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Contemporary Geriatric Medicine

Buch | Hardcover

436 Seiten

1983
Kluwer Academic/Plenum Publishers (Verlag)
978-0-306-41301-8 (ISBN)

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This volume marks the first of a new series, Contemporary Geriatric Medicine, joining the ever growing "Contemporary" family. As with the other "Contem- porary" volumes, our goal is to assist the reader in maintaining currency in a rapidly changing field. Perhaps no field has shown such major advances in such a short time as geriatrics. Over the last several years, the "demographic impera- tive" has become a source of concern for many, including clinicians, scientists, econ- omists, and health planners. Our geriatric knowledge base continues to grow, often making it difficult to keep abreast of advances and current therapeutic modalities. Contemporary Ger- iatric Medicine presents the state-of-the-art thinking regarding a variety of topics all of major concern to the health practitioner caring for the elderly person. The authors, for the most part serving as members of a stable editorial board, have chosen topics that should have immediate interest to the readership. By having a stable editorial board, continuity is ensured in successive volumes.
Every two years, a subsequent issue will either address new thoughts on already presented topics or focus on new topics of current interest. As with the other "Contempo- rary" series volumes, the every other year interval is intended to allow new find- ings to develop and be tested. It also provides the authors with time to provide the highest quality of work.

1 Geriatric Cardiology and Blood Pressure.- 1.1. Cardiovascular Morbidity-Mortality.- 1.2. Cardiovascular Anatomy and Physiology.- 1.2.1. Anatomic Changes.- 1.2.2. Intrinsic Cardiac Function.- 1.2.3. Autonomic Reflexes.- 1.2.4. Pulse Wave Characteristics.- 1.3. Clinical Evaluation.- 1.4. Laboratory Investigations.- 1.4.1. Electrocardiogram.- 1.4.2. Exercise Cardiography.- 1.4.3. Nuclear Cardiology.- 1.4.4. Echocardiography.- 1.4.5. Ambulatory Electrocardiography.- 1.4.6. Computerized Tomography.- 1.4.7. Invasive Procedures.- 1.4.7.1. Catheterization and Angiography.- 1.4.7.2. Electrophysiology.- 1.5. Coronary Artery Disease.- 1.5.1. Presentation and Diagnosis.- 1.5.2. Therapy.- 1.5.2.1. Beta-Blockers.- 1.5.2.2. Nitrate and Calcium Channel Blockers.- 1.5.2.3. Antiplatelet Agents.- 1.5.3. Unstable Angina.- 1.5.4. Coronary Artery Surgery.- 1.5.5. Myocardial Infarction.- 1.6. Cardiomyopathy.- 1.6.1. Amyloidosis.- 1.6.2. Hypertrophic Cardiomyopathy.- 1.7. Dissection of the Aorta.- 1.7.1. Diagnosis.- 1.7.2. Therapy.- 1.8. Valvular Heart Disease.- 1.8.1. Aortic Valve Disease.- 1.8.2. Mitral Valve Disease.- 1.8.3. Valve Surgery.- 1.8.4. Endocarditis.- 1.9. Atrial Septal Defect.- 1.10. Syncope.- 1.10.1 Heart Block.- 1.10.2. Sick Sinus Syndrome.