1st ed. 2019 Edition
by Nages Nagaratnam (Editor), Kujan Nagaratnam (Editor), Gary Cheuk (Editor)
As the Baby Boomers age, concerns
over healthcare systems' abilities to accommodate geriatric patients
grow increasingly challenging. This is especially true with the
population deemed to be “the oldest of the old,” specifically those over
the age of 85. Unlike any other time in history, this demographic is
the fastest growing segment of most developed countries. In the United
States the oldest old is projected to double from 4.3 million to 9.6
million by 2030.
The increased life expectancy of the
population since the early 1900s has been built on the improvement of
living conditions, diet, public health and advancement in medical care.
With this we have seen a steady decline in the age-specific prevalence
of vascular and heart diseases, stroke and even dementia. Older persons
are healthier today than their counterparts decades ago. More
importantly than in any other age group, the care of the oldest old must
be individualized; management decisions should be made taking into
consideration the older persons’ expressed wishes, quality of life,
function and mental capacity.
The inevitable consequence is that
there will be an increase in the prevalence of older persons with
chronic diseases, multiple co-existing pathologies and
neuro-degenerative diseases. The oldest of the aging population are
often excluded from drug trials and their treatments are largely based
on findings extrapolated from that of the younger old. Furthermore,
among the oldest old, physiologically they are more diverse than other
segments of the population. Their demographic characteristics are
unparalleled and different compared to that of the younger old.
Several studies have drawn attention to the differing attitudes
among health professionals towards elderly people and many show
prejudice because they are old. As a result, the use of age as a
criteria in determining the appropriateness of treatment is of very
limited validity, yet there are limited resources that guide physicians
through these challenges.
This book creates a greater awareness
of these challenges and offers practical guidelines for working within
the infrastructures vital to this demographic. This book is designed for
geriatricians, primary care physicians, junior medical officers,
specialty geriatrics nurses, and gerontologists. It is divided into 3
sections: General Considerations, Chronic diseases and Geriatric
Syndromes. Each chapter provides a summary of important and essential
information under the heading of Key Points. Case studies are included
in some of the chapters to highlight the principles of management.
