Pathy's Principles and Practice of Geriatric Medicine 5/e

Pathy's Principles & Practice of Geriatric Medicine,5/e


As the population of older people continues to grow rapidly, both in the developed and the developing world, geriatric
medicine is an increasingly important topic for clinicians. In most countries, and especially in Europe, North America
and Japan, the impact of an expanding population, the result of a reduction of disease in early life, has had a
dramatic effect on the diseases of later life. This new edition of the comprehensive and renowned textbook Principles
and Practice of Geriatric Medicine has been renamed after the late Professor John Pathy, editor of the 1st and
subsequent editions. It has been extensively revised, includes several new chapters, and provides up-to-date, evidence-
based, and practical information about all the major medical problems of ageing citizens.


The three editors, from UK, USA and France, have ensured that updated chapters describe both European and US approaches
to geriatric medicine, as well as reflecting the changes in treatment options and medical conditions which have emerged
since publication of the 4th edition in 2006. The book addresses a global audience, and its section on world issues is
of special interest. Several generic issues, such as minorities/ethnicity, sepsis and the importance of the caregiver
are included in all chapters as core issues. The topic of acute stroke has been expanded, as have the sections on
dementia, cardiovascular disease and health, respiratory diseases and training.




This book is an essential reference work for all clinicians who deal with older people, particularly geriatric medical
specialists, gerontologists, researchers and general practitioners, as well as post graduates, nurses, care home staff,
trainees in health specialties and social workers.

Table of Contents
Part 1 Ageing: Biological, Social and Community Perspectives




1 A biological perspective of ageing, 13
H. James Armbrecht




2 The demography of ageing, 23
Kenneth G. Manton and John E. Morley




3 The physiology of ageing, 33
Rafi T. Kevorkian and John E. Morley




4 Psychological aspects of ageing, 43
Peggy A. Szwabo




5 Ageing of the brain, 49
Jean-Franc퇻is Demonet and Pierre Celsis




6 Epidemiology of ageing and disability, 55
Lenise A. Cummings-Vaughn




7 Social and community aspects of ageing, 67
John E. Morley and Nina Tumosa




8 The developmental origins of ageing, 81
Avan Aihie Sayer and Cyrus Cooper




9 Sexuality and ageing, 93
John E. Morley and Debbie T. Tolson




10 Physical fitness and exercise, 103
Maria A. Fiatarone Singh and John E. Morley




11 Health literacy and cultural sensitivity, 121
Nina Tumosa




Part 2 Medicine and Prescribing in Old Age




12 Preventive geriatrics, 135
Gerald M. Mahon, Joseph H. Flaherty and Suzanne M. Mahon




13 Polypharmacy, 145
Oscar A. Cepeda and John E. Morley




14 Patient safety, 153
Susannah Long and Charles Vincent




Section 1 Eating Disorders and Nutritional Health




15 Epidemiology of nutrition and ageing, 173
Wija A. van Staveren and Lisette C.P.G.M. de Groot




16 The anorexia of ageing, 185
Ian M. Chapman




17 Weight loss, 197
David R. Thomas




18 Dehydration, 209
David R. Thomas




19 Vitamins and minerals, 217
Seema Joshi and John E. Morley




20 Obesity, 237
Joan Khoo, Richard Y.T. Chen and Gary A. Wittert




Section 2 Gastro Disorders




21 Changes in gastrointestinal motor and sensory function associated with ageing, 249
Christopher K. Rayner and Michael Horowitz




