Geriatric Medicine: An Evidence-Based Approach / Edition 4

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This new edition of a critically-acclaimed text, completely revised and updated, offers practical and comprehensive coverage of the diseases, common problems, and medical care of older persons. Building on the third edition, this revision will present a new approach focusing on Evidence-Based Medicine, with new chapters including: Physiology of Aging, Clinical Strategies of Prescribing for Older Adults, Chronic Disease Management, Prevention, Doctor-Patient Communication Issues, Sources of Suffering in the Elderly, and many others. In addition, there will be a separate chapter on Evidence-Based Geriatrics, as well as sidebars in every chapter, where applicable, on Evidence-Based Medicine. This will be an all-encompassing, authoritative volume on geriatric medicine, needed more than ever because the over-80 population is the fastest growing age group in the country.

The book contains predominantly black-and-white illustrations, with some color illustrations.

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Editorial Reviews

Doody's Review Service
Reviewer: David O. Staats, MD (University of Oklahoma Health Sciences Center)
Description: This is a multiauthored textbook of geriatric medicine. Now in its fourth edition, it emphasizes an evidence-based approach to geriatric medicine. The third edition was published in 1997.
Purpose: Its purpose is to provide a comprehensive review of geriatric medicine, incorporating rapidly expanding new information in the field.
Audience: This book is aimed at practicing physicians as well as medical trainees at all levels. The entire team of health professionals caring for older persons will find this book a useful reference.
Features: There are chapters with extensive explanations, and leading the parade is a chapter on the nature of evidence-based medicine. Some of the chapters (e,g., neurobiological basis of dementing disorders) are used as a basis for understanding the advances in the field. Others read like a bibliographic updating in the relevant area, in which the evidence-based domains are not clearly indicated, and which also leave the reader without a clear understanding of the context.
Assessment: The expertise of individual authors shines through in many places. The thoroughness, pagination, and ease of using the information here maintain this book's status as one of the leading comprehensive textbooks of geriatric medicine.
Isaac Kleinman
This third edition is reorganized, enlarged, and updated from the second edition of 1990. The purpose is to codify and assemble in one place the body of geriatric knowledge in a way that is useful for both practicing clinicians and physicians-in-training. The audience includes medical students and residents, geriatricians, and some primary care physicians. This edition has excellent chapters on rehabilitation, management of patients in long term care facilities, ethical questions, social policy, and medicolegal concerns. The chapters on demography of aging and theories of death are good. There is a small color atlas of frequently encountered skin, oral, and fundoscopic disorders. The references appended to each chapter are extensive and up-to-date. This book serves best for reading on large topics, and does not function well as a problem-solving clinical handbook for the practitioner, partly because of its organization and partly because of an inadequate index. There are also a few omissions. This edition has omitted a good chapter on hypothermia which was included in the second edition. Nevertheless, this ambitious text is comprehensive and encompasses well the body of knowledge needed to practice geriatrics.
Text/reference reviews central issues in geriatrics from biological, psychosocial, and philosophical perspectives. The 52 essays are grouped in sections addressing geriatric fundamentals, medical disorders, neurologic and psychiatric disorders, common problems in elderly persons, and health systems and health policy. Updated to reflect diagnostic, therapeutic, and policy advances. With 150 figures, some in color. Annotation c. Book News, Inc., Portland, OR (
From the Publisher
From the Third Edition:

"The third edition 'covers basic gerontoloic concepts, contexts of care, clinical approaches to the geriatric patient, medical disorders, and ethics and health policy'consistent effort throughout the chapters to address how the site of care, coexisting conditions and the health status of the patient influence management. The book offers an approach to serving as a knowledgeable advocate for older adults, ranging from the vigorous 80-year-old in whom prevention and assertive intervention may be appropriate to the elderly person who is dying and needs a provider with extensive skills in comfort care and communication with patients. Other perspectives unique to geriatrics are demonstrated in chapters on the determination of decision-making capacity, screening for cancer, nutrition, and pain management. Geriatrics is and will continue to be a predominant part of the daily practice of most generalists. I recommend [this book] for thoughtful reading about rational and compassionate management of geriatric problems." — New England Journal of Medicine