- 1.10.3. Ventricular Arrythmias.- 1.10.4. Diagnosis and Treatment.- 1.11. Cardiovascular Pharmacology.- 1.11.1. Digitalis.- 1.11.2. Antiarrhythmics.- 1.11.3. Propranolol.- 1.11.4. Vasodilators.- 1.12. Preoperative Evaluation.- 1.13. Blood Pressure and Aging.- 1.13.1. Blood Pressure: Determinants and Effects of Age.- 1.13.1.1. Cardiac Influences.- 1.13.1.2. Neurohumoral Influences.- 1.13.2. Population Studies.- 1.13.3. Hypertension: Definition.- 1.13.4. Approach to the Patient.- 1.13.4.1. History.- 1.13.4.2. Physical Examination.- 1.13.4.3. Laboratory Evaluation.- 1.13.5. Essential Hypertension in the Aged.- 1.13.6. Therapeutic Decision Making.- 1.13.6.1. Systolic Hypertension.- 1.13.6.2. Combined Systolic Diastolic Hypertension.- 1.13.7. Treatment.- 1.13.7.1. Nonmedical Treatment.- 1.13.7.2. Medical Therapy.- 1.13.8. Hypotension.- 1.13.8.1. Definitions.- 1.13.8.2. Management.- 1.13.9. Conclusion.- References.- 2 Pulmonary Aspects of Aging.- 2.1. Introduction.- 2.2. The Aging Lung.- 2.2.1. Introduction.- 2.2.2. Physiologic Changes.- 2.2.2.1. Lung Volumes.- 2.2.2.2. Flow Rates.- 2.2.2.3. Respiratory Mechanics.- 2.2.2.4. Gas Exchange.- 2.2.2.5. Diffusing Capacity.- 2.2.2.6. Respiratory Muscle Function.- 2.2.2.7. Control of Breathing.- 2.2.3. Effects of Cigarette Smoking.- 2.3. Aging and Physical Performance.- 2.3.1. Introduction.- 2.3.2. Normal Physiologic Responses to Exercise.- 2.3.3. Effects of Age on Exercise Performance.- 2.3.3.1. Oxygen Consumption.- 2.3.3.2. Cardiac Function.- 2.3.3.3. Ventilation.- 2.3.3.4. Oxygen Extraction.- 2.3.4. Physical Conditioning and Aging.- 2.4. Chronic Obstructive Pulmonary Disease.- 2.4.1. Introduction.- 2.4.2. Definitions and Differentiation of Diseases.- 2.4.2.1. Asthma.- 2.4.2.2. Chronic Bronchitis.- 2.4.2.3. Emphysema.- 2.4.3. Diagnosis of Airway Obstruction.- 2.4.3.1. Pulmonary Function Testing.- 2.4.3.2. Assessment of Airway Reversibility.- 2.4.4. Physical Examination.- 2.4.5. Laboratory Studies.- 2.4.5.1. Blood Tests.- 2.4.5.2. Sputum Analysis.- 2.4.5.3. Arterial Blood Gases.- 2.4.5.4. Chest Radiography.- 2.4.6. Mechanisms Limiting Exercise Performance.- 2.4.6.1. Diminished Ventilatory Capacity.- 2.4.6.2. Hypoxemia.- 2.4.6.3. Respiratory Muscle Fatigue.- 2.4.6.4. Right Ventricular Dysfunction Secondary to Pulmonary Hypertension.- 2.4.7. Therapeutic Strategies.- 2.4.7.1. Smoking Cessation.- 2.4.7.2. Bronchodilator Therapy.- 2.4.7.3. Oxygen Therapy.- 2.4.7.4. Respiratory Muscle Training.- 2.4.7.5. Pulmonary Vasodilator Therapy.- 2.4.8. Management of Complications.- 2.4.8.1. Upper Respiratory Infections.- 2.4.8.2. Pulmonary Hypertension and Cor Pulmonale.- 2.5. Pneumonia in the Elderly.- 2.5.1. Introduction.- 2.5.2. Pathogenesis of Pneumonia.- 2.5.3. Respiratory Defenses.- 2.5.4. Clinical Pneumonia Syndrome.- 2.5.4.1. Typical Bacterial Pneumonias.- 2.5.4.2. Aspiration Pneumonia.- 2.5.4.3. Atypical and the "New" Pneumonias.