Progress Report On Geriatric Medicine

This book offers an up-to-date review on the principles and practice of multidimensional assessment and management of the older individual, which represents the cornerstone of modern clinical practice in the elderly. The early chapters cover the main elements and scope of the comprehensive geriatric approach and explain the pathways of care from screening and case finding through to in-depth assessment and treatment planning. Subsequent chapters review the evidence of how best to apply the multidimensional assessment and management approach in defined healthcare settings and within specific clinical areas, such as cancer and surgery. Finally, the education and training challenges are reviewed and the prospects for future clinical service and research in this important field are examined. The book is very timely given the recent advances in application of this approach, which reflect the growing international realization that older people are “core business” in many clinical areas where the role of specialist geriatric medicine has hitherto been limited. Accordingly, the book will be relevant to a wide range of clinicians. The authorship comprises many of the best known and widely published experts in their respective fields.

With the appearance of a textbook as comprehensive as this one, it is clear that the field of geriatrics is coming of age. The broad scope of these volumes shapes a substantial answer to the question, "What is geriatrics and why should we be interested in it?" As I see it, there are at least five reasons. First, the scientific or intellectual reason: gerontology is the study of aging from the biologic, psychological, and social perspectives. There is increasing interest in the fascinating insights into the biologic mechanisms of aging, errors in protein synthesis, DNA repair mechanisms, alterations of the neuroendocrine system, changes in the immune system, genetic controls, and somatic mutations. Second, the demographic reason: this is the century of old age. There has been a 26-year gain in the average life expectancy. This gain compares with that acquired from 3,000 years B.C. (the Bronze Age) to the year 1900, which was about 29 years. Therefore, in one century, there has been a gain in the average life expectancy almost equal to 5,000 previous years of human history. In 1830, one of three newborn infants survived beyond 60 years of age.

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