Geriatrics and gerontology
The Study of Aging (Magill’s Medical Guide, Sixth Edition)
The field of geriatrics deals with the care of the elderly. The U.S. government’s definition of elderly includes persons sixty-five years of age or older. Geriatricians are physicians with specialized training in geriatric medicine who restrict their practices to caring for persons seventy-five years of age or older. These patients are most likely to suffer from specific geriatric syndromes, including dementia, delirium, urinary incontinence, malnutrition, osteoporosis, falls and immobility, decubitus ulcers, polypharmacy, and sleep disorders. The majority of older persons in the United States live in family settings with their spouses or children. Approximately 30 percent of older persons live alone, the majority of them being women. According to the U.S. Census Bureau, in 2000 the proportion of older persons (those over sixty-five) who lived in nursing homes was about 4.5 percent. Those aged eighty-five and over had a higher proportion, at 18.2 percent, thus indicating that the number of elderly people residing in nursing homes increases strikingly with age. However, the overall percentage of the elderly living in nursing homes is declining. While one may attribute this change to improvements in health care, it may also be attributable to the use of home health aides who provide assisted living services to seniors.
The focus of geriatric medicine is on improving functional disability and treating chronic disease...
(The entire section is 1085 words.)
Diseases Affecting the Elderly (Magill’s Medical Guide, Sixth Edition)
One of the chronic diseases frequently seen in elderly people is osteoporosis. Osteoporosis is defined as a decreased amount of bone per unit of volume; mineralization of the bone remains normal. Many studies have shown that bone mass decreases with age. Vertebral fractures resulting from osteoporosis cause deformity of the spine, loss in height, and pain. The absolute number of vertebral fractures that occur in older persons has been difficult to estimate, as some of these fractures go undiagnosed. The approximately 300,000 hip fractures that the elderly in the United States suffer annually have much more serious consequences. The lifetime risk of hip fracture by the age of eighty is approximately 15 percent for white women and 7 percent for white men. The risk of hip fracture by this age is significantly less in African Americans, with a 6 percent risk for women and a 3 percent risk for men.
One approach to preventing osteoporosis is to maximize the amount of bone that is formed during adolescence. Under normal circumstances, people begin to experience a net bone loss after the age of thirty-five. In women, the onset of menopause accelerates bone loss because of the decline in estrogen levels. Relative calcium deficiency has also been implicated in age-related osteoporosis. By definition, age-related osteoporosis is a diagnosis of exclusion. An older patient who has suffered a fracture first should be...
(The entire section is 1208 words.)
Perspective and Prospects (Magill’s Medical Guide, Sixth Edition)
In the United States, there has been increasing interest in the fields of geriatrics and gerontology because of the country’s changing demographics. In 2000, 35 million Americans were sixty-five years of age or older. Because of the very large numbers in the baby-boom age group—that is, people born between 1946 and 1964—it was expected that the number of elderly people would increase dramatically by the year 2030 to 71.5 million, more than doubling the amount of elderly people in 2000. By 2050, it is expected that this number will reach 86.7 million. Those individuals aged sixty-five and over made up approximately 12.5 percent of the U.S. population in 2000. In 2030, this percentage could increase to 19.5 percent.
Another reason for the increase in the size of the older population in the United States is an increase in life expectancy. Life expectancy is defined as the average number of years a person is expected to live, given population mortality rates. It can be calculated for any age category but is usually given as life expectancy from birth. The life expectancy in the United States is much higher than in undeveloped countries and in most other developed countries as well. This figure rose steadily throughout the twentieth century. A child born in 2000 could expect to live seventy-five years, while someone born in 1900 could expect to live only fifty years. Most of this increase in life expectancy is...
(The entire section is 895 words.)
For Further Information: (Magill’s Medical Guide, Sixth Edition)
Beerman, Susan, and Judith Rappaport-Musson. Eldercare 911: The Caregiver’s Complete Handbook for Making Decisions. Rev. ed. Amherst, N.Y.: Prometheus Books, 2008. A practical guide for elder care. Includes topics such as locating services, managing medications, understanding benefits, choosing a nursing home, coping with memory loss, hiring and handling in-home help, helping a parent who refuses help, and recognizing signs of elder abuse.
Beers, Mark H., and Robert Berkow, eds. The Merck Manual of Geriatrics. 3d ed. Whitehouse Station, N.J.: Merck Research Laboratories, 2000. Addresses the challenges of geriatric care. Provides diagnosis and treatment information specific to aging patients.
Birren, James E., and K. Warner Schaie, eds. Handbook of the Psychology of Aging. 6th ed. Boston: Academic Press/Elsevier, 2007. Twenty-four contributions from international researchers explore topics such as the genetics of behavioral aging, environmental influences on aging, gender roles, mental health, declining motor control, wisdom, and technological change and the older worker.
Centers for Disease Control and Prevention. Injury Center. http://www.cdc.gov/ncipc. This site includes a suggestion of fall precautions that can be implemented by the elderly population to help reduce the risk of fracture.
Coni, Nicholas, et al. Lecture Notes on Geriatrics. 6th ed. Malden,...
(The entire section is 670 words.)