- 2.5.5. Diagnostic Approach.- 2.5.5.1. Sputum.- 2.5.5.2. Blood.- 2.5.5.3. Other Fluids and Tissue.- 2.5.6. Antibiotic Therapy.- 2.5.6.1. Typical Bacterial Pneumonias.- 2.5.6.2. Aspiration Pneumonia.- 2.5.6.3. Atypical and the "New" Pneumonias.- 2.5.7. Prophylactic Immunization.- 2.5.7.1. S. pneumoniae Pneumonia.- 2.5.7.2. Influenza Pneumonia.- References.- 3 Gastroenterology and the Elderly.- 3.1. Esophagus.- 3.1.1. Dysphagia.- 3.1.2. Pre-esophageal Dysphagia.- 3.1.3. Dysfunction of the Gricopharyngus Muscle.- 3.1.3.1. Diagnosis.- 3.1.3.2. Complications.- 3.1.3.3. Treatment.- 3.1.3.4. Esophageal Dysphagia.- 3.1.4. Achalasia of the Lower Esophagus.- 3.1.4.1. Clinical Findings.- 3.1.4.2. Diagnosis.- 3.1.4.3. Treatment.- 3.1.5. Diffuse Esophageal Spasm.- 3.1.5.1. Diagnosis.- 3.1.5.2. Presbyesophagus.- 3.1.5.3. Treatment for DES.- 3.1.6. Structural Lesions.- 3.1.7. Esophagitis.- 3.1.7.1. Infectious Esophagitis.- 3.1.7.2. Reflux Esophagitis.- 3.1.7.3. Pathogenesis.- 3.1.7.4. Clinical Findings.- 3.1.7.5. Diagnosis.- 3.1.7.6. Treatment.- 3.2. Stomach.- 3.2.1. Upper Gastrointestinal Bleeding.- 3.2.1.1. Early Endoscopy-Pro and Con.- 3.2.1.2. Therapeutic Endoscopy.- 3.2.2. Peptic Ulcer Disease.- 3.2.2.1. Incidence.- 3.2.2.2. Etiology.- 3.2.2.3. Diagnosis.- 3.2.2.4. Clinical Course.- 3.2.2.5. Treatment of Ulcer Disease.- 3.2.2.6. Long-Term Therapy with Cimetidine.- 3.2.2.7. Side Effects.- 3.2.2.8. Antacids.- 3.2.2.9. Side Effects of Antacids.- 3.2.3. New Drugs.- 3.2.3.1. Predicators of Ulcer Healing.- 3.2.3.2. Complications.- 3.2.3.3. Bleeding.- 3.2.3.4. Factors Predisposing to Rebleeding.- 3.2.3.5. Diagnosis of Bleeding Ulcers.- 3.2.3.6. Endoscopy versus Barium Radiologic Studies.- 3.2.3.7. Rebleeding.- 3.2.3.8. Treatment of Bleeding Ulcers.- 3.2.3.9. Prognosis.- 3.2.4. Giant Duodenal Ulcer.- 3.2.4.1. Obstruction.- 3.2.4.2. Surgery.- 3.2.5. Gastritis.- 3.2.5.1. Etiology.- 3.2.5.2. Clinical Findings.- 3.2.5.3. Diagnosis.- 3.2.5.4. Treatment.- 3.3. Hepatobiliary Disease.- 3.3.1. Cirrhosis.- 3.3.1.1. Etiology.- 3.3.1.2. Clinical Findings.- 3.3.1.3. Treatment.- 3.3.2. Viral Hepatitis.- 3.3.3. Chronic Active Hepatitis.- 3.3.3.1. Etiology.- 3.3.3.2. Clinical Findings.- 3.3.3.3. Diagnosis.- 3.3.3.4. Treatment.- 3.3.3.5. Prognosis.- 3.4. Cholelithiasis.- 3.4.1. Incidence.- 3.4.1.1. Etiology.- 3.4.1.2. Prognosis.- 3.4.1.3. Treatment.- 3.4.1.4. Gallstone Dissolution.- 3.4.2. Acute Cholecystitis.- 3.4.2.1. Etiology.- 3.4.2.2. Clinical Findings.- 3.4.2.3. Diagnosis.- 3.4.2.4. Treatment.- 3.4.3. Choledocholithiasis.- 3.5. Acute Pancreatitis.- 3.5.1. Incidence.- 3.5.2. Alcoholic Pancreatitis.- 3.5.3. Gallstone Pancreatitis.- 3.5.4. Diagnosis.- 3.5.5. Prognosis.- 3.5.6. Treatment.- 3.5.6.1. Medical.- 3.5.6.2. Surgical.- 3.5.7. Complications.- 3.6. The Colon.- 3.6.1. Diverticulosis.- 3.6.1.1. Incidence.- 3.6.1.2. Etiology.- 3.6.1.3. Clinical Findings.- 3.6.1.4. Diagnosis.