Public Health and Aging: Maximizing Function and Well-Being, Second Edition

Contents......Page 8
Preface......Page 14
1 Introducing Public Health and Aging......Page 20
Essential Services of Public Health......Page 21
Chronological vs. Biological Aging......Page 24
Senescence vs. Disease......Page 25
Aging and “Social Age”......Page 27
Five Faces of Aging......Page 33
The Robust Elder......Page 34
The Frail Elder......Page 35
The Elder With Dementia......Page 36
The Dying Elder......Page 37
The Compensating, Adaptive Elder......Page 38
Healthy vs. Successful vs. Optimal Aging......Page 40
How the First 50 Years Matter for Health Risks in the Second 50 Years: Three Illustrations......Page 43
Entry Into Late Life With Lower Cognitive Reserve......Page 45
Entry Into Late Life With Differences in Physical Reserve......Page 47
Early and Midlife Influences on Late-Life Disability Trends......Page 49
The Domains of Public Health and Healthy Aging......Page 51
Population Aging and the Goals of Public Health: Beyond Disease Prevention and Health Promotion......Page 53
Summary......Page 57
2 Population Aging: Demographic and Epidemiologic Perspectives......Page 60
Measures of Population Aging......Page 61
The Demographic Transition......Page 68
The Demographic Transition and Declining Death Rates......Page 69
The Demographic Transition and Increasing Life Expectancy......Page 73
The Epidemiologic Transition and Shifting Causes of Death......Page 81
Why Population Aging Matters......Page 82
Shifting Health Care Needs of the Population......Page 83
Emergence of the Oldest Old in America......Page 85
Summary......Page 86
3 The Aging and Public Health Systems: Building a Healthy Aging Network......Page 88
Parallel “Health Care Workforces” for the Aged......Page 89
Attempts to Bridge the Parallel Systems of Elder Health Service Delivery......Page 92
The Challenges of Bridging the Aging Services and Health Department Networks: A Case Study......Page 96
Efforts to Develop Healthy Aging Networks......Page 100
The Challenges of Standardizing Measurement in Healthy Aging Interventions: A Case Study......Page 103
Promoting Healthy Aging: Alternative Community-Based Approaches......Page 107
Estimating Aging Services Network Challenges in the Community......Page 114
Summary......Page 121
4 Chronic Disease in Older Adults......Page 124
Prevalence......Page 125
Incidence......Page 126
Comparing Prevalent, Debilitating, and High-Mortality Conditions......Page 129
Comorbidity, Multimorbidity, and Self-Care......Page 131
The State of Health Promotion and Chronic Disease Prevention for Older Adults......Page 133
The U.S. Preventive Services Task Force......Page 134
Older Adults and the Influenza Vaccine......Page 142
Criteria for a Public Health Program......Page 144
Medicare’s Basic Benefit Structure......Page 145
Growing Emphasis on Prevention......Page 148
Medicare’s Fiscal Health and Disability and Disease Prevention......Page 150
Promoting Chronic Disease Management in Later Life......Page 152
Geriatric Evaluation and Management......Page 154
Making Patients and Families Partners in Medical Care......Page 158
Avoiding Inappropriate Medication Use and Managing Polypharmacy......Page 161
Summary......Page 163
5 Disability and Functioning......Page 166
The Language of Disability......Page 167
The International Classification of Functioning, Disability and Health (ICF)......Page 168
The Nagi Model of Disablement......Page 171
Centrality of the Activities of Daily Living in Measuring Late-Life Disability......Page 174
Difficulties in Measuring Activity Limitations Among Older Adults......Page 178
Measuring Capacity: Performance-Based Tests......Page 181
Measuring the Environment......Page 183
Trends in Prevalence......Page 184
Trends in Active Life Expectancy......Page 186
Disparities in Trends and Causes......Page 187
The Epidemiology of Disability: Risk Factors for Functional Decline......Page 189
A Clinical Perspective: Identifying Disablement Pathways......Page 192
The Link Between Capacity and Performance......Page 193
The Role of Accommodations......Page 196
Preventing Falls......Page 200
