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As the first of the nation's 78 million baby boomers begin reaching age 65 in 2011, they will face a health care workforce that is too small and woefully unprepared to meet their specific health needs. Retooling for an Aging America calls for bold initiatives starting immediately to train all health care providers in the basics of geriatric care and to prepare family members and other informal caregivers, who currently receive little or no training in how to tend to their aging loved ones. The book also recommends that Medicare, Medicaid, and other health plans pay higher rates to boost recruitment and retention of geriatric specialists and care aides. Educators and health professional groups can use Retooling for an Aging America to institute or increase formal education and training in geriatrics. Consumer groups can use the book to advocate for improving the care for older adults. Health care professional and occupational groups can use it to improve the quality of health care jobs.
This book explains how to promote and prolong “healthy ageing,” which constitutes maintaining daily functioning and well-being until the end of life. In this context, the editor of the book and the international team of authors, all of whom are experts on the various aspects of ageing, demonstrate the value of this new approach in clinical practice. The systematic integration of a functional assessment, if not a complete and comprehensive geriatric assessment, is fundamental in daily clinical practice. Identifying risk factors at midlife will help to promote health at any age. Moreover, randomized control trials are making it increasingly clear that interventions could help ageing and elderly adults enjoy their remaining years without disability. Indeed, wellbeing will also increase, allowing elderly adults to stay independent until a very advanced age. The book also shows how considerable societal benefits can be easily forecast when more lifetime is spent without disability, followed by a dignified end of life. This book will be of interest to all medical doctors, general practitioners and organ specialists as well as geriatricians who want to have a complete overview of what healthy ageing means.
This book was prepared as extension of author’s accidental discoveries on experimental models of acute and chronic ocular inflammatory diseases that were established at the University of Pennsylvania in 1980’s. Analyses of original data suggest a series of first evidence for direct link between inflammation and developmental phases of immune dysfunction in multistep tumorigenesis and angiogenesis. The only evidence presented on initial events for interactions and synergies between activated host and recruiting cells toward tumorigenesis. Effective immunity was defined as balance between two highly regulated and biologically opposing arms, Yin and Yang of acute inflammation, an amazingly precise signal communications between immune and non-immune systems requiring differential bioenergetics. Unresolved inflammation is a common denominator mapping aging process and induction of ‘mild’, ‘moderate’ or ‘severe’ immune disorders including cancers. Our knowledge of the fascinating biology of immunity in health or chronic diseases is fragmentary, chaotic and confusing, particularly for cancer science. Lack of progress in curing majority of chronic diseases or cancer is primarily due to the fact that scientists work on isolated molecules/cells or topics that are funded and promoted by decision makers in medical/cancer establishment. Despite existence of over 25 million articles on cancer-related topics, cancer biology and cure remain mysteries to be solved. After a century of cancer research, the failure rates of therapies for solid tumors are 90% (+/-5). Current reductionist views on cancer science are irresponsible, shut-gun approaches and create chaos. Outcomes are loss of millions of precious lives and economic drain to society. Very little is known about initial events that disturb effective immunity whose function is to monitor and arrest growth of cancerous cells or defend against other external or internal hazardous agents that threaten body’s survival. The author demonstrates the serious need for systematic understanding of how immune disruptors and aging process would alter effective immunity. Outcomes of proposed orderly studies are expected to provide logical foundations for cost-effective strategies to promote immunity toward a healthier society. The policy makers and medical/cancer establishment are urged to return to the common sense that our Forefathers used to serve the public.
Chronic Medical Disease and Cognitive Aging: Toward a Healthy Body and Brain explores the important and often overlooked connection between how chronic medical diseases of the body can affect cognitive function and brain health. As population demographics shift to that of an aging population it has become more important to understand and improve cognitive function in late life. Chronic medical diseases often increase the risk of cognitive impairment, and those with cognitive impairment may be less able to effectively manage their medical conditions, suggesting a reciprocal relationship may exist where medical disease impacts cognition that in turn may exacerbate physical health. Chronic Medical Disease and Cognitive Aging discusses current research on the association between a variety of chronic medical diseases and cognition and, where appropriate, promising interventions or accepted treatment strategies. While a cure for many diseases continues to be elusive, insights garnered from the interplay between diseases of the body and mind may help point the way to novel therapeutic strategies to improve cognitive function in late life.
This book provides the first comprehensive overview of a new scientific discipline termed Geroscience. Geroscience examines the molecular and cellular mechanisms that might explain why aging is the main risk factor for most chronic diseases affecting the elderly population. Over the past few decades, researchers have made impressive progress in understanding the genetics, biology and physiology of aging. This book presents vital research that can help readers to better understand how aging is a critical malleable risk factor in most chronic diseases, which, in turn, could lead to interventions that can help increase a healthy lifespan, or ‘healthspan.’ The book begins with an analysis of the Geroscience hypothesis, as well as the epidemiological underpinnings that define aging as a candidate main risk factor for most chronic diseases. Next, each chapter focuses on one particular disease, or group of diseases, with an emphasis on how basic molecular and cellular biology might explain why aging is a major risk factor for it. Coverage in the book includes: cancer, cardiovascular disease, dementias, stroke, Parkinson's and Alzheimer’s diseases, osteoporosis, arthritis, diabetes asthma, emphysema, kidney disease, vision impairment, and AIDS/HIV. It finishes with a chapter on pain in the elderly and an overview of future steps needed to bring the newly acquired knowledge into the clinic and the public at large.