- 3.6.1.5. Prognosis.- 3.6.2. Diverculititis.- 3.6.2.1. Etiology.- 3.6.2.2. Diagnosis.- 3.6.2.3. Clinical Findings.- 3.6.2.4. Treatment.- 3.6.2.5. Complications.- 3.6.3. Polyposis.- 3.6.3.1. Incidence.- 3.6.3.2. Etiology.- 3.6.3.3. Multiple Adenomas.- 3.6.3.4. Relation to Cancer.- 3.6.3.5. Clinical Findings.- 3.6.3.6. Treatment.- 3.6.4. Superior Mesenteric Artery Occlusion.- 3.6.4.1. Incidence.- 3.6.4.2. Etiology.- 3.6.4.3. Nonocclusive Disease.- 3.6.4.4. Clinical Findings.- 3.6.4.5. Prognosis.- 3.6.4.6. Treatment.- 3.6.5. Ischemic Colitis.- 3.6.5.1. Etiology.- 3.6.5.2. Acute Transitory Colitis.- 3.6.5.3. Acute Nongangrenous Colitis.- 3.6.5.4. Gangrenous Colitis.- 3.6.5.5. Diagnosis.- 3.6.5.6. Treatment.- 3.6.6. Constipation.- 3.6.6.1. Etiology.- 3.6.6.2. Secondary Constipation.- 3.6.6.3. Diagnosis.- 3.6.6.4. Treatment.- 3.6.6.5. Major Complications.- 3.6.6.6. Fecal Impaction.- 3.6.6.7. Treatment.- 3.6.7. Diarrhea.- 3.6.7.1. Etiology.- 3.6.7.2. Pathogenesis of Diarrhea.- 3.6.7.3. Diagnosis.- 3.6.7.4. Treatment.- 3.6.8. Flatus.- 3.6.8.1. Etiology.- 3.6.8.2. Diagnosis.- 3.6.8.3. Treatment.- 3.6.9. Irritable Bowel Syndrome.- 3.6.9.1. Etiology.- 3.6.9.2. Clinical Findings.- 3.6.9.3. Diagnosis.- 3.6.9.4. Treatment.- 3.7. Lower Gastrointestinal Bleeding.- 3.7.1. Etiology.- 3.7.1.1. Vascular Ectasias (Angiodysplasias).- 3.7.1.2. Diverticulosis.- 3.7.1.3. Cancer.- 3.7.1.4. Diagnosis.- 3.7.1.5. Treatment.- 3.8. Cancer.- 3.8.1. Cancer of the Esophagus.- 3.8.1.1. Etiology.- 3.8.1.2. Clinical Findings.- 3.8.1.3. Diagnosis.- 3.8.1.4. Treatment.- 3.8.2. Cancer of the Stomach.- 3.8.2.1. Etiology.- 3.8.2.2. Clinical Findings.- 3.8.2.3. Diagnosis.- 3.8.2.4. Treatment.- 3.8.3. Colorectal Cancer.- 3.8.3.1. Etiology.- 3.8.3.2. Diagnosis.- 3.8.3.3. Treatment.- 3.8.4. Cancer of the Pancreas.- 3.8.4.1. Clinical Findings.- 3.8.4.2. Diagnosis.- 3.8.4.3. Treatment.- 3.8.5. Hepatoma.- 3.8.5.1. Etiology.- 3.8.5.2. Clinical Findings.- 3.8.5.3. Diagnosis.- 3.8.5.4. Treatment.- 3.8.6. Cancer of Gallbladder.- 3.8.6.1. Clinical Findings.- 3.8.6.2. Treatment.- 3.8.7. Summary.- References.- 4 Rheumatology in Geriatrics.- 4.1. Age-Related Changes in the Immune System.- 4.2. Laboratory Evaluation in the Rheumatic Diseases.- 4.2.1. Erythrocyte Sedimentation Rate.- 4.2.2. Rheumatoid Factor.- 4.2.3. Antinuclear Antibody.- 4.3. Rheumatoid Arthritis.- 4.3.1. Epidemiology.- 4.3.2. Clinical Manifestations.- 4.3.3. Management.- 4.4. Systemic Lupus Erythematosus.- 4.4.1. Epidemiology.- 4.4.2. Clinical Manifestations.- 4.4.3. Management.- 4.4.4. Drug-Induced Systemic Lupus Erythematosus.- 4.4.4.1. Clinical Manifestations.- 4.4.4.2. Management.- 4.5. Sjogren's Syndrome.- 4.5.1. Epidemiology.- 4.5.2. Diagnosis.- 4.5.3. Clinical Associations.- 4.5.4. Clinical Manifestations.- 4.5.4.1. Natural History.- 4.5.4.2. Immunologic Correlates.- 4.5.4.3. Management.- 4.6. Amyloidosis.- 4.6.1. Biochemistry of Amyloid.