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Pages 321-332

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From page 321...
... See Depression Age. See also Elderly and bone loss, 83, 89-91, 94 and calcium absorption, 90 and cancer screening, 148 and cardiovascular risk, 174 and drug effects, 59, 60 and falling, 82, 84, 264, 266, 275 and fractures, 78, 79 and high blood pressure, 34-35, 38, 40, 42 and infections, 65 and muscle impairment, 229 and nutrition requirements, 161 and oral diseases, 120, 121, 124 and physical inactivity, 225, 226, 228, 229 and renal and hepatic function, 54 321 and risk of cancer, 121, 137 and sensory loss, 101 Aging, attitudes toward, 210-21 1 Aging Population in the Twenty-first Century: Statistics for Health Policy, 26 Alameda County Study, 13-14, 228, 249-250 Alcohol use, 172 and bone loss, 92-93 offset effect and, 213 and oral diseases, 121, 127, 131 and osteoporosis, 95 and risk of cancer, 171 Alphamethyldopa, 39, 43 Alzheimer's disease, 109, 126, 216, 246 Amantadine, 68, 69, 71 American Arthritis Foundation, 180 American Association of Retired Persons, 180 American Cancer Society, 180 American College of Physicians, 67 American College of Sports Medicine, 232 Amputation, 177, 183 Angina, 250 Anthropometry, 162 Antibiotics, 66-67, 71 Anticonvulsant use, 91 Anticoronary Club of New York, 178
From page 322...
... 322 Antidepressant medication, 129, 206, 208-209, 210, 219 Antihypertensive medication adverse effects of, 42-44, 206 benefits of, 38-40 and risk of falls, 272, 281 Arrhythmias, 208 Arthritis, 36 drug treatment of, 56-57 and hearing impairment, 107 and risk of falls, 271, 272 Asians bone mass, 85 fracture risk, 94 Aspirin, 57 Atherosclerosis, 168, 176, 184 Australian Trial on Mild Hypertension, 38, 39, 40 B Baby boom cohort, 11 Bacteremia, 65, 66, 69, 71 Balance and gait training, 276 Bantu people, fracture rates, 85 Baroreceptor reflex, 42 Barthel Index, 164 Beck Depression Inventory, 217 Behavioral changes, and prevention of falls, 277-278 Behavioral Risk Factor Surveillance System, 225 Benfluorothiazide, 39 Benzodiazepines, 54 and cognitive function, 59 and risk of falls, 272 Bereavement, 210, 217-218, 254 Beta blockers, 39, 42, 59 Bioethicists, 31 Blacks bone mass, 85 cancer screening and, 149 fracture risk, 94 glaucoma and, 104 high blood pressure in, 34, 35, 36, 47 physical inactivity, 227, 228 sodium sensitivity, 44 Blindness causes of, 104, 105, 177 prevalence of, 102 prevention of, 111 Bone loss, 76 age-related, 89-91, 94 hypogonadal, 86-89 INDEX risk factors for, 85, 91-93 therapies, 89, 94, 280 Bone mass, 85 and fractures, 82-84, 92-93, 274 measurement, 86-88, 95-97 screening tests, 93 therapies, 89, 91, 275 Bone pain, cancer, 140 Boorse, Christopher, 302 Breast cancer estrogen therapy and, 89 impairment, 140 prevalence, 139 screening, 136, 141-143, 147, 148, 149, 150 British Medical Research Council, 45 Bronchitis, 66 Butler, Robert, 113 C Caffeine, 171 Calcitonin, 89 Calcium, and bone loss, 89, 90, 94, 171 Canadian Task Force on the Periodic Health Examination, 16 Cancer breast, 89, 139, 141-143 diet and, 158, 168 estrogen and, 89 impairment, 140 incidence and mortality, 137-140 lung, 194, 198 oral, 119, 121, 127, 130 risks for, 78, 231 screening, 130, 136-137, 141-151 smoking and, 171, 193, 194-195, 196 surgery, 163 therapy, 126, 136 Carbohydrates, 170-171 Cardiovascular disease, 46, 172 cholesterol and, 57 diet and, 173 estrogen and, 58, 89 morbidity and mortality, 35, 38-42, 45-46 physical activity and, 179 risk factors, 33, 166, 174, 176, 177 smoking and, 195, 196 Cardiovascular system, oxygen delivery, 229 Caries, 120, 121-122, 124 prevention of, 128 radiation, 126 research on, 131
From page 323...
