Americans are living longer than ever before. For many, though, these extra years have become a bitter gift, marred by dementia, disability, and loss of independence.
Extending Life, Enhancing Life sets the course toward practical solutions to these problems by specifying 15 research priorities in five key areas of investigation:
- Basic biomedicine—To understand the fundamental processes of aging.
- Clinical—To intervene against common disabilities and maladies of older persons.
- Behavioral and social—To build on past successes with behavioral and social interventions.
- Health services delivery—To seek answers to the troubling issues of insufficient delivery of health care in the face of increasing health care costs.
- Biomedical ethics—To clarify underlying ethical guidelines about life and death decisions.
Most important, the volume firmly establishes the connection between research and its beneficial results for the quality of life for older persons.
- Extending Life, Enhancing Life
- Copyright
- Preface
- Contents
- Executive Summary and Recommendations for Funding
- BACKGROUND
- Support for Training and Research in Geriatrics and Gerontology
- The Aging Society: Current Costs for Health Care of Older Persons
- The Potential of Research on Aging
- A NATIONAL RESEARCH AGENDA ON AGING
- Basic Biomedical Research
- Priority Research Recommendations
- Additional Research Opportunities
- Resource Recommendations
- Clinical Research
- Priority Research Recommendations
- Additional Research Opportunities
- Resource Recommendations
- Behavioral and Social Research
- Priority Research Recommendations
- Additional Research Opportunities
- Resource Recommendations
- Health Services Delivery Research
- Priority Research Recommendations
- Additional Research Opportunities
- Resource Recommendations
- Research in Biomedical Ethics
- Priority Research Recommendations
- Additional Research Opportunities
- Resource Recommendations
- CROSSCUTTING ISSUES
- Basic Biomedical Research
- Clinical Research
- Behavioral and Social Research
- Health Services Delivery Research
- RECOMMENDATIONS FOR FUNDING THE RESEARCH AGENDA ON AGING
- Derivation of Recommendations for Funding
- Funds for Research Projects
- Funds for Training in Age-Related Studies
- Funds for Centers
- Funds for Infrastructure
- Funds for Construction
- IMPLICATIONS FOR FUNDING AGENCIES
- CONCLUDING COMMENTS
- REFERENCES
- 1 Introduction
- 2 Basic Biomedical Research
- RESEARCH PRIORITIES
- ADDITIONAL RESEARCH OPPORTUNITIES
- RESOURCE RECOMMENDATIONS
- Funding of Research Proposals
- Materials
- Animal Models
- Cell Line and Tissue Samples
- Further Development of Existing Longitudinal Studies
- CROSSCUTTING ISSUES
- REFERENCES
- 3 Clinical Research
- RESEARCH PRIORITIES
- Health Promotion and Disease Prevention in Old Age
- Studies of Geriatric Syndromes
- Failure to Thrive (Inanition)
- Impaired Postural Stability, Strength, and Mobility
- Mismanagement of Medications
- Urinary Incontinence
- Delirium
- Cardiovascular Disease
- Dementia, Pseudodementia, and Psychiatric Disorders
- Musculoskeletal Disorders
- Infectious Disease and Immunosenescence
- Neoplasia
- Disorders of Metabolism and Homeostasis
- ADDITIONAL RESEARCH OPPORTUNITIES
- RESOURCE RECOMMENDATIONS
- CROSSCUTTING ISSUES
- REFERENCES
- 4 Behavioral and Social Sciences
- JUSTIFICATION AND MAJOR THEMES
- The Dynamic Interaction of Individuals and Sociocultural Contexts
- Differentiation
- Modifiability
- RESEARCH PRIORITIES
- ADDITIONAL RESEARCH OPPORTUNITIES
- METHODOLOGICAL NEEDS
- Tests and Instruments
- Coordination of Large-Scale Research
- Field Intervention Studies
- RESOURCE RECOMMENDATIONS
- CROSS-DISCIPLINARY AND CROSSCUTTING ISSUES
- Gender
- Race and Ethnicity, Socioeconomic Status, and Other Cultural Factors
- Population Dynamics
- Brain, Environment, Society, and Behavior
- REFERENCES
- 5 Health Services Delivery Research
- LONG-TERM CARE AND CONTINUITY OF CARE FOR OLDER PERSONS
- Characteristics of Older Persons Requiring Long-Term Care
- Informal Providers of Long-Term Care
- Formal Long-Term Care
- Supply of Personnel for Long-Term Care
- Locus of Long-Term Care
- Quality Assurance
- Technologies
- FINANCING OF HEALTH CARE FOR OLDER PERSONS
- DRUG USE
- Inappropriate Prescribing
- Noncompliance
- Drug Costs and Older Persons
- MENTAL HEALTH SERVICES
- DISABILITY/DISEASE PREVENTION AND HEALTH PROMOTION SERVICES
- RESEARCH PRIORITIES
- ADDITIONAL RESEARCH OPPORTUNITIES
- RESOURCES REQUIRED
- CROSS-DISCIPLINARY AND CROSSCUTTING ISSUES
- REFERENCES
- 6 Research in Biomedical Ethics
- RESEARCH PRIORITIES
- Life-Sustaining Treatment in Older Persons
- Improving Discussions About Life-Sustaining Treatment
- Improving Decision Making for Incompetent Patients Who Have Not Given Clear Advance Directives
- Defining the Role of Institutional Ethics Committees, Particularly Within Nursing Homes
- Establishing Medical Futility
- Resolving Disagreements Between Health Care Professionals and Patients (or Patients' Families)
- Issues of Equity and Access
- Identification of Criteria for Appropriate Practice Standards
- Age as a Criterion for Allocating Health Care Resources
- Allocation of Resources for Patient Care and for Research
- Ethical Issues in Aging Research
- Innovative Approaches to Informed Consent
- Proxy Consent for Incompetent Patients
- Attitudes Toward Participation in Research
- Research Review in Long-Term Care
- ADDITIONAL RESEARCH OPPORTUNITIES
- CONCLUSIONS AND RESOURCE RECOMMENDATIONS
- REFERENCES
- 7 Review of Resources Committed to Research on Aging
- FUNDING SUPPORT FOR RESEARCH ON AGING
- The Federal Government
- National Institutes of Health
- Department of Veterans Affairs
- Alcohol, Drug Abuse, and Mental Health Administration
- Health Care Financing Administration
- Agency for Health Care Policy and Research
- Other Federal Departments and Agencies
- Industry and Foundations
- INSTITUTIONS ENGAGED IN RESEARCH ON AGING
- Centers for Research on Aging Supported by the NIA
- Centers for the Study of Alzheimer's Disease
- Centers of Excellence in Research and Teaching in Geriatrics and Gerontology (Claude Pepper Centers)
- Geriatric Research, Education, and Clinical Centers of the Department of Veterans Affairs
- Teaching and Research Nursing Homes
- Other Institutional Supports for the Study of Aging
- PUBLICATIONS ON RESEARCH IN AGING
- PERSONNEL ENGAGED IN THE STUDY OF AGING
- REFERENCES
- Appendixes
- A Acknowledgments
- Liaison Teams
- Basic Biomedical Research
- Clinical Research
- Behavioral and Social Sciences
- Behavioral Sciences
- Social Sciences
- Health Services Delivery Research
- Biomedical Ethics
- Experts Providing Information to the Committee
- Directors, Dva Geriatric Research, Education, and Clinical Centers
- Directors, Pharmaceutical Company Research
- B Background Documents
- Index
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