- 4.6.2. Clinical Amyloid Syndromes.- 4.6.2.1. Primary Generalized Amyloidosis.- 4.6.2.2. Amyloidosis of Aging.- 4.6.3. Diagnosis.- 4.6.4. Management.- 4.7. Crystal-Induced Arthropathies.- 4.7.1. Hyperuricemia and Gout.- 4.7.1.1. Epidemiology.- 4.7.1.2. Clinical Manifestations.- 4.7.1.3. Management.- 4.7.2. Calcium Pyrophosphate Dihydrate Crystal Deposition Disease.- 4.7.2.1. Epidemiology.- 4.7.2.2. Clinical Manifestations.- 4.7.2.3. Etiology and Pathogenesis.- 4.7.2.4. Associated Disorders.- 4.7.2.5. Management.- 4.7.3. Hydroxyapatite Deposition Disease.- 4.8. Osteoarthritis.- 4.8.1. Epidemiology.- 4.8.2. Biology of Normal Cartilage.- 4.8.3. Pathology of OA and Age-Related Changes in Cartilage.- 4.8.4. Pathogenesis.- 4.8.5. Clinical Manifestations.- 4.8.6. Management.- 4.9. Seronegative Spondyloarthropathies.- 4.10. Polymyalgia Rheumatica and Giant-Cell Arteritis.- 4.10.1. Clinical Manifestations.- 4.10.2. Diagnosis.- 4.10.3. Management.- 4.11. Malignancies and Rheumatic Diseases.- 4.11.1. Hypertrophic Osteoarthropathy.- 4.11.2. Malignancy-Related Polyarthritis.- 4.11.3. Polymyositis and Dermatomyositis.- 4.11.4. Metastatic Disease.- 4.11.5. Leukemia.- 4.11.6. Carcinoma of the Pancreas.- 4.12. Medications for the Treatment of Rheumatic Diseases.- 4.12.1. General Principles of Drug Therapy.- 4.12.2. Nonsteroidal Antiinflammatory Drugs.- 4.12.2.1. Mechanisms of Action.- 4.12.2.2. Metabolism.- 4.12.2.3. Side-Effects and Hypersensitivity Reactions.- 4.12.2.4. Drug Interactions.- 4.12.2.5. Drug Administration.- 4.12.3. Corticosteroids.- 4.12.4. Gold Therapy.- 4.12.5. Allopurinol.- References.- 5 Genitourinary Problems in the Elderly.- 5.1. Renal Function.- 5.1.1. Renal Changes with Aging.- 5.1.2. Acute Renal Failure.- 5.1.2.1. Prerenal Azotemia.- 5.1.2.2. Acute Parenchymal Renal Failure.- 5.1.2.3. Postrenal (Obstructive) Uropathy.- 5.1.3. Management of Acute Renal Failure.- 5.1.4. Electrolytes in Renal Failure.- 5.1.5. Neurologic Manifestations of Renal Failure.- 5.1.6. Chronic Renal Failure.- 5.1.7. Hemodialysis.- 5.1.8. Peritoneal Dialysis.- 5.1.9. Rehabilitation on Dialysis.- 5.2. Bladder Physiology.- 5.2.1. Anatomy and Physiology of Micturition.- 5.2.2. Urodynamics.- 5.2.3. Neurogenic Bladder.- 5.2.4. Treatment of Neurogenic Bladder.- 5.2.5. Intermittent Catheterization and Diversion.- 5.3. Carcinoma of the Bladder.- 5.3.1. Etiology and Natural History of Bladder Cancer.- 5.3.2. Staging of Bladder Cancer.- 5.3.3. Treatment of Bladder Cancer.- 5.3.4. Topical Chemotherapy of Bladder Cancer.- 5.3.5. Systemic Chemotherapy for Bladder Cancer.- 5.4. Physiology of the Prostate Gland.- 5.4.1. The Normal Prostate.- 5.4.2. The Aging Prostate.- 5.4.3. Relief of Prostatic Obstruction.- 5.4.4. Infection of the Prostate Gland.- 5.5. Prostatic Carcinoma.- 5.5.1. Etiology and Natural History of Prostatic Carcinoma.- 5.5.2. Current Treatment of Prostatic Carcinoma.- 5.5.3. Screening for Prostatic Cancer.