22 Gastrointestinal bleeding, 265
Syed H. Tariq




23 Liver and gall bladder, 275
Margaret-Mary G. Wilson




24 Sphincter function, 289
Syed H. Tariq




25 Constipation, 303
Charlene M. Prather




26 Management of diarrhoea, 313
Lenise A. Cummings-Vaughn




27 Diseases of the pancreas, 321
John S. Morris and John E. Morley




Section 3 Haematological Disorders




28 Anaemia, 331
Anjali S. Kamat and David R. Thomas




29 Disorders of haemostasis, 343
Kingsley K. Hampton




30 Disseminated intravascular coagulation, 353
Kingsley K. Hampton




31 Anticoagulants, 357
Hamsaraj G.M. Shetty and Philip A. Routledge




32 Myelodysplasia, 363
Martha Wadleigh, David S. Rosenthal and Richard M. Stone




33 Management of myelodysplastic syndromes and acute leukaemia, 375
Heidi D. Klepin and Bayard L. Powell




Section 4 Cardiovascular Diseases and Health




34 Epidemiology of heart disease, 389
Ahmed H. Abdelhafiz




35 Cardiac ageing and systemic disorders, 405
David J. Stott and Terence J. Quinn




36 Arrhythmias, 413
Abhay Bajpai and A. John Camm




37 Ischaemic heart disease, 437
Wilbert S. Aronow




38 Lipid management, 449
Adie Viljoen and Anthony S. Wierzbicki




39 Hypotension, 461
Suraj Alakkassery




40 Hypertension, 471
Anthony S. Wierzbicki and Adie Viljoen




41 Heart failure, 483
Michael W. Rich




42 Cardiac surgery, 499
Ulrich O. von Oppell and Adam Szafranek




43 Peripheral arterial disease, 517
Leocadio Rodr?uez Manas, Marta Castro Rodr?uez and Cristina Alonso Bouzon




44 Venous thromboembolism, 529
Gordon D.O. Lowe




45 Cardiac rehabilitation, 535
Niccolo Marchionni, Francesco Fattirolli, Francesco Orso, Marco Baccini, Lucio A. Rinaldi and Giulio Masotti




