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This text provides a structured discussion, emphasizing principles and methods, of the public health and epidemiologic approach to the investigation of the health problems of older persons. The authors bring a wide variety of backgrounds to this text, including geriatrics, gerontology, sociology, survey research, and economics, as well as epidemiology and biostatistics. There is a synthesis of traditional health measures, such as morbidity and mortality, with more modern health indices such as functional status, social networks and support, medication use and mental and emotional conditions. The text will assist both practitioners and investigators in approaching the health problems of older persons in the community and population context. It is a uniquely comprehensive resource.
The average age of the world’s population is increasing at an unprecedented rate and this increase is changing the world. This “Silver tsunami” emphasizes the need to provide advanced training in epidemiology and increase the cadre of experts in the study of aging. This book is designed to summarize unique methodological issues relevant to the study of aging, biomarkers of aging and the biology/physiology of aging and in-depth discussions of the etiology and epidemiology of common geriatric syndromes and diseases. Contributing authors in the book represent many disciplines, not only epidemiology and clinical geriatrics, but also demography, health services, research, cardiovascular disease, diabetes, psychiatry, neurology, social services, musculoskeletal diseases and cancer. The aim of the book is to provide a broad multidisciplinary background for any student/researcher interested in aging. The material in the book is organized and comprehensive. It represents the most up-to-date information on the scientific issues in aging research written by academics who specialize in research and training in the broad field of aging. The structure and organization of the book reflects our course series in the Epidemiology of Aging starting with the broad issues of demography and methodology, and then addressing specific health conditions and geriatric conditions common to older persons.
Older Americans, even the oldest, can now expect to live years longer than those who reached the same ages even a few decades ago. Although survival has improved for all racial and ethnic groups, strong differences persist, both in life expectancy and in the causes of disability and death at older ages. This book examines trends in mortality rates and selected causes of disability (cardiovascular disease, dementia) for older people of different racial and ethnic groups. The determinants of these trends and differences are also investigated, including differences in access to health care and experiences in early life, diet, health behaviors, genetic background, social class, wealth and income. Groups often neglected in analyses of national data, such as the elderly Hispanic and Asian Americans of different origin and immigrant generations, are compared. The volume provides understanding of research bearing on the health status and survival of the fastest-growing segment of the American population.
Family caregiving affects millions of Americans every day, in all walks of life. At least 17.7 million individuals in the United States are caregivers of an older adult with a health or functional limitation. The nation's family caregivers provide the lion's share of long-term care for our older adult population. They are also central to older adults' access to and receipt of health care and community-based social services. Yet the need to recognize and support caregivers is among the least appreciated challenges facing the aging U.S. population. Families Caring for an Aging America examines the prevalence and nature of family caregiving of older adults and the available evidence on the effectiveness of programs, supports, and other interventions designed to support family caregivers. This report also assesses and recommends policies to address the needs of family caregivers and to minimize the barriers that they encounter in trying to meet the needs of older adults.
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.
Since the late 1970s when Congressman Claude Pepper held widely publicized hearings on the mistreatment of the elderly, policy makers and practitioners have sought ways to protect older Americans from physical, psychological, and financial abuse. Yet, during the last 20 years fewer than 50 articles have addressed the shameful problem that abusersâ€"and sometimes the abused themselvesâ€"want to conceal. Elder Mistreatment in an Aging America takes a giant step toward broadening our understanding of the mistreatment of the elderly and recommends specific research and funding strategies that can be used to deepen it. The book includes a discussion of the conceptual, methodological, and logistical issues needed to create a solid research base as well as the ethical concerns that must be considered when working with older subjects. It also looks at problems in determination of a report's reliability and the role of physicians, EMTs, and others who are among the first to recognize situations of mistreatment. Elder Mistreatment in an Aging America will be of interest to anyone concerned about the elderly and ways to intervene when abuse is suspected, including family members, caregivers, and advocates for the elderly. It will also be of interest to researchers, research sponsors, and policy makers who need to know how to advance our knowledge of this problem.
This comprehensive volume provides a practical framework for evaluation, management and disposition of this growing vulnerable patient population.