This report focuses on preventing potentially disabling conditions from developing into disabilities and on minimizing the effects of such conditions on a person's productivity and quality of life. It describes disability as a social and public health issue and not just a physical condition. The report begins with an executive summary, an introduction which discusses prevention issues in general and defines concepts, and a list of 27 recommendations. Subsequent chapters discuss: (1) the magnitude and dimensions of disability in the United States; (2) a conceptual approach to disability prevention and use of the tools and principles of epidemiology; (3) major areas of disability (developmental disabilities, injury-related disabilities, chronic diseases and aging, and secondary conditions associated with primary disabling conditions); (4) government and private sector programs concerned with disability prevention; and (5) conclusions and recommendations in the areas of a national program for the prevention of disability, surveillance, research, access to care and preventive services, and professional and public education. Appendixes contain a paper by Saad Z. Nagi titled "Disability Concepts Revisited: Implications for Prevention"; a statement of one committee member dissenting from this majority report of the Committee on a National Agenda for the Prevention of Disabilities; a response to the dissenting statement by committee members; and committee biographies. (Approximately 375 references) (JDD)
Social isolation and loneliness are serious yet underappreciated public health risks that affect a significant portion of the older adult population. Approximately one-quarter of community-dwelling Americans aged 65 and older are considered to be socially isolated, and a significant proportion of adults in the United States report feeling lonely. People who are 50 years of age or older are more likely to experience many of the risk factors that can cause or exacerbate social isolation or loneliness, such as living alone, the loss of family or friends, chronic illness, and sensory impairments. Over a life course, social isolation and loneliness may be episodic or chronic, depending upon an individual's circumstances and perceptions. A substantial body of evidence demonstrates that social isolation presents a major risk for premature mortality, comparable to other risk factors such as high blood pressure, smoking, or obesity. As older adults are particularly high-volume and high-frequency users of the health care system, there is an opportunity for health care professionals to identify, prevent, and mitigate the adverse health impacts of social isolation and loneliness in older adults. Social Isolation and Loneliness in Older Adults summarizes the evidence base and explores how social isolation and loneliness affect health and quality of life in adults aged 50 and older, particularly among low income, underserved, and vulnerable populations. This report makes recommendations specifically for clinical settings of health care to identify those who suffer the resultant negative health impacts of social isolation and loneliness and target interventions to improve their social conditions. Social Isolation and Loneliness in Older Adults considers clinical tools and methodologies, better education and training for the health care workforce, and dissemination and implementation that will be important for translating research into practice, especially as the evidence base for effective interventions continues to flourish.
Chronic Disease in the Twentieth Century challenges the conventional wisdom that the concept of chronic disease emerged because medicine's ability to cure infectious disease led to changing patterns of disease. Instead, it suggests, the concept was constructed and has evolved to serve a variety of political and social purposes. How and why the concept developed differently in the United States, an United Kingdom, and France are central concerns of this work. While an international consensus now exists, the different paths taken by these three countries continue to exert profound influence. This book seeks to explain why, among the innumerable problems faced by societies, some problems in some places become viewed as critical public issues that shape health policy. -- from back cover.
The population of Asia is growing both larger and older. Demographically the most important continent on the world, Asia's population, currently estimated to be 4.2 billion, is expected to increase to about 5.9 billion by 2050. Rapid declines in fertility, together with rising life expectancy, are altering the age structure of the population so that in 2050, for the first time in history, there will be roughly as many people in Asia over the age of 65 as under the age of 15. It is against this backdrop that the Division of Behavioral and Social Research at the U.S. National Institute on Aging (NIA) asked the National Research Council (NRC), through the Committee on Population, to undertake a project on advancing behavioral and social research on aging in Asia. Aging in Asia: Findings from New and Emerging Data Initiatives is a peer-reviewed collection of papers from China, India, Indonesia, Japan, and Thailand that were presented at two conferences organized in conjunction with the Chinese Academy of Sciences, Indian National Science Academy, Indonesian Academy of Sciences, and Science Council of Japan; the first conference was hosted by the Chinese Academy of Social Sciences in Beijing, and the second conference was hosted by the Indian National Science Academy in New Delhi. The papers in the volume highlight the contributions from new and emerging data initiatives in the region and cover subject areas such as economic growth, labor markets, and consumption; family roles and responsibilities; and labor markets and consumption.