... INDEX Carter Center Health Policy Project, 14 Case-control studies, 137 Cataracts, 103-104, 111, 112, 218, 272 Catastrophic Health Care Program, 292-293 Centers for Disease Control, 14, 67, 224, 225 Cerebral perfusion, 42-43 Cerebrovascular disease, 41, 172 morbidity and mortality, 38, 38, 45-46 Cervical cancer screening, 144-145, 147, 148 Chewing disorders, 119 Children health care policy and, 296 social supports and, 253 Chlorothiazide, 39 Chlorthalidone, 39 Cholesterol levels, 35, 43 reduction, 57, 173, 174-176, 185 screening, 173-174 Chronic illness prevention, 12, 25 Chronic obstructive lung disease, 91, 193, 194 Cognitive-behavioral therapies, 210 Cognitive impairment, 184 diabetes and, 177 diet and, 158 medications and, 44, 59 and risk of falls, 272, 281 sensory loss and, 107, 109, 112 Colon and rectal cancer, 139-140, 145, 150-151, 230-231 Community intervention, exercise programs, 235 Comprehensive Assessment and Referral Evaluation, 108 Connective tissue diseases, 123 Cooper, A F., 108 Coronary Artery Surgery Study, 195196 Coronary heart disease cholesterol and, 174-175 diet and, 158, 166 exercise and, 231, 232 high blood pressure treatment and, 41 morbidity and mortality, 36 risk factors, 14, 248 smoking and, 193, 194, 195 social supports and, 250 Corticosteroid use, 91 Cost-effectiveness dietary cholesterol reduction, 175 estrogen therapy, 88 323 exercise programs, 236-237 high blood pressure treatment, 45 Costs bone mass measurement, 96, 97 dental services, 126-127 depression, 210, 21 1-213 drug-induced disability, 55-56, 59-60 falls, 268-269, 282 health care, 11-12, 36, 182, 211, 235, 291-294, 296, 297 infections, 66, 67, 68 nutrition-related diseases, 166 osteoporosis, 76, 81-82 social isolation, 246-247 Council on Health Fraud, 180 Cushing's disease, 91 D Deafness, 109 Decubitus ulcers, 70 Dementia, 36, 109 Dentures, 124-125, 164 Depression, 42, 80 age and, 59 costs of, 21 1-213 definition and prevalence, 202-204 and nutritional status, 168 recommendations, 21 7-219 risk factors for, 205-206 and risk of falls, 272 sensory loss and, 107, 108, 109, 112 and suicide, 213-215 treatment of, 206-211, 215-217 Descartes, Rene, 315-317 Diabetes mellitus, 92 and exercise, 232 nutrition and, 168, 177-178, 184 Diabetic nephropathy, 176 Diabetic retinopathy, 103-104, 105, 177 Diabetics, 115 glaucoma and, 104 oral infection and, 126 physical limitations, 231 Dialysis, 176, 293 Diastolic blood pressure, 33, 34, 35, 38, 45-46 treatment of, 40, 42, 44-45, 46-47 Diet, 159, 193 calcium in, 90 cholesterol reduction, 174, 175 and drug metabolism, 179 and nutritional status, 161-162 and oral health, 126 vitamin D in, 90-91
From page 324...
