Geriatric Medicine

Since the publication of the third edition of Geriatric Medicine,extraordinary advances have occurred in the science of aging and the potential for biomedical research to give us answers to many, if not most, of the age-related disorders that threaten the quality of life in older years. At the most basic level, the successful mapping of the human genome was declared complete in the fall of 2000. Understanding the map of the human genome is as important as understanding the map of genomes of important laboratory species, ranging from the microscopic worms and fruit?ies used in most classic genetic studies to rodents such as laboratory mice, and eventually to primates, on which much of the research on the aging human brain is done. The genetic maps of all of these species,including our own,does not answer clinical questions,but it does open the door to dramatic, rapid, and ef?cient answers to questions about the genetic polymorphisms related to diseases in humans. The telomerase story also unfolded since the third edition. Telomerase is an enzyme responsible for maintaining the telomeres-the redundant DNA portions at the end of chromosomes-whose shortening seems to be linked directly to cell senescence,ap- tosis,and the control over cell death,which,at the level of the individual cell,seems to be linked to the decline of organ function and eventually aging and death within the org- ism.

Basics of Gerontology.- Evidence-Based Medicine and Geriatrics.- Molecular and Biologic Factors in Aging.- Physiology of Aging.- The Demography of Aging.- Epidemiology and Aging.- Psychosocial Influences on Health in Later Life.- Principles of Pharmacology.- Clinical Strategies of Prescribing for Older Adults.- Changing Contexts of Care in Geriatric Medicine.- Contexts of Care.- The Long and the Short of Long-Term Care.- The Geriatrician in the Nursing Home.- Home Care.- Acute Hospital Care.- Clinical Approaches to the Geriatric Patient.- Clinical Approach to the Older Patient: An Overview.- Chronic Disease Management.- Prevention.- Instruments to Assess Functional Status.- Comprehensive Geriatric Assessment and Systems Approaches to Geriatric Care.- Neuropsychological Testing.- Preoperative Assessment and Perioperative Care.- Anesthesia for the Geriatric Patient.- Surgical Approaches to the Geriatric Patient.- Rehabilitation.- Palliative Care.- Old Age and Care Near the End of Life.- Doctor-Patient Communication Issues.- Care Near the End of Life.- Sources of Suffering in the Elderly.- Acute and Chronic Pain.- Palliative Care in Early, Moderate, and Advanced Dementia.- The Value of Achieving a Peaceful Death.- Medical Care.- Cancer in the Elderly: An Overview.- The Science of Neoplasia and Its Relationship to Aging.- Screening for Cancer.- Breast Cancer.- Colon Cancer and Other Gastrointestinal Malignancies.- Lung Cancer.- Prostate Cancer.- Gynecologic Cancers.- Hematologic Malignancies.- Cardiovascular Disease.- Hypertension.- Peripheral Arterial Disease.- Rheumatologic Diseases.- Skeletal Fragility in the Elderly.- Orthopedic Problems with Aging.- Medical Aspects of Hip Fracture Management.- Treatment of Diabetes.- Thyroid Disorders.- Changes in Male Sexuality.- Sexual Function and the Older Woman.- Gynecologic and Urologic Problems of Older Women.- Benign Prostatic Hyperplasia.- Nephrology/Fluid and Electrolyte Disorders.- Immunology of Aging.- Infectious Diseases.- Hematologic Problems.- Gastroenterologic Disorders.- Pulmonary Disease.- Dermatologic Diseases and Problems.- Changes and Diseases of the Aging Eye.- Otologic Changes and Disorders.- Aging and the Oral Cavity.- Dietary Supplements for Geriatric Patients.- Urinary Incontinence.- Syncope in the Elderly.- Management of Chronic Wounds.- Falls.- Chronic Dizziness and Vertigo.- Nutrition.- Exercise.- Sleep and Sleep Disorders.- Herpes Zoster.- Elder Mistreatment.- Frailty.- Neurologic and Psychiatric Disorders.- Dementia.- Neurobiologic Basis of Age-Related Dementing Disorders.- Delirium.- Cerebrovascular Disease and Stroke.- Abnormalities of Posture and Movement.- Depression, Anxiety, and Other Mood Disorders.- Late-Life Psychosis.- Ethics and Health Policy Issues for Older Adults.- Mechanisms of Paying for Health Care.- Justice and the Allocation of Health Care Resources.- Medical Treatment and the Physician's Legal Duties.- Determination of Decision-Making Capacity.- Ethical and Policy Issues in End-of-Life Care.- Ethical Challenges to Research in Geriatric Medicine.