Taking its title from the second 50 years of the human life span of about 100 years, this book presents wide-ranging and practical recommendations for health care providers, policymakers, and other sectors of society. These recommendations range from setting new national policies to changing the way elderly patients are interviewed in the doctor's office and from what exercises older persons should do to how city planners should design our urban environment.
The bulk of this volume presents the latest research on 13 major health threats to the elderly, covering prevalence, impact on the older person's life, cost, and intervention.
In addition, the authors provide a detailed analysis of why older people often do not receive the benefit of prevention programs.
- The Second Fifty Years
- Copyright
- Acknowledgment
- Preface
- Contents
- Summary
- GENERAL ISSUES OF HEALTH PROMOTION AND DISABILITY PREVENTION
- CONCLUSIONS AND RECOMMENDATIONS
- High Blood Pressure
- Medications
- Infectious Diseases
- Osteoporosis
- Sensory Loss
- Oral Health
- Cancer Screening
- Nutrition
- Smoking
- Depression
- Physical Inactivity
- Social Isolation
- Falls
- 1 Introduction
- 2 Disability Classification
- DISABILITY AND THE DISEASE MODEL
- CLASSIFYING DISABILITIES
- REFERENCES
- 3 High Blood Pressure
- BURDEN
- PATHOPHYSIOLOGY
- UTILITY OF SCREENING
- EVIDENCE THAT TREATMENT IS BENEFICIAL
- Evidence That Treatment of Systolic/Diastolic High Blood Pressure Is Beneficial
- Evidence That Treatment of Isolated Systolic High Blood Pressure Is Beneficial
- Impact of Treatment on Cerebrovascular Versus Coronary Heart Disease
- Impact of the Treatment of High Blood Pressure on Total Mortality
- Adverse Effects of Antihypertensive Therapy
- NONPHARMACOLOGIC THERAPY
- SUMMARY OF INTERVENTION DATA
- COST-EFFECTIVENESS OF TREATMENT FOR HIGH BLOOD PRESSURE IN PERSONS OVER 50
- SUMMARY
- RECOMMENDATIONS
- Services
- Clinical
- Research
- Policy
- REFERENCES
- 4 Medications
- BURDEN
- Prevalence
- Costs
- The Impairment/Disability/Handicap Sequence
- PREVENTABILITY OF BURDEN
- RECOMMENDATIONS
- Services
- Research
- Education
- Policymakers
- REFERENCES
- 5 Risk Factors for Infection in the Elderly
- PNEUMOCOCCAL DISEASE
- INFLUENZA
- NOSOCOMIAL INFECTIONS
- INFECTIONS IN LONG-TERM FACILITIES
- OTHER INFECTIONS
- RECOMMENDATIONS
- Services
- Research
- Education
- REFERENCES
- 6 Osteoporosis
- BURDEN OF OSTEOPOROSIS AND FRACTURES
- Morbidity
- Mortality
- Disability
- Costs
- DETERMINANTS OF FRACTURES
- PREVENTABILITY OF OSTEOPOROSIS
- Peak Bone Mass
- Hypogonadal Bone Loss
- Age-related Bone Loss
- Secondary Osteoporosis
- RECOMMENDATIONS
- Services
- Research
- Education
- Policymakers
- Providers
- The Public
- APPENDIX
- SINGLE-PHOTON ABSORPTIOMETRY
- DUAL-PHOTON ABSORPTIOMETRY
- DUAL-ENERGY X-RAY ABSORPTIOMETRY
- QUANTITATIVE COMPUTED TOMOGRAPHY
- REFERENCES
- 7 Preventing Disability Related to Sensory Loss in the Older Adult
- DEFINITION AND PREVALENCE
- ETIOLOGIC BREAKDOWN
- Visual Impairments
- Hearing Impairments
- DISABILITIES ASSOCIATED WITH SENSORY LOSS
- APPROACHES TO PREVENTION
- RECOMMENDATIONS
- Policymakers and Government Agencies
- Professional Societies
- Clinicians
- REFERENCES
- 8 Oral Health Problems in the "Second Fifty"
- BURDEN
- Perioral Tissue and Oral Mucosal Tissue Pathologies and Oral Cancer
- Caries
- Periodontal Diseases
- Other Oral Conditions
- Tooth Loss
- Oral Expressions of Medications, Systemic Conditions, and Diseases
- Orofacial Pain
- BURDEN PREVENTABILITY
- Prevention of Oral Cancer
- Prevention of Caries
- Prevention of Gingivitis and Periodontitis
- Prevention of Oral Pain
- General Prevention
- RECOMMENDATIONS
- Services
- Research
- Public Policy
- Education
- NOTE
- REFERENCES
- 9 Screening for Cancer
- BURDEN