... 324 Dietary status, 157, 160-161 Dietary therapies, 172, 176 Digestive system, 164 Disability cancer, 140 classification of, 22-31, 316, 318 drug-induced, 55-56, 58, 59 falls, 268 fracture-related, 94 nutrition and, 165-166, 170-171 oral, 120 osteoporosis, 78-81 prevention of, 15-16, 53 sensory loss, 107-111, 112, 114 Disease classification of, 24, 28, 316 consequences of, 314-317, 318 definition of, 300-305, 316 prevention, 15 social isolation and, 248-249, 250251, 252-253 Disease model of care, 23-25, 26, 28, 303, 306-308 Disuse atrophy, 179, 225 Diuretics, 41, 42, 44 and risk of falls, 272, 281 Driving, 110 Dual-energy x-ray absorptiometry, 8688, 96-97 Dual-photon absorptiometry, 86-88, 95, 96 Duke Longitudinal Study, 196 Dysgeusia, 179 Dysphoria, 218 E Ecologic studies, 137 Education cancer screening, 151 depression, 219 exercise programs, 239 falls, 282-283 infections, 72 medication use, 60-62 nutritional, 185 oral health, 131-132 osteoporosis, 94-95 social isolation, 258-259 Efficacy, cancer screening, 141-150 Elderly anthropometry and, 162 and cancer screening, 148, 149-150 chewing disorders, 119 cholesterol and, 173, 175 demographics, 11, 82, 295-296 INDEX depression in, 202, 203-204, 207, 218 falls, 263, 264-265, 274, 275 health care costs and, 211, 291-292 health care rationing and, 292, 294298 health care utilization, 22, 256, 314 health promotion and disability prevention, 12-17, 23, 308 high blood pressure in, 33-34, 35, 36, 37, 40, 42-43, 44 infections and, 65-66, 67-68, 71 medication use, 53-55, 56-59, 60, 61, 172, 178, 179, 276 nutritional assistance, 169, 174, 181-184 nutrition fraud and, 167, 180 physical inactivity, 224, 231, 232233, 238 and sensory loss, 114 smoking rate, 194 social isolation, 246, 254, 256, 257, 259 suicide risk, 214-215 vitamin D deficiency in, 90-91 Electroconvulsive therapy, 209-210, 219 Electrolyte disturbance, 208 Emotional state, 27, 44 End Stage Renal Disease Program, 293294 Environmental factors, in falls, 274, 277, 280 Estrogen, and breast cancer, 143 Estrogen replacement therapy {ERT) , 58, 86, 88-89, 94, 171, 185 Etiology, 28 caries, 122 hearing impairments, 105-107 visual impairments, 103-105 European Working Party on Hypertension in the Elderly, 38, 39, 43, 45 Evolution, 302 Exercise, 44, 224, 231, 232-235 cost-effectiveness of, 236-237 and prevention of falls, 275-276, 280, 284 recommendations, 237-240 F Falls, 263-264 costs of, 268-269 determinants of, 269-275 and fractures, 42, 82, 84-85, 265267, 268, 274-275 frequency of, 267-268
From page 325...
... See also Physicians and disability classification, 22, 23, 27, 31 and exercise programs, 239 and medications, 60-61 and oral health, 130 and sensory loss, 114-115 and social supports, 258 Health promotion and disability prevention, 12, 13, 14, 15, 17, 25, 57,308,311,313,314 Healthy People {USDHEW) , 183 Hearing aids, 112 Hearing Handicap Inventory for the Elderly, 112 Hearing impairments, 101, 102-103 disabilities, 107-110, 112 etiology, 105-107 prevention, 111-112, 115 Hepatic function, age and, 54
From page 326...
