Index

A

Academic research, 4–5, 124, 129–130

Activities of daily living, 58–59

Agency for Health Care Policy and Research, 23, 120

Aging, Our Future Selves, 2, 3

Aging process, general, 2, 3, 44, 45, 48, 49

brain, 10

defined, 9, 47

differential, 17, 51, 71, 72, 73–74, 77

diseases and, 9–10, 14-16, 42, 44, 47–48, 62–66

multidisciplinary approach, 9, 49

nutrition and, 16

productivity, 77, 79, 80, 82

senescence, general, 9, 10, 11, 47, 51, 54–55, 65

social-psychological, 17–20, 71, 75–77, 78–80

Alcohol, Drug Abuse, and Mental Health Administration, 20, 103, 120

Alzheimer’s disease, 5, 6-7, 14, 41, 50, 53, 63-64, 99, 126

genetics, 10, 11, 49, 51, 64, 68

Alzheimer’s Disease Research Centers, 54, 123

Animal research, 11, 33, 34, 48, 51, 53

ethics, 24

Atherosclerosis, 10, 14, 49, 54, 63, 66

Attitudes professionals, 94

research participants, 114

B

Behavioral sciences, 2, 3, 16, 25, 71– 75, 127, 138

brain, 84–85

clinical studies, relations to, 18, 24–25

databases, 78, 83

differential aging, 17, 51, 71, 72, 73–74, 77

funding, 20, 30, 82–83

lifestyle risk factors, 55, 59, 100

longitudinal studies, 17, 19, 71, 81, 82, 83

multidisciplinary approach, 25, 46, 58, 71, 72, 73, 81-82, 83-85

neurobehavioral approach, 18, 73, 76

research, priority, 17–19, 75–80

research, secondary, 20, 81



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Extending Life, Enhancing Life: A National Research Agenda on Aging Index A Academic research, 4–5, 124, 129–130 Activities of daily living, 58–59 Agency for Health Care Policy and Research, 23, 120 Aging, Our Future Selves, 2, 3 Aging process, general, 2, 3, 44, 45, 48, 49 brain, 10 defined, 9, 47 differential, 17, 51, 71, 72, 73–74, 77 diseases and, 9–10, 14-16, 42, 44, 47–48, 62–66 multidisciplinary approach, 9, 49 nutrition and, 16 productivity, 77, 79, 80, 82 senescence, general, 9, 10, 11, 47, 51, 54–55, 65 social-psychological, 17–20, 71, 75–77, 78–80 Alcohol, Drug Abuse, and Mental Health Administration, 20, 103, 120 Alzheimer’s disease, 5, 6-7, 14, 41, 50, 53, 63-64, 99, 126 genetics, 10, 11, 49, 51, 64, 68 Alzheimer’s Disease Research Centers, 54, 123 Animal research, 11, 33, 34, 48, 51, 53 ethics, 24 Atherosclerosis, 10, 14, 49, 54, 63, 66 Attitudes professionals, 94 research participants, 114 B Behavioral sciences, 2, 3, 16, 25, 71– 75, 127, 138 brain, 84–85 clinical studies, relations to, 18, 24–25 databases, 78, 83 differential aging, 17, 51, 71, 72, 73–74, 77 funding, 20, 30, 82–83 lifestyle risk factors, 55, 59, 100 longitudinal studies, 17, 19, 71, 81, 82, 83 multidisciplinary approach, 25, 46, 58, 71, 72, 73, 81-82, 83-85 neurobehavioral approach, 18, 73, 76 research, priority, 17–19, 75–80 research, secondary, 20, 81