Section 5 Respiratory Diseases




46 Epidemiology of respiratory infection, 551
Joseph M. Mylotte




47 Pneumonia, 555
Joel Belmin




48 Aspiration pneumonia, 565
Takashi Ohrui and Hiroyuki Arai




49 Interstitial lung disease and lung cancer, 573
Christopher Dyer




50 Chronic obstructive pulmonary disease and asthma, 579
Christopher Dyer




51 Pulmonary hypertension, 589
Dennis J. Shale




52 Pulmonary rehabilitation, 601
Peter Spiegler and Jonathan Ilowite




Section 6 CNS Disorders




53 Neurological signs of ageing, 609
Andrew J. Larner




54 Sleep apnoea and sleep disorders, 617
Paul Montgomery and Lindsay Dianne Shepard




55 Headache, 629
Stephen D. Silberstein and William B. Young




56 Normal pressure hydrocephalus, 643
Dennis S. Oh and Peter McL. Black




57 Acute stroke care and management of carotid artery stenosis, 655
David Doig and Martin M. Brown




58 Stroke and stroke rehabilitation, 675
Lalit Kalra




59 Communication disorders and dysphagia, 691
Pamela M. Enderby




60 Acute and chronic subdural haematoma, 701
Eric Schmidt and Emmanuel Moyse




61 Epilepsy, 711
Pamela M. Crawford




62 Syncope and non-epileptic attacks, 721
Richard C. Roberts




63 Parkinson's disease, 731
Joel Belmin




64 Non-parkinsonian movement disorders, 739
Katie Kompoliti and Cynthia L. Comella




65 Diabetic neuropathy, 751
Aaron I. Vinik and Elsa S. Strotmeyer




66 Disorders of the neuromuscular junction, 769
Sivakumar Sathasivam and Andrew J. Larner




67 Muscle disorders, 779
David Hilton-Jones




68 Motor neurone disease, 793
Hardev S. Pall




69 Control of chronic pain, 809
Robert D. Helme and Benny Katz




70 Multiple sclerosis, 823
Florian P. Thomas




Appendix Function assessment scales, i
John E. Morley




Index, xi




A colour plate section is to be found in Volume 2, between pages 1414 and 1415




Contents of Volume 2




About the Editors, xiii




List of Contributors, xv




Preface to the Fourth Edition, xxiii




Preface to the Fifth Edition, xxv




Foreword, xxvii




Section 7 Dementia and Cognitive Disorders




71 Delirium, 837
Joseph H. Flaherty




72 Memory clinics, 851
Antony Bayer




73 Alzheimer's disease, 865
James E. Galvin




74 Mild cognitive impairment, 881
Eric G. Tangalos and Ronald C. Petersen




75 Vascular dementia, 895
Marie-Laure Seux




76 Mental stimulation and dementia, 903
Joe Verghese




77 Exercise and dementia, 911
Yves Rolland




78 Drug development and Alzheimer뭩 disease, 923
Julien Delrieu, Antoine Piau and Bruno Vellas




79 Other dementias, 943
Wee Shiong Lim




80 Treatment of behavioural disorders, 961
Ladislav Volicer




81 Geriatric psychiatry, 977
Abhilash K. Desai and George T. Grossberg




82 Organization of services in geriatric psychiatry, 991
Susan Mary Benbow and David Jolley




83 Depression in later life: aetiology, epidemiology, assessment, diagnosis and treatment, 1001
Natalie Sachs-Ericsson and Dan G. Blazer




84 The older patient with Down syndrome, 1017
John E. Morley




Section 8 Special Senses




85 Disorders of the eye, 1025
Nina Tumosa




86 The ageing auditory system ?pathology and epidemiology of age-related hearing loss, 1033
Mathieu Marx and Olivier Deguine




