particularly in the field of primary care, when management has to be on analyis of symptoms and on knowledge of the individual patient and family. This series follows that on Problems in Practice which was concerned more with diagnosis in the widest sense and this series deals more defini tively with general care and specific treatment of symptoms and diseases. Good management must include knowledge of the nature, course and outcome of the conditions, as well as prominent clinical features and as sessment and investigations, but the emphasis is on what to do best for the patient. Family medical practitioners have particular difficulties and advantages in their work. Because they often work in professional islation in the com munity and deal with relatively small numbers of near-normal patients their experience with the more serious and more rare conditions is restricted. They find it difficult to remain up-to-date with medical advances and even more difficult to decide on the suitability and application of new and rela tively untried methods compared with those that are 'old' and well proven. Their advantages are that because of long-term continuous care for their patients they have come to know them and their families well and are able to become familiar with the more common and less serious diseases of their communities."

In recent years, remarkable discoveries have been made concerning the underlying mechanisms of aging. In Life-Span Extension: Single-Cell Organisms to Man, the editors bring together a range of illuminating perspectives from researchers investigating the aging process in a variety of species. This novel work addresses the aging process in species ranging from yeast to man and, among other subjects, features detailed discussions of the naked mole-rat, an exceptionally long-lived rodent; the relationship between dietary factors/food restriction and aging; and an evolutionary view of the human aging process.

Single mutations that extend life span have been identified in yeast, worms, flies, and mice, whereas studies in humans have identified potentially important markers for successful aging. At the same time, it has been discovered that the genes and pathways identified in these studies involve a surprisingly small set of conserved functions, most of which have been the focus of aging research for some time. For example, the mTOR pathway, a regulator of translation and protein synthesis, has been identified as a common longevity pathway in yeast and Caenorhabditis elegans. In mammals, this pathway intersects with neuroendocrine pathways and with the insulin/insulin-like growth factor pathways, which have been identified as major modulators of life span and aging in both invertebrates and mice.

Novel, emerging technologies and the increasingly wide variety of systems that are now used to study aging and the mechanisms of aging provide enormous opportunities for the identification of common pathways that modulate longevity. It is these common pathways that are the focus of this important volume.

The fact that there are special problems in the care of the elderly in the community is ample justification for writing a separate volume on the subject. The knowledge that there are increasing numbers of older people in virtually every country in the world makes it all the more important that the family physician should have sympathy with and understanding of the problems of them, since they are lilcely to make up a significant part of his worlcload and, increasingly, will take up more of his time and energy. There is a progressive amount of disability with advancing years, and this is particularly true of those aged 75 years and over. Increasing age is associated with serious impairment of hearing and vision, senses which younger people take for granted. Old age sees the arrival of major diseases of middle age with much greater frequency, such as ischaemic heart and cerebrovascular disease, diabetes mellitus and osteoarthritis. There are other disorders that are virtually confined to the elderly, such as fractures of the femoral neck, Paget's disease and myeloma. We now know that the disintegration of the con ducting tissue of the heart is largely an age-related phenomenon. Ageing processes affect every major organ system in the body and the impairment of physiological perfor mance resulting from these affects the elderly individual's response to infections, disease and environmental changes in complex ways that are not seen in younger people."

Most patients in developed nations with medical problems requiring hospital care are elderly. Increasingly the dividing line between general internal medi cine and acute geriatric medicine is becoming more blurred. It is, nevertheless, apparent that some elderly patients on medical or sub-specialty hospital wards become 'bed blockers'. Why? Also, why are 'bed blockers' less of a problem on an acute geriatric ward? Many clinicians believe this is related to a faster access to the long-stay beds of the geriatric unit. Even a brief study of hospital operating statistics will show this is not and cannot be the case. When geria tricians are asked to see elderly 'bed blockers' on colleagues' wards they approach with anxiety because these patients often have to be placed on a long waiting list for these scarce and very expensive continuing care beds. Do geria tricians see different acute medical problems compared with their colleagues? The answer is not immediately obvious, though geriatricians are likely to receive more potential 'bed blockers' than their general medical colleagues. How is it then, that geriatricians seem to cope better than their colleagues? All geriatricians have experience of general internal medicine but the opposite unfortunately does not hold. This book is written in the hope of redressing the imbalance."

What does it mean for a person to move from work to retirement? What characterizes this experience? The significant demographic, economic and socio-cultural changes that have taken place recently have also had an impact on ways of achieving full withdrawal from work. Retirement is a difficult transition in which people lose some material and psychosocial resources, but they can experience new opportunities for enrichment and define new projects. However, this potential positive outcome is not promptly achievable and requires personal commitment as well as social and organizational facilities to master it. Retirement is not an event, but a process that begins to foresee progressive forms of exit and re-entry into a social reality to be defined by the person. Therefore, we do not refer to a simple or automatic conclusion of "active life", but to the possible construction of a new composite system of self-manageable activities that has to be supported by organizations and institutions. In the cultural imaginary, in fact, the condition of the elderly is associated with the idea of a general process of decay, deriving from a progressive loss of psychophysical, social and productive functions. The traits that are most frequently attributed to older people are those of weakness and disengagement, starting from the fact that the birth of the separation of old age from adulthood is anchored to the escape of the subject from the productive system. The lengthening of a lifespan is reshaping the structure and demographic profile of our society and the generational system, with consequences on the economic and social system. It represents one of the great challenges with important consequences for contemporary societies.