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Extending Life, Enhancing Life: A National Research Agenda on Aging technological innovations, effects, 19, 80, 94 urinary incontinence, 14 see also Health promotion; Mental health and illness; Psychology and psychiatry; Social sciences and services Biomedical ethics, 3, 23, 46, 107, 139 animal research, 24 clinical research, 23, 25, 68–69, 113–115 competency issues, 23, 108, 109, 114 drugs, 69 funding, 107, 115 genetics, 24 informed consent, 23, 69, 108, 109, 113–114 institutionalized persons, 23, 108, 110 life-sustaining treatments, 23, 108–110 long-term care, 23, 108, 110, 114–115 Medicare, 111 nursing homes, 109, 110, 114–115 research, priority, 23, 107–115 research, secondary, 23–24, 115 resource allocation, 23, 24, 95, 111–113 Biomedical research, basic, 9–10, 46, 47–55, 135–136 funding, 11–12, 30, 50–55 longitudinal studies, 11–12, 53–55 multidisciplinary approach, 24, 55, 58 professional education, 12, 24, 54 research, priority, 10, 49–50 research, secondary, 10–11, 50–52 see also specific subdisciplines Bone diseases, see Musculoskeletal system Brain, 10, 18, 73, 84–85 see also Cognitive abilities Brookdale Foundation, 36 C Cancer, 15, 49, 54, 65–66, 68 cellular carcinogenesis, 10 Cardiovascular system, 6, 14, 59, 63, 77–78, 110 atherosclerosis, 10, 14, 49, 54, 63, 66 cellular studies, general, 11, 50 hypertension, 14, 25, 59, 63, 66, 76 Case management, 22 Cell biology, 48, 50, 52, 53 cardiovascular system, 11, 50 dementia, 15, 64, 68 genetics, 11, 55, 63 homeostasis, 10, 16, 49, 54–55, 66 neurons, 11, 50 postmitotic, 11, 50 Centers of Excellence in Geriatric and Gerontological Research and Training, 12, 16, 32–33, 54, 67, 83, 102, 124 Chronic diseases, 2, 6–7, 41, 91 life expectancy and, 8, 77–78 mental, 20, 81; see also Dementia see also Disabilities; Long-term care; specific diseases Claude Pepper Centers, see Centers of Excellence in Geriatric and Gerontological Research and Training Clinical science, 2, 3, 24–25, 57–58, 136–138 behavioral, 18, 24–25 databases, 12, 57 dementia, 59, 63–64 disabilities, 12–13, 57, 58–62, 68 ethical issues, 23, 25, 68–69, 113–115 funding, 16, 67–68 genetics, 24–25 multidisciplinary approach, 24–25, 57–58, 68–69 professional education 16, 67–68 research, priority, 12–16, 58–66 research, secondary, 16, 66–67 see also Health promotion; Health services delivery; Pharmacological agents; Rehabilitation Cognitive abilities, 18, 77 delirium, 14, 62 learning, 17, 18, 75, 77 memory, 18, 75, 76, 77, 84–85 see also Dementia Commonwealth Fund, vii, 123 Competency issues, 23, 108, 109 see also Informed consent Computers and computer science, 22 databases, 11–12, 34, 45, 57, 78, 83, 96, 97 Consent, see Informed consent Construction of facilities, 26, 34–35 Cost factors clinical research, 58 construction, 26, 34–35 disabled, care of, 1–2, 8, 21, 111 drugs, 96, 98

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Extending Life, Enhancing Life: A National Research Agenda on Aging employer cost sharing, 22, 102 geriatric syndromes, 61, 62 infrastructure, 33–34 long-term care, 21, 101, 111 Medicare, 7, 111, 120 musculoskeletal disorders, 15, 64 overall, 7, 20, 89, 95–96, 101, 111 professional education, 32 reduction of, 3, 8, 58 research, priority, 101 urinary incontinence, 14 Criteria for selection of priorities, 3, 44 Crosscutting issues, 24–25, 55, 68–69, 83–86, 103–104 Cultural factors, 17, 25, 45, 53, 72–73, 77–78, 84 D Charles A. Dana Foundation, 123 Databases, 34, 45, 96 archival, 11–12 behavioral research, 78, 83 clinical research, 12, 57 pharmacological, 97 Decision making life-sustaining treatments, 23, 108–110 resource allocation, ethical issues, 23, 24, 95, 111–113 surrogate, 108, 109, 114 see Competency issues; Informed consent Delirium, 14, 62 Dementia, 1, 6–7, 14–15, 20, 99, 126 cellular studies, 15, 64, 68 clinical research, 59, 63–64 see also Alzheimer's disease Demographic factors, 1, 45, 77–78, 81–82, 84, 88, 100, 103 drug expenditures, 98 epidemiology, 53, 77–78, 81–82, 103 funding of research, 30–31, 34 gender differences, 25, 45, 53, 55, 68, 74, 78, 83–84, 103 morbidity and mortality, 3, 6, 7–8, 18–19, 77–78, 81 poverty, 2, 18, 74, 78, 93, 95, 113 race/ethnicity, 17, 25, 45, 53, 68, 72, 74, 78, 79, 84, 95, 103 socioeconomic status, general, 78, 79, 84, 95, 103 Demonstration projects, 92–93, 97, 100, 120 Dental and oral diseases, 16, 66 Department of Health and Human Services education and training, 32 see also National Institutes of Health; other specific agencies Department of Veterans Affairs, 120, 124, 125, 142–143 research and training, 5, 6 Dependence/independence, 2, 6, 7–8, 90, 91 activities of daily living, 58–59 behavioral interventions, 16–17, 81 drug management, 61 employment, 19 functional capacity, 44 Diabetes, 6, 16, 53 Diet, see Nutrition Differential aging, 17, 51, 71, 72, 73–74, 77 Disabilities, 3, 6–7, 41, 49, 89 behavioral studies, 18–19 clinical studies, 12–13, 57, 58–62, 68 cost of care, 1–2, 8, 21, 111 defined, 6 disease and, 100 health promotion, 22, 100 life expectancy and, 8 musculoskeletal system, 13 reductions in, 2 see also Long-term care; Rehabilitation; specific disabling diseases Diseases and disorders, 3 aging process and, general, 9–10, 14–16, 42, 44, 62–63 disability and, 100 psychological concomitants, 20 senescence, general, 9, 10, 11, 47, 51, 54–55, 65 see also Chronic diseases; Infectious diseases; Morbidity and mortality; specific diseases and anatomical systems Drugs, see Pharmacological agents E Economic factors, 74 see also Cost factors; Financial factors; Poverty; Socioeconomic status Education, 74 see also Professional education Employment and unemployment, 19, 78, 93, 96 cost sharing by employer, 22, 102