Comparing Potentially High-Impact Interventions......Page 203
Summary......Page 205
6 Cognitive Function: Dementia......Page 208
What Is Dementia?......Page 210
Making and Receiving the Diagnosis of Alzheimer’s Disease......Page 212
Cognitive Decline With Age: Distinct From Alzheimer’s Disease?......Page 218
Cognitive Decline Prior to Frank Dementia......Page 221
Insight on Declining Cognitive Ability......Page 223
Mild Cognitive Impairment and Disability......Page 224
Prevalence and Incidence of Alzheimer’s Disease......Page 226
Genetic Risk Factors......Page 230
Socioeconomic Factors: Education, Lifelong Occupation, Cognitive Reserve......Page 231
Medical Morbidity: Hypertension and Vascular Disease, Diabetes, Bone Mineral Density Loss, Estrogen Deficiency, Depression......Page 232
Mortality......Page 236
Nursing Home Care......Page 239
Hospitalization and Primary Care......Page 240
Disability and Psychiatric Morbidity......Page 241
Family Caregiving......Page 243
Quality of Life in AD......Page 247
Dementia and the End of Life......Page 249
Non-Alzheimer’s Dementias......Page 250
Interventions to Prevent Cognitive Decline......Page 251
Interventions to Support Family Caregivers......Page 252
Summary......Page 255
7 Affective and Social Function: Suffering, Neglect, Isolation......Page 260
Burden of Mental Illness......Page 261
Presentation of Mental Health Symptoms in Late Life......Page 264
Prevalence of Mental Illness at Older Ages......Page 267
Mental Health in a Disabled Older Population......Page 270
Outcomes Associated With Mental Illness in Late Life......Page 272
Treatment of Depression in Late Life......Page 274
Reducing the Risk of Depression and Associated Morbidity in Seniors......Page 275
Neglect and Abuse......Page 277
Social Isolation......Page 279
Broader Considerations of Environmental Influences on Health......Page 280
Summary......Page 285
8 Aging, Public Health, and Application of the Quality-of-Life Paradigm......Page 288
Identification of QOL Domains......Page 289
Clinical Significance of QOL Measures......Page 295
The Quality-of-Life Paradigm in Aging......Page 297
Generalization of the Quality-Adjustment Paradigm......Page 305
Health-Related and Environment-Related QOL in Old Age......Page 308
Summary......Page 309
9 Aging, Public Health, and Long-Term Care......Page 312
What Is Long-Term Care?......Page 313
Overview: Trends in Long-Term Care Use and Spending......Page 314
Home- and Community-Based Services......Page 316
Personal Assistance Services and Public Health......Page 318
Family Caregiving......Page 322
Long-Term Residential Care Arrangements......Page 325
Enhancing Long-Term Care......Page 328
Recognizing and Taking Older People’s Care Preferences Seriously......Page 330
Upgrading Home Attendant and Nursing Assistant Care......Page 332
Special Care Units for People With Alzheimer’s Disease......Page 337
Expansion of Options for Supportive Care and Housing......Page 338
Summary......Page 340
10 Mortality and End-of-Life Care......Page 342
Causes of Death......Page 343
Mortality Trends by Age and Sex......Page 346
Crude Versus Age-Adjusted Trends......Page 348
Trends in Causes of Death at Older Ages......Page 349
Flow and Location of Older People Before Death......Page 353
Disparities in Mortality Risk......Page 355
The High Costs of Dying......Page 360
Quality of Life Near the End of Life......Page 363
End-of-Life Goals......Page 364
The End-of-Life System: Hospice......Page 365
Aligning Goals With End-of-Life Trajectories......Page 366
Terminal Drop......Page 368
Summary......Page 369
11 Ethical Issues in Public Health and Aging......Page 372
Age as a Criterion to Ration Medical Care......Page 374
Other Conceptions of the Life Course and the Ethics of Care at the End of Life......Page 378
Minimize Suffering or Maximize Care?......Page 380
Rethinking Autonomy......Page 382
Beyond Spare-Parts Medicine......Page 385
Summary......Page 388
References......Page 390
Index......Page 430
A......Page 432
C......Page 434
D......Page 436
F......Page 437
G......Page 438
I......Page 439
L......Page 440
M......Page 441
O......Page 442
P......Page 443
R......Page 444
T......Page 445
Y......Page 446