... See also Disability cancer, 140 drug-induced, 59 nutritional, 165-166 oral, 120, 121-126 physical inactivity, 228-231 social isolation, 247-251 visual and hearing, 101-107 Incontinence, 58, 272 Infections, 65-66, 123-124 influenza, 67-69 nosocomial, 69-70 pneumococcal disease, 66-67 recommendations, 71-72 Influenza, 65, 67-69, 70 Injuries, from falls, 265-267, 274-275 Injury in America, 77-78, 93, 282 Institute of Medicine, 14, 77-78, 172, 282 Division of Health Promotion and Disease Prevention, 16 Committee on Health Promotion and Disability Prevention for the Second Fifty, 12-13, 30 Instrumental Activities of Daily Living, 26, 110, 160 Insurance private, 47, 215-216, 291 social, 25, 26 INSURE project, 16 International Classification of Diseases, 28, 282 International Classification of Impairments' Disabilities, and Handicaps, 22, 27-31, 228, 230, 247, 249, 311, 313, 314-317 Intraocular pressure, 104, 111 Ischemic heart disease, 38 Isoniazid prophylaxis, 70, 71 Johns Hopkins Hearing and Speech Clinic, 108-109 Johnson and Johnson Live for Life project, 235 K Katz index, 164 Kenney system, 164 Koop, C Everett, 295 Kuhn, Thomas, 317-318
From page 327...
... INDEX L Leukoplakia, 121 Life expectancy, 11 cancer screening and, 149 cholesterol reduction and, 175 estrogen therapy and, 88 high blood pressure and, 172 indices of, 164 men, 11 nutrition and, 158 physical activity and, 231, 233 smoking and, 194, 195, 196 women, 11, 148 Lipid-lowering therapy, 57 Lipophilic medications, 54 Lithium, 54 Longitudinal studies, 13-14, 113, 238 Long-term care facilities admissions, ambulation and fractures, 80 costs, 81, 82, 215 and depression, 204 falls in, 268, 269 infections in, 65, 69, 70, 71 medications in, 60, 61-62, 276 mental health screening, 216 nutrition in, 158-159, 182, 183, 184 quality of life in, 307 Lung cancer, 140 screening for, 146, 151 smoking and, 136, 194, 198 M Macular degeneration, 103-105, 111, 115 Malnutrition, 157-158, 171, 299 diseases and, 165-166, 167, 168-169 health effects of, 183-184 long-term care facilities and, 183 Mammography, 136, 143, 147, 149, 150 Marital status, 250 Massachusetts Health Care Panel Study, 110 Meals on Wheels, 181-182, 184 Medicaid, 11, 59-60, 215, 295 Medicare, 11-12, 15-16, 17, 295, 314 blood pressure screening reimbursement, 47 Catastrophic Health Care Program, 292-293 End Stage Renal Disease Program, 293-294 and nutritional assessments, 184 psychiatric care coverage, 215, 217 vaccination reimbursement, 67, 68, 72 327 Medications, 53-55, 172 adverse reactions, 55, 58-59, 60, 62 antidepressant, 129, 206, 208-209, 210, 219 antihypertensive, 38-40, 42-44, 206, 272, 281 disability effects, 56-62 and nutrition, 164-165, 178 and oral health, 125-126 osteoporosis, 82 over-the-counter, 59 prescribing practices, 54, 56, 59-60, 61, 89, 277 and risk of falls, 272, 276-277, 280, 281, 284 and sensory impairment, 115 side effects, 42, 43, 53, 61, 119, 123124, 179, 208-209 toxicity, 42, 43, 57, 208 Melanoma, 145-146 Men, 254 bone loss, 85, 86, 91-92 calcium RDA, 90 cholesterol reduction, 174, 175 fractures, 77, 78, 86 hearing impairments, 102 high blood pressure, 35 life expectancy, 11 oral cancer and, 121 risk of falls, 264, 266-267 social isolation, 250 suicide prevention, 215 Meningitis, 66 Menopause and bone loss, 83, 86, 93 and breast cancer, 143 and cholesterol levels, 174 Mental health services, 211, 314 Mercury sphygmomanometer blood pressure measurement, 37 Meta-analysis, 42 Mind/body paradox, 249, 315 Mini-Mental State Examination, 217 Minorities, 211, 233. See also Blacks; Hispanics Monoamine oxidase inhibitors, 209 Morbidity and mortality cancer, 121, 136-140, 141-143, 144, 146, 147, 151 cardiovascular, blood pressure and, 35, 36, 45-46 cardiovascular, treatment and, 3842, 56 cholesterol levels and, 174-175 depression therapy and, 210
From page 328...