- Incidence, Mortality, Survival, and Prevalence
- Impairment, Disability, Handicap, and Costs
- Impairment
- Disability
- Handicap
- PREVENTABILITY OF BURDEN
- Ecologic Considerations
- Female Breast Cancer
- Cancer of the Uterine Cervix
- Cancer of the Colon and Rectum
- Skin Cancer (Including Malignant Melanoma)
- Screening for Other Cancers
- DISCUSSION
- RECOMMENDATIONS
- Implementation of Screening
- Research
- Education
- REFERENCES
- 10 Nutrition
- NUTRITION AND QUALITY OF LIFE
- NUTRITION AND FUNCTION
- FUNCTIONAL INDICES OF NUTRITIONAL STATUS
- DIETARY INDICES
- ANTHROPOMETRY
- PROGNOSTIC INDICATORS OF MORBIDITY OR MORTALITY
- NUTRITIONAL RISK SCREENING INDICES
- NUTRITION IN A FUNCTIONAL PERSPECTIVE
- BURDEN
- PREVENTABILITY OF BURDEN
- High Blood Pressure
- Hypercholesterolemia
- Hypertriglyceridemia
- Renal Disease-related Risks
- Diabetes Mellitus
- Weight Reduction
- Physical Activity
- Polypharmacy: Controlling Side Effects
- Nutrition Fraud
- Oral Health
- Nutritional Support: Food Programs
- RECOMMENDATIONS
- Services
- Research
- Education
- REFERENCES
- 11 Cigarette Smoking
- PREVALENCE
- BURDEN
- EVIDENCE THAT SMOKING CESSATION IS BENEFICIAL
- SMOKING CESSATION TECHNIQUES
- PASSIVE SMOKING
- RECOMMENDATIONS
- Those Over the Age of 50
- Services
- Public Health and Environmental Policymakers
- Advocacy Groups
- REFERENCES
- 12 Depression
- DEFINITION AND PREVALENCE
- RISK FACTORS
- REMEDIABILITY: OUTCOME OF TREATMENT
- COSTS
- SUICIDE
- REIMBURSEMENT
- RESEARCH AND THE FUTURE
- RECOMMENDATIONS
- Services
- Insurance Providers (Governmental and Private)
- Clinicians (Particularly Primary Care Physicians)
- Persons Over the Age of 50
- Research
- Education
- REFERENCES
- 13 Physical Inactivity
- BURDEN
- Prevalence
- Impairment, Disability, and Handicap
- PREVENTABILITY OF BURDEN: AVAILABILITY AND EFFECTIVENESS OF INTERVENTIONS
- Individuals
- The Community
- Worksite
- COST-EFFECTIVENESS OF INTERVENTIONS
- RECOMMENDATIONS
- Services
- Research
- Education
- Policymakers
- REFERENCES
- 14 Social Isolation Among Older Individuals The Relationship to Mortality and Morbidity
- DEFINITION
- BURDEN
- Prevalence
- Costs
- Impairment, Disability, and Handicap
- PREVENTABILITY OF BURDEN
- Available Interventions
- Effectiveness of Each Intervention
- RECOMMENDATIONS
- Services
- Research
- Education
- Providers
- Families
- The Elderly
- REFERENCES
- 15 Falls in Older Persons Risk Factors and Prevention
- THE HEALTH BURDEN OF FALLS AND FALL-RELATED INJURIES IN OLDER PERSONS
- Mortality
- Fall-related Injuries
- Frequency of Falls
- Disability
- Costs
- DETERMINANTS OF FALLS: RISK FACTORS AND CAUSES
- Intrinsic Risk Factors
- Situational and Extrinsic Risk Factors
- Environmental Factors
- Determinants of Injury and Other Outcomes of Falls
- PREVENTABILITY OF BURDEN
- Exercise and Physical Activity
- Rehabilitative Therapies: Balance and Gait Training
- Medications
- Environmental and Behavioral Interventions
- Frameworks for Multiple Risk Factor Interventions
- Targeting Interventions
- RECOMMENDATIONS
- Research
- Education and Services
- Other Areas
- REFERENCES
- A Can Philosophy Cure What Ails the Medical Model?
- CAN THE AMERICAN HEALTH CARE SYSTEM COPE WITH SUCCESS?
- CAN PHILOSOPHY CURE OUR AILING HEALTH CARE SYSTEM?
- IF YOU ARE NOT SICK, ARE YOU HEALTHY?
- THE DEFINITION OF DISEASE AND IMPAIRMENT: NORMATIVISM VERSUS NONNORMATIVISM
- OBJECTIVITY AND VALUES IN THE DEFINITION OF HEALTH AND DISEASE
- THE DEMEDICALIZATION OF CHRONIC ILLNESS AND DISABILITY
- THE DEMEDICALIZATION OF HEALTH
- REFERENCES
- B Looking for Order Health Promotion, Disability Prevention, and the Disability Classification System of the World Health...
- THE GOAL OF HEALTH CARE
- THE PHILOSOPHY OF HEALTH CARE
- REFERENCES
- Index
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