87 Disorders of the vestibular system, 1047
Charlotte Agrup and Linda M. Luxon




88 Smell and taste, 1061
Richard L. Doty




Section 9 Bone and Joint Health




89 Paget's disease of bone, 1075
Horace M. Perry III




90 Management of osteoporosis; its consequences: a major threat to quality of life, 1083
Roger M. Francis




91 Gait, balance and falls, 1091
Dulce M. Cruz-Oliver




92 Foot problems, 1111
Arthur E. Helfand and Donald F. Jessett




93 Hip fracture and orthogeriatrics, 1131
Christine Lafont




94 Diseases of the joints, 1145
Terry L. Moore




Section 10 Endocrine and Metabolic Disorders




95 Endocrinology of ageing, 1155
John E. Morley and Kim J. Moon




96 Water and electrolyte balances in ageing, 1163
Stewart G. Albert




97 The pituitary gland, 1173
James F. Lamb and John E. Morley




98 Thyroid disorders, 1183
Ligia J. Dominguez, Mario Belvedere and Mario Barbagallo




99 Ovarian function and menopause, 1199
Nicola Pluchino, Tommaso Simoncini and Andrea R. Genazzani




100 Testicular function, 1211
Nazem Bassil




101 Diabetes mellitus, 1225
Alan J. Sinclair and Graydon S. Meneilly




102 New therapies for diabetes mellitus, 1241
George T. Griffing




Section 11 Urogenital Disorders




103 Gynaecology and the older patient, 1261
Radha Indusekhar, Fidelma O'Mahony and P.M Shaughn O'Brien




104 The ageing bladder, 1271
James M. Cummings and Kimberly C. Berni




105 Prostate diseases, 1281
Clement Gaudin, Nicolas Doumerc, Loic Mourey, Stephane Gerard and Laurent Balardy




106 Urinary incontinence, 1299
Ramzi R. Hajjar




107 Geriatric nephrology, 1309
Carlos G. Musso and Dimitrios G. Oreopoulos




Section 12 Cancer




108 Cancer and ageing, 1319
Tanya M. Wildes




109 Oncological emergencies, 1333
Chantal Bernard-Marty, Clement Gaudin, Stephane Gerard and Laurent Balardy




110 Breast cancer, 1345
Robert E. Mansel and Bedanta P. Baruah




111 Maintaining functional status, 1355
Miriam B. Rodin




Section 13 Functional Disorders and Rehabilitation




112 Multidimensional geriatric assessment, 1377
Laurence Z. Rubenstein and Andreas E. Stuck




113 Frailty, 1387
John E. Morley




114 Rehabilitation, 1395
Michael Watts and Paul Finucane




Section 14 Iatrogenic Infections




115 Tuberculosis, 1415
Shobita Rajagopalan and Thomas T. Yoshikawa




116 Valvular heart disease and infective endocarditis, 1425
Aneil Malhotra, Sam Dawkins and Bernard D. Prendergast




117 Infections of the central nervous system, 1447
Michael Blank and Allan R. Tunkel




Section 15 Special Issues




I Abuse and older people




118 Elder abuse: a UK perspective, 1467
Claudia Cooper and Gill Livingston




119 Good quality care: abuse, 1473
Jean-Pierre Aquino and Genevieve Ruault




120 Alcohol consumption and cognition, 1479
Luc Letenneur and Jean-Francois Dartigues




121 Drug misuse and the older person: a contradiction in terms?, 1483
Antoine Piau and Fatima Nourhashemi




122 The use and abuse of prescribed medicines, 1495
Abdi Sanati and Mohammed T. Abou-Saleh




II Emerging themes




123 Transportation, driving and older adults, 1503
Desmond O'Neill and David Carr




124 Smart homes, 1513
Roger Orpwood




III Dermatology




125 Skin disorders, 1525
Robert A. Norman and Jaffer Babaa




126 The prevention and management of pressure ulcers, 1531
David R. Thomas




IV Surgical themes




127 Perioperative and postoperative medical assessment, 1545
Milta Oyola Little




128 Anaesthesia, 1557
Suzanne Crowe




V Ageing themes and ethical issues




129 Health issues in the ageing female, 1569
Carolyn D. Philpot




130 Antiageing strategies, 1575
Ligia J. Dominguez and Mario Barbagallo




131 Ethics in geriatric medicine, 1589
Francois Blanchard




132 Participation of older people in clinical trials, 1595
Nicola Coley and Sandrine Andrieu




133 Restraints and immobility, 1607
Elizabeth A. Capezuti, Laura M. Wagner and Kathleen C. Reid




134 Centenarians, 1621
Thomas T. Perls




VI End-of-life care




135 End-of-life and palliative care, 1631
Rachelle E. Bernacki, Ryan Westhoff and Miguel A. Paniagua




136 End-of-life care: special issues, 1641
Victoria J. Wheatley and Ilora G. Finlay




Part 3 Global Healthcare Systems




137 Improving quality of care, 1653
Julie K. Gammack and Carolyn D. Philpot




138 Clinical audit of healthcare, 1673
Rhona Buckingham, Jonathan Potter and Adrian Wagg




139 Carers and the role of the family, 1687
Jo Moriarty




140 Nursing home care, 1697
David R. Thomas, Yves Rolland and John E. Morley




141 Geriatric occupational therapy: achieving quality in daily living, 1709
Karen F. Barney




142 Geriatric medicine education in Europe and the United States, 1719
Antonio Cherubini, Philippe Huber, Jean-Pierre Michel and Miguel A. Paniagua




143 Systems of healthcare: the United States, 1725
Julie K. Gammack




144 Systems of healthcare: Australia, 1735
Gideon A. Caplan




145 Systems of healthcare: the United Kingdom, 1741
Simon Conroy




146 Geriatric medicine in China, 1747
Leung-Wing Chu




147 Ageing in developing countries, 1761
Renato Maia Guimaraes




148 Geriatric medicine in the European Union: towards unification of diversity, 1765
Alfonso J. Cruz-Jentoft




Appendix Function assessment scales, i
John E. Morley




Index, xi