- 5.5.4. Spread of Prostatic Cancer to Bone.- 5.5.5. Pattern of Metastatic Spread of Prostatic Cancer.- 5.5.6. Host Response to Metastatic Prostatic Cancer.- 5.5.7. Calcium Metabolism in Patients with Metastatic Prostatic Cancer.- 5.5.8. Assessment of Bone Metastases.- 5.5.9. Treatment of Bone Metastases.- References.- 6 Endocrinology and Metabolism in the Elderly.- 6.1. Osteoporosis.- 6.1.1. Introduction.- 6.1.2. Definition.- 6.1.3. Pathogenesis.- 6.1.4. Natural History.- 6.1.5. Diagnosis.- 6.1.6. Treatment.- 6.1.7. Summary.- 6.2. Osteomalacia.- 6.2.1. Pathophysiology and Natural History.- 6.2.2. Diagnosis.- 6.2.3. Treatment.- 6.2.4. Summary.- 6.3. Paget's Disease of Bone.- 6.3.1. Definition.- 6.3.2. Pathophysiology.- 6.3.3. Diagnosis.- 6.3.4. Treatment.- 6.3.5. Summary.- 6.4. Age-Related Changes in Thyroid Hormone Economy.- 6.4.1. Introduction.- 6.4.2. Thyroid Function Testing.- 6.4.3. Effect of Age on Hypothalamic-Pituitary-Thyroid Interrelationships.- 6.5. Hyperthyroidism in the Elderly.- 6.5.1. Introduction.- 6.5.2. Clinical Presentation.- 6.5.3. Treatment.- 6.6. Hypothyroidism.- 6.6.1. Introduction.- 6.6.2. Clinical Presentation.- 6.6.3. Treatment.- 6.7. Clinical Aspects of Gonadal and Sexual Function in Elderly Men ..- 6.7.1. Introduction.- 6.7.2. Sexual Function in the Elderly.- 6.7.2.1. The Physiology of the Male Sexual Response.- 6.7.2.2. Effects of Aging on Sexual Activity in Men.- 6.7.2.3. Alterations in the Physiological Sexual Response with Age.- 6.7.3. The Hypothalamic-Pituitary-Testicular Axis.- 6.7.3.1. Brief Review of Hormonal Physiology.- 6.7.3.2. Hormonal Changes in Aging Men.- 6.7.3.3. Pituitary Function in Aging Men.- 6.7.4. Testosterone and Sexual Activity.- 6.7.5. Other Causes of Impotence in the Elderly.- 6.7.6. Evaluating Impotence.- 6.7.7. Conclusions.- 6.8. Menopause.- 6.8.1. Introduction.- 6.8.2. Hormonal Changes in the Peri- and Postmenopausal Period.- 6.8.3. Sex Steroids.- 6.9. Clinical Problems of the Climacteric.- 6.9.1. Introduction.- 6.9.2. Vasomotor Symptoms.- 6.9.3. Osteoporosis.- 6.9.4. Atrophy of the Genitalia.- 6.9.5. Cardiovascular Disease.- 6.10. Estrogen Use in Postmenopausal Women.- 6.10.1. Benefits and Risks.- 6.10.2. Conclusions.- References.- 7 Neuropsychiatric Problems in the Elderly.- 7.1. Introduction.- 7.2. Psychiatric Problems.- 7.2.1. Thought Disorders.- 7.2.1.1. Schizophrenia.- 7.2.1.2. Late-Occurring Paranoid States.- 7.2.1.3. Thought Disorders Secondary to an Organic Mental Disorder.- 7.2.2. Affective Disorders.- 7.2.2.1. Depression.- 7.2.2.2. Mania.- 7.2.3. Neurotic Disorders.- 7.2.3.1. Anxiety Neurosis.- 7.2.3.2. Compulsive Neurosis.- 7.2.3.3. Hysterical Neurosis.- 7.2.3.4. Chronic Fatigue.- 7.2.3.5. Hypochondriasis.- 7.2.4. Special Problems.- 7.2.4.1. Sleep Disturbances.- 7.2.4.2. Stress.- 7.2.4.3. Relationship between Functional Disorder and Physical Illness.- 7.2.4.4. Suicide.- 7.3. Drugs of Abuse.