3 Stars from Doody
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Product Details

  • ISBN-13: 9780387955148
  • Publisher: Springer New York
  • Publication date: 1/27/2003
  • Edition description: 4th ed. 2003
  • Edition number: 4
  • Pages: 1343
  • Sales rank: 956,129
  • Product dimensions: 8.94 (w) x 11.10 (h) x 2.65 (d)

Table of Contents

1 Evidence-Based Medicine and Geriatrics 3
2 Molecular and Biologic Factors in Aging 15
3 Physiology of Aging 27
4 The Demography of Aging 37
5 Epidemiology and Aging 45
6 Psychosocial Influences on Health in Later Life 53
7 Principles of Pharmacology 65
8 Clinical Strategies of Prescribing for Older Adults 83
9 Contexts of Care 93
10 The Long and the Short of Long-Term Care 99
11 The Geriatrician in the Nursing Home 113
12 Home Care 121
13 Acute Hospital Care 133
14 Clinical Approach to the Older Patient: An Overview 149
15 Chronic Disease Management 163
16 Prevention 169
17 Instruments to Assess Functional Status 185
18 Comprehensive Geriatric Assessment and Systems Approaches to Geriatric Care 195
19 Neuropsychological Testing 205
20 Preoperative Assessment and Perioperative Care 213
21 Anesthesia for the Geriatric Patient 229
22 Surgical Approaches to the Geriatric Patient 239
23 Rehabilitation 259
24 Old Age and Care Near the End of Life 281
25 Doctor-Patient Communication Issues 287
26 Care Near the End of Life 299
27 Sources of Suffering in the Elderly 311
28 Acute and Chronic Pain 323
29 Palliative Care in Early, Moderate, and Advanced Dementia 343
30 The Value of Achieving a Peaceful Death 351
Cancer in the Elderly: An Overview 361
31 The Science of Neoplasia and Its Relationship to Aging 363
32 Screening for Cancer 375
33 Breast Cancer 393
34 Colon Cancer and Other Gastrointestinal Malignancies 417
35 Lung Cancer 441
36 Prostate Cancer 455
37 Gynecologic Cancers 469
38 Hematologic Malignancies 487
39 Cardiovascular Disease 509
40 Hypertension 545
41 Peripheral Arterial Disease 561
42 Rheumatologic Diseases 573
43 Skeletal Fragility in the Elderly 621
44 Orthopedic Problems with Aging 651
45 Medical Aspects of Hip Fracture Management 669
46 Treatment of Diabetes 681
47 Thyroid Disorders 695
48 Changes in Male Sexuality 719
49 Sexual Function and the Older Woman 727
50 Gynecologic and Urologic Problems of Older Women 737
51 Benign Prostatic Hyperplasia 755
52 Nephrology/Fluid and Electrolyte Disorders 769
53 Immunology of Aging 783
54 Infectious Diseases 801
55 Hematologic Problems 819
56 Gastroenterologic Disorders 835
57 Pulmonary Disease 853
58 Dermatologic Diseases and Problems 869
59 Changes and Diseases of the Aging Eye 883
60 Otologic Changes and Disorders 893
61 Aging and the Oral Cavity 901
62 Dietary Supplements for Geriatric Patients 921
63 Urinary Incontinence 931
64 Syncope in the Elderly 957
65 Management of Chronic Wounds 967
66 Falls 979
67 Chronic Dizziness and Vertigo 995
68 Nutrition 1009
69 Exercise 1023
70 Sleep and Sleep Disorders 1031
71 Herpes Zoster 1043
72 Elder Mistreatment 1057
73 Frailty 1067
74 Dementia 1079
75 Neurobiologic Basis of Age-Related Dementing Disorders 1095
76 Delirium 1113
77 Cerebrovascular Disease and Stroke 1123
78 Abnormalities of Posture and Movement 1139
79 Depression, Anxiety, and Other Mood Disorders 1163
80 Late-Life Psychosis 1185
81 Mechanisms of Paying for Health Care 1201
82 Justice and the Allocation of Health Care Resources 1213
83 Medical Treatment and the Physician's Legal Duties 1221
84 Determination of Decision-Making Capacity 1233
85 Ethical and Policy Issues in End-of-Life Care 1243
86 Ethical Challenges to Research in Geriatric Medicine 1253
Index 1263
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