Taking its title from the second 50 years of the human life span of about 100 years, this book presents wide-ranging and practical recommendations for health care providers, policymakers, and other sectors of society. These recommendations range from setting new national policies to changing the way elderly patients are interviewed in the doctor's office and from what exercises older persons should do to how city planners should design our urban environment.

The bulk of this volume presents the latest research on 13 major health threats to the elderly, covering prevalence, impact on the older person's life, cost, and intervention.

In addition, the authors provide a detailed analysis of why older people often do not receive the benefit of prevention programs.

Contents

• Acknowledgment
• Committee on Health Promotion and Disability Prevention for the Second Fifty
• Preface
• Summary
• 1. Introduction
• 2. Disability Classification
  • DISABILITY AND THE DISEASE MODEL
  • CLASSIFYING DISABILITIES
  • REFERENCES
• 3. High Blood Pressure
  • BURDEN
  • PATHOPHYSIOLOGY
  • UTILITY OF SCREENING
  • EVIDENCE THAT TREATMENT IS BENEFICIAL
  • NONPHARMACOLOGIC THERAPY
  • SUMMARY OF INTERVENTION DATA
  • COST-EFFECTIVENESS OF TREATMENT FOR HIGH BLOOD PRESSURE IN PERSONS OVER 50
  • SUMMARY
  • RECOMMENDATIONS
  • REFERENCES
• 4. Medications
  • BURDEN
  • PREVENTABILITY OF BURDEN
  • RECOMMENDATIONS
  • REFERENCES
• 5. Risk Factors for Infection in the Elderly
  • PNEUMOCOCCAL DISEASE
  • INFLUENZA
  • NOSOCOMIAL INFECTIONS
  • INFECTIONS IN LONG-TERM FACILITIES
  • OTHER INFECTIONS
  • RECOMMENDATIONS
  • REFERENCES
• 6. Osteoporosis
  • BURDEN OF OSTEOPOROSIS AND FRACTURES
  • DETERMINANTS OF FRACTURES
  • PREVENTABILITY OF OSTEOPOROSIS
  • RECOMMENDATIONS
  • APPENDIX SCREENING TESTS FOR OSTEOPOROSIS
  • SINGLE-PHOTON ABSORPTIOMETRY
  • DUAL-PHOTON ABSORPTIOMETRY
  • DUAL-ENERGY X-RAY ABSORPTIOMETRY
  • QUANTITATIVE COMPUTED TOMOGRAPHY
  • REFERENCES
• 7. Preventing Disability Related to Sensory Loss in the Older Adult
  • DEFINITION AND PREVALENCE
  • ETIOLOGIC BREAKDOWN
  • DISABILITIES ASSOCIATED WITH SENSORY LOSS
  • APPROACHES TO PREVENTION
  • RECOMMENDATIONS
  • REFERENCES
• 8. Oral Health Problems in the “Second Fifty”
  • BURDEN
  • BURDEN PREVENTABILITY
  • RECOMMENDATIONS
  • REFERENCES
• 9. Screening for Cancer
  • BURDEN
  • PREVENTABILITY OF BURDEN
  • DISCUSSION
  • RECOMMENDATIONS
  • REFERENCES
• 10. Nutrition
  • NUTRITION AND QUALITY OF LIFE
  • NUTRITION AND FUNCTION
  • FUNCTIONAL INDICES OF NUTRITIONAL STATUS
  • DIETARY INDICES
  • ANTHROPOMETRY
  • PROGNOSTIC INDICATORS OF MORBIDITY OR MORTALITY
  • NUTRITIONAL RISK SCREENING INDICES
  • NUTRITION IN A FUNCTIONAL PERSPECTIVE
  • BURDEN
  • PREVENTABILITY OF BURDEN
  • RECOMMENDATIONS
  • REFERENCES
• 11. Cigarette Smoking
  • PREVALENCE
  • BURDEN
  • EVIDENCE THAT SMOKING CESSATION IS BENEFICIAL
  • SMOKING CESSATION TECHNIQUES
  • PASSIVE SMOKING
  • RECOMMENDATIONS
  • REFERENCES
• 12. Depression
  • DEFINITION AND PREVALENCE
  • RISK FACTORS
  • REMEDIABILITY: OUTCOME OF TREATMENT
  • COSTS
  • SUICIDE
  • REIMBURSEMENT
  • RESEARCH AND THE FUTURE
  • RECOMMENDATIONS
  • REFERENCES
• 13. Physical Inactivity
  • BURDEN
  • PREVENTABILITY OF BURDEN: AVAILABILITY AND EFFECTIVENESS OF INTERVENTIONS
  • COST-EFFECTIVENESS OF INTERVENTIONS
  • RECOMMENDATIONS
  • REFERENCES
• 14. Social Isolation Among Older Individuals: The Relationship to Mortality and Morbidity
  • DEFINITION
  • BURDEN
  • PREVENTABILITY OF BURDEN
  • RECOMMENDATIONS
  • REFERENCES
• 15. Falls in Older Persons: Risk Factors and Prevention
  • THE HEALTH BURDEN OF FALLS AND FALL-RELATED INJURIES IN OLDER PERSONS
  • DETERMINANTS OF FALLS: RISK FACTORS AND CAUSES
  • PREVENTABILITY OF BURDEN
  • RECOMMENDATIONS
  • REFERENCES
• A Can Philosophy Cure What Ails the Medical Model?
• B Looking for Order: Health Promotion, Disability Prevention, and the Disability Classification System of the World Health Organization

This project was supported by funds from the National Institute on Aging, the National Institute for Dental Research, the Food and Drug Administration, the Alliance on Aging, the Charles A. Dana Foundation, and the Pew Charitable Trusts.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competencies and with regard for appropriate balance.

This report has been reviewed by a group other than the authors according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.

The Institute of Medicine was chartered in 1970 by the National Academy of Sciences to enlist distinguished members of the appropriate professions in the examination of policy matters pertaining to the health of the public. In this, the Institute acts under both the Academy's 1863 congressional charter responsibility to be an adviser to the federal government and its own initiative in identifying issues of medical care, research, and education.