- 7.3.1. Introduction.- 7.3.2. Comparison of Drugs of Abuse-Young versus Aged.- 7.3.3. The Elderly Abuser.- 7.3.4. Thought on Causation of Alcohol Abuse in the Elderly.- 7.4. Organic Mental Disorders.- 7.4.1. Introduction.- 7.4.2. Causes of Dementia.- 7.4.3. Dementia as a Biopsychosocial Problem.- 7.4.4. Differential Diagnosis.- 7.4.5. Specifics Regarding Diagnosis of Dementia.- 7.4.6. Alzheimer's Disease.- 7.4.6.1. Epidemiology.- 7.4.6.2. Etiological/Risk Factors.- 7.4.6.3. Pathological Correlations.- 7.4.6.4. Pick's Disease-The Clinical/Pathological Comparison with Alzheimer's.- 7.4.6.5. Treatment.- 7.5. Neurologic Diseases.- 7.5.1. Huntington's Disease.- 7.5.2. Parkinson's Disease.- 7.6. Conclusion.- References.- 8 Nutritional Problems in the Elderly.- 8.1. Statement of Purpose.- 8.2. Introduction.- 8.3. Aging Influences on Nutritional Data Interpretation.- 8.3.1. Metabolic Change.- 8.3.2. Physical Activity.- 8.4. Nutritional Assessment in the Elderly.- 8.4.1. Dietary History.- 8.4.1.1. Nutritional Interview and History-Taking in the Elderly.- 8.4.1.2. Geriatric Nutritional History.- 8.4.1.3. Major Tools of Dietary History.- 8.4.2. Clinical Evaluation.- 8.4.2.1. Introduction.- 8.4.2.2. Anthropometric Indicators of Nutritional Status.- 8.4.2.3. Clinical Evaluation: Summary.- 8.4.3. Biochemical and Laboratory Evaluations of Nutritional Status.- 8.5. Nutritional Surveys.- 8.5.1. Introduction.- 8.5.2. Major Nutritional Surveys.- 8.5.2.1. Introduction.- 8.5.2.2. Details.- 8.5.2.3. Summary.- 8.5.3. Detailed, but Limited, Nutritional Surveys.- 8.5.3.1. Introduction.- 8.5.3.2. Details of Surveys.- 8.5.3.3. Summary.- 8.6. Nutrient Recommendations for Older Americans.- 8.7. Drug-Diet Interactions in the Aged.- 8.8. The Kitchen: A Geriatric Health Hazard.- 8.9. Final Summary and Nutritional Research Imperative for the Elderly.- References.- 9 Preventive Medicine for the Elderly.- 9.1. Introduction.- 9.2. Primary Prevention.- 9.2.1. Anticipatory Guidance for the Elderly Patient.- 9.2.2. Nutrition in the Elderly.- 9.2.3. Exercise for the Elderly.- 9.2.4. Smoking and the Elderly.- 9.2.5. Promoting the Safe Use of Drugs in the Elderly.- 9.2.6. Mental Health of the Elderly.- 9.2.7. Alcoholism in the Elderly.- 9.2.8. Environmental Geriatrics.- 9.2.9. Geriatric Dentistry.- 9.3. Secondary Prevention.- 9.3.1. Introduction.- 9.3.2. Assessment of Psychosocial and Physical Function.- 9.4. Tertiary Prevention.- 9.4.1. General Rehabilitation for the Geriatric Patient.- 9.4.1.1. Preventive Aspects of Rehabilitation.- 9.4.1.2. Potential Problems with Rehabilitating the Elderly.- 9.4.2. Cardiac Rehabilitation.- 9.4.3. Pulmonary Rehabilitation.- 9.5. Summary.- References.

Zusatzinfo	biography
Sprache	englisch
Gewicht	789 g
Themenwelt	Medizin / Pharmazie ► Medizinische Fachgebiete ► Geriatrie
ISBN-10	0-306-41301-9 / 0306413019
ISBN-13	978-0-306-41301-8 / 9780306413018
Zustand	Neuware