... See Long-term care facilities Nutritional Programs for Older Adults, 182 Nutritional quackery and fraud, 166167, 179-180, 184 Nutritional Risk Index, 164-165 Nutritional status, 157-158 dietary indices of, 161-162 food programs and, 181-184 functional indices of, 159-161 oral health and, 180-181 prognostic indicators, 162-164 and quality of life, 158-159 recommendations, 184-185 relation to diseases, 166-178 risk screening, 164-165 o Office of Technology Assessment, 104, 111 Offset effects, 212-213 Omnibus Budget Reconciliation Act (1987) , 216 On Lok project, 16 Oophorectomy, 86 Oral cancer, 121, 126 prevention of, 127, 130 screening, 146 Oral health problems, 119-126 nutrition and, 168, 170-171, 180-181 prevention of, 126-130 recommendations, 130-132 Organ and tissue transplantation, 294 Orofacialpain, 119, 126, 128-129 Osteoarthritis, 56-57, 169 Osteoblasts, 89-90, 93 Osteoporosis, 28, 30, 58, 76 costs of, 81-82, 268 determinants of fractures, 82-85, 263, 265 disability, 78-81 morbidity and mortality, 77-78 nutrition and, 169, 171, 184 physical activity and, 179 preventability of, 85-93 recommendations, 93-95 screening tests, 88, 95-97 secondary, 83, 91-93 smoking and, 196 Otitis media, 107
From page 329...
... , 58, 88-89 Quality of life, 17, 26, 147, 305-306, 307 depression and, 202-203 fractures and, 80 hypertension therapy and, 43-44 infections and, 65 medications and, 53, 58 nutrition and, 158-159, 182 oral health and, 131 sensory loss and, 110-111 Quantitative computed tomography, 86-88, 95, 97
From page 330...
... 330 R Race and bone mass, 85 and fractures, 78 and hearing loss, 103 high blood pressure and, 34, 38 and vision loss, 104 Radiation caries, 126 RAND Corporation, 211-212 Randomized controlled trials, 59, 114, 276, 280 high blood pressure treatment, 39, 40-41, 42, 46 Reagan, Ronald, 292 Receptors, age and, 54-55 Recommendations cancer screening, 150-151 depression, 21 7-219 falls, 280-284 high blood pressure treatment, 4647 infections, 67, 68-69, 70, 71-72 medications, 60-62 nutrition, 184-185 oral health, 130-132 osteoporosis, 93-95 physical inactivity, 237-240 sensory loss, 113-115 smoking, 198-199 social isolation, 256-259 Recommended daily allowances, 90 Recommended Dietary Allowances, 161-162 Rectal cancer, 139-140, 145, 150-151 Rehabilitative therapies, 276 Reimbursement, 59-60 blood pressure screening, 47 psychiatric care, 215-216, 217 vaccination, 67, 68, 72 Relaxation therapy, 44 Renal function, 42, 54 End Stage Renal Disease Program, 293-294 nutrition and, 168, 176 Renin levels, 36 Research, 12, 13-15, 17, 18 cancer screening, 150-151 depression, 216-217, 218-219 drug effects, 58 exercise, 233-235, 238 falls, 272, 280-282, 284 high blood pressure, 47 infections, 72 medications, 60 INDEX nutrition, 184 oral health, 130-131 osteoporosis, 93-94 sensory loss, 113-114 smoking, 199 social support, 257-258 Reserpine, 39 Respiratory infections, 65 Retirement communities, 256 Rimantadine, 69 Risk factors, 13-15, 16, 17-18 blood pressure, 45-46 for bone loss, 85 for cancer, 127, 137 cardiovascular, 35-36, 166, 173 for caries, 122 for depression, 205-206 for falls, 84, 263, 269-274, 278-279, 281 for fractures, 82, 84, 89 infections, 65-66, 67, 69, 71 nutrition and, 167, 173 for osteoporosis, 91-93, 94 social isolation, 243, 248-249, 252, 256, 257 S Salivary gland dysfunction, 120, 123124, 125-126 Salmonella, 65, 70 decreeing blood pressure' 36-37 bone mass, 93 cancer, 136-137, 141-151 cholesterol, 173-174 glaucoma, 115 hearing impairment, 111-112 mental health, 216 nutritional, 164-165, 184 oral cancer, 127, 130 osteoporosis, 88, 95-97 triglyceride, 176 visual impairments, 111 Secondary osteoporosis, 83, 91-93 Secondary prevention, 111, 136 Select Committee on Aging, 179-180 Self-reports, 26 Seneca, Lucius Annaeus, 11 Sensory loss disabilities, 107-111 etiology, 103-107 and falls, 280 prevalence, 101-103 prevention of, 111-113 recommendations, 113-1 15
From page 331...
