Committee on Aging placed health quackery costs at $10 billion.110 Other, more recent reviews document the fact that diet-related nostrums and homeopathic remedies of unproven effectiveness account for substantial unnecessary expenditures by the elderly (total costs may exceed $40 billion or more for all forms of fraud).2,110 Indeed, the Select Committee estimated that the elderly accounted for more than 30 percent of the fraud victims in this country, a burden particularly heavy in that such losses by older individuals are disproportionate because the elderly are slower to recover physically, financially, and mentally than younger, more affluent victims.

Common among the frauds perpetrated on the elderly are the so-called nutritional therapies for various chronic degenerative diseases and conditions. The extensive use of vitamin and mineral supplements is well documented.63 Overreliance on such remedies often means that diseases or impairments that might otherwise be prevented or assisted by medical means (e.g., arthritis) may become both economically and medically handicapping. Elderly individuals with chronic degenerative diseases such as cancer, heart disease, arthritis, and gastrointestinal disturbances are especially at risk. Even those who do not have overt signs and symptoms of these diseases often assume themselves to be at special risk of vitamin or mineral deficiencies, although they may not necessarily be so.28

At the federal level, the Food and Drug Administration has major enforcement responsibilities to prevent health fraud by regulating health claims for the efficacy of nutrients and other substances in the prevention, cure, and treatment of disease. The agency is also responsible for other measures to assure that the food supply is safe. In addition, the U.S. Postal Service, the Federal Trade Commission, and other federal agencies act to ensure that the mails and communications media are not used to aid and abet fraudulent sales of products.

The education of consumers on the steps they can take to avoid nutritional and other types of fraud is crucial. By assisting individuals to avoid inefficacious or fraudulent remedies and by helping them obtain appropriate medical help, many conditions that would otherwise lead to severe losses of independent function can be identified and treated. The American Association of Retired Persons, the American Cancer Society, the American Arthritis Foundation, and other groups such as the Council on Health Fraud all have a role to play in educating consumers on these issues.

Oral Health

The oral health of aging individuals often influences their nutritional status. For example, in one study, elderly veterans with self-perceived



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