Aging research on the human eyes crosses all areas of ophthalmology and also relies upon biological, morphological, physiological, and biochemical tools for its study. This book reviews all aspects of human eye aging. In addition to descriptions of age-related changes in almost all the structures of the human eyes, the authors also include interesting accounts of personal experiments and data. It provides an extensive panorama of what happens during aging in the eye.

The Handbook of Nutrition in Ophthalmology is the first general text on nutrition and eye health created for physicians, nutritionists, and researchers. The author provides important links between the epidemic of obesity and implications it has for eye disease and blindness. The volume also includes chapters addressing nutritional aspects of preventing eye disease in diabetes mellitus and other optical neuropathies, making this a unique book.

- Not only written by experts but the content of each of the chapters has also been peer-reviewed.

- Presents a step-by-step approach to the treatment of chronic wounds.

- For dermatologists, but also many other medical disciplines such as general practitioners and family physicians who also treat chronic wounds.

This important handbook addresses technologies targeted at the assessment, early detection and the mitigation of common geriatric conditions. These include decline in functional abilities, gait, mobility, sleep disturbance, vision impairment, hearing loss, falls, and cognitive decline. This book not only describes the state of both embedded and wearable technologies, but also focuses on research showing the potential utility of these technologies in the field.

Cancer and aging are integrally related. Cancer incidence and mortality increase with age, with most cancer diagnoses and deaths occurring in patients aged 65 and older. The aging of the Baby Boomer population, along with an overall increase in life expectancy, points to a doubling of the U.S. population over age 65 by the year 2030. This demographic shift, combined with the known association of cancer and aging, is expected to bring about a rapid growth in the older cancer-patient population. It is clear that geriatric principles must become part of oncology care. The evaluation and development of treatment recommen- tions for an older adult with cancer can be challenging for many reasons. Tumor biology and response to therapy are affected by age. In addition, age-related factors may impact treatment patterns, tolerance, and efficacy. These age-related factors include functional status declines, comorbid conditions, changes in cognitive function, weakening of organ function, decreases in physiologic reserve, and faltering social support.

As the Baby Boom generation ages, an increased need for geriatric specialty care becomes particularly important. This shift will especially affect ophthalmology, as the occurrence of common visual disorders such as cataracts, macular degeneration, glaucoma and diabetic retinopathy increases with age. This book anticipates this pending and inevitable demographic shift and fulfills the need for a practical, "bread-and-butter" approach to Geriatric Ophthalmology.

Key research in the world's largest aging population - in China - has fed into this important new work, which aims to answer questions critical to older people worldwide. These include: is the period of disability compressing or expanding with increasing life expectancy and what factors are associated with these trends in the recent decades? And is it possible to realize morbidity compression with a prolongation of the life span in the future? Essential reading for gerontologists.

Anemia in the elderly has been properly defined as the silent epidemic, representing 3 million people in the United States aged 65 years and older. Incidence and prevalence of this condition increase with age. It differs in its etiology, pathogenesis and treatment from anemia in children and younger adults. Anemia is associated with reduced survival, increased risk of functional dependence and hospitalization, increased risk of congestive heart failure and stage renal disease and cognitive disorders. Approximately 70% of anemia in older individuals is reversible.

The book covers topics ranging from basic sciences (developmental changes in neuroanatomy and neurophysiology and effects of neuropharmacology) to special situations such as brain death, ethical issues and palliative care. It discusses various neurological surgical problems and their challenges along with common problems such as Alzheimer's and Parkinson's disease. A section on Pain covers all possible modalities for relieving pain in this patient population followed by the important issue of palliative care. The book addresses the issue of cognition decline, common in this group. The fact that basic sciences are included along with clinical sciences makes it a unique read for the audience.

The global burden of geriatric hip fractures is enormous. From both the patient's and physician's perspective, the injury is complex. A hip fracture often changes a patient's life and/or the life of the patient's family permanently. From the physician's perspective, care of geriatric hip fracture patients requires a multidisciplinary team, which is led by the surgeon and which includes internists and other subspecialists within internal medicine, anesthesiologists, nurses, operating room technicians, social workers, physical therapists, and rehabilitation center coordinators and staff. Nowhere in the orthopedic literature is there a text that guides care for these complex patients from injury through recovery. This text is the first to do so by organizing and synthesizing a large body of literature. Its main themes include pre-operative, operative, and post-operative care of the patient who sustains a geriatric hip fracture. Its main objective is to organize the current body of literature into a cohesive whole so that the busy orthopedic surgeon does not have to undertake a literature search each time he or she wants an answer to the myriad questions that characterize a patient's injury, treatment, and recovery course. With regard to pedagogy, because orthopedic surgeons in training will utilize this book, and because the case study is the central pedagogical tool in the field of orthopedic surgery, this book includes case studies within each chapter, with the author's preferred treatment and decision-making rationale for each case. Selected video supplements reinforce real-world application of knowledge. Practicing orthopedic surgeons, as well as orthopedic residents and fellows in training, will find Geriatric Hip Fractures: A Practical Approach a highly useful and informative resource.

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

Depression is one of the most common mental health problems facing older people, and it is often unrecognised and usually under-treated. Integrated Management of Depression in the Elderly provides an entirely new approach to understanding late-life depression, by using a series of case studies with commentaries from practitioners internationally. The book covers the epidemiology, presentation and diagnosis of depression in older people and outlines current evidence for effective management drawing on recently published work. The substantive part of the book presents ten case studies of increasing complexity, each case has a commentary from a primary care clinician and a health or social care professional, to outline how professionals should work together to manage the patient within their community. Contributions from world experts give the book an international appeal. It will appeal to a wide audience of health and social care professionals together with psychiatrists-in-training.