... See also Medications adverse drug reactions, 55, 58-59, 60, 62 antibiotic, 66-67 bone loss, 94 cancer, 126, 136 depression, 202, 206-211, 215-216, 217, 219 high blood pressure, 35, 37-45, 4647, 172 influenza, 68 nutritional, 160 nonpharmacological, 44, 47, 172, 184 vision loss, 105
From page 332...
... 332 Triamterene, 39, 43 Tricyclic antidepressants, 208-209, 210 Triglyceride screening, 176 Tuberculosis, 23, 65, 71 U Ultrasound screening, 151 United States cancer prevalence, 139 falls, deaths and injuries, 264, 265266 dental care costs, 126-127 Department of Health, Education, and Welfare, 193 elderly population, 11, 82, 295-296 health care costs, 291-298, 305, 306 oral cancer deaths, 121 osteoporosis fractures, 76 smoking prevalence, 194 social insurance programs, 25, 26 suicides in, 213 United States Congress, 16, 216, 292 United States Postal Service, 180 United States Preventive Services Task Force, 14-15, 16, 93-94 United States Public Health Service, 14, 132, 224, 247 University of Minnesota, 307 Urinary tract infections, 65, 69 V Vaccines influenza, 68-69, 70, 71, 72 pneumococcal polysaccharide, 6667, 70, 71 Vancomycin treatment, 70n Vascular disease, 107, 177 Vascular resistance, 36 Ventricular hypertrophy, 35-36 Vertebral Spine) fractures, 77, 78, 81, 83-84, 86, 89, 92-93 Veterans Administration, 38, 39, 40, 215 Vision impairments, 101-102 disabilities, 107-108, 109-110 etiology, 103-105, 107 prevention, 111, 115 and risk of falls, 271 Vitamin A, 162 INDEX Vitamin D, 95, 171 alcohol use and, 93 and bone loss, 89, 90-91 Vitamin deficiencies, 89, 90-91, 170, 185 W Weight age and, 54 reduction, 44, 168, 170, 172, 177, 178 Wellbutrin, 209 Whites bone mass, 85 and falling, 264 fracture risk, 94 high blood pressure, 34, 35 Women bone loss, 83, 85, 86, 91-92 calcium RDA, 90 and cancer screening, 143, 144-145 cholesterol levels, 173, 174, 175 fractures, 77, 78, 88-89 hearing impairments, 102 high blood pressure, 35 life expectancy, 11 nutritional status, 181 oral health, 121, 123 osteoporosis, 58, 81-82, 95 physical inactivity, 225, 226, 233 risk of falling, 84, 264, 266 smoking rates, 194, 197 social supports and, 253 Workshop on Health Promotion and Aging, 283-284 Worksite, exercise promotion, 235 World Health Organization, 249, 299 International Classification of Diseases, 28, 282 International Classification of Impairments, Disabilities, and Handicaps, 22, 27-31, 228, 230, 247, 249, 311, 313, 314-317 Wrist {CollesJ fractures, 77, 78, 81, 8384, 86, 265-266 X Xerostomia Dry mouth)


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