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Extending Life, Enhancing Life: A National Research Agenda on Aging geriatrics personnel, 127–130 long-term care workers, 93, 96 productivity and aging, 77, 79, 80, 82 retirement, 19, 76–77, 79, 82 women, 89, 93 Endocrinology, 11, 50, 76 Environmental factors, 9, 11, 18, 45, 51, 52, 66, 72–73, 74 see also Cultural factors; Nutrition; Social sciences; Technological innovation Epidemiology, 53, 77–78, 81–82, 103 Ethics, see Biomedical ethics Ethnicity; see Cultural factors; Race/ethnicity F Failure to thrive, 13, 60 Families, 23, 110–111 decisions about elderly, surrogate, 108, 109, 114 long-term care, 90, 91–92, 93–94, 96 social support structures, 79 Federal government, general see Funding; Regulations; Standards; specific departments and agencies Field studies, 72, 82 Financial factors, 89, 95–96, 101, 119–123 long-term care, 21, 82, 90 see also Cost factors; Funding Foundations, 26, 35–36, 37, 82, 103, 122–123 Funding, 2, 26–37, 45, 119–130 allocation, ethical issues, 23, 24, 95, 111–113 behavioral sciences, 20, 30, 82–83 biomedical research, basic, 11–12, 30, 50–55 clinical research, 16, 67–68 demography, 30–31, 34 ethics research, 107, 115 health promotion, 30–31 health services delivery, 22–23, 102–103, 112–113 G Gender differences, 25, 45, 53, 55, 68, 74, 78, 83–84, 103 see also Women Genetics, 9–10, 11, 15, 46, 47–48, 50, 51–52, 63 Alzheimer's disease, 10, 11, 49, 51, 64, 68 cancer, 15, 65–66 cardiovascular diseases, 14 cellular, 11, 55, 63 clinical studies, relations to, 24–25 ethics research, 24 immune system, 65 metabolism and homeostasis, 16, 66 methodology, 48–49 musculoskeletal disorders, 15, 16, 65 nutrition and, 63, 66 Geriatric Research and Training Centers, see Centers of Excellence in Geriatric and Gerontological Research and Training Geriatrics and gerontology, 2, 42, 49 personnel, 127–130 syndromes, 12, 13–14, 57, 60–62 see also Professional education Government role, see Funding; Regulations; Standards; specific departments and agencies Grants, see Funding H Handicaps, see Disabilities John A. Hartford Foundation, 123, 124 Health Care Financing Administration, 20, 23, 30, 83, 90, 120 Medicare, 7, 96, 111, 120 Health promotion, 18, 21, 45–46, 49, 59, 62, 63, 74–75, 89, 100 disabilities, 22, 100 during chronic illness, 20 field studies, 72, 82 funding, 30–31 Medicare, 96 research, priority, 13, 22, 101, 102 resource allocation, ethical issues, 112 Health services delivery, 3, 20–21, 25, 46, 88–100, 139 case management, 22 costs, 1–2, 8, 21, 111 equity and access, 111–113 funding, 22–23, 102–103, 112–113 mental health, 22, 89, 99–100 multidisciplinary approach, 22, 25, 58, 103–104

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Extending Life, Enhancing Life: A National Research Agenda on Aging professional education, 88–89, 93, 103 research, priority, 21–22, 89, 101–102 research, secondary, 22, 102 research vs, care, 112–113 see also Institutionalized persons; Long-term care; Nursing homes Heart disease, see Cardiovascular system Home care, 90, 91–92, 93–94, 96 costs, 8 Homeostasis, 10, 16, 49, 54–55, 66 Hypertension, 14, 25, 59, 63, 66, 68, 76 I Imaging, 15 Immune system, 49, 50–51, 65 infectious diseases, 15, 65, 127 vaccines, 15, 65 Independence, see Dependence/independence Infectious diseases, 15, 65, 127 Information databases, 11–12, 34, 45, 57, 78, 83, 96, 97 publications, 40–41, 43, 125–127, 128, 129 see also specific publications Informed consent, 23, 69, 108, 113–114 surrogate, 108, 109, 114 Infrastructure, 22, 33–34, 50, 68 computers and computer science, 22 construction costs, 26, 34–35 databases, 11–12, 34, 45, 57, 78, 83, 96, 97 laboratories, 33, 54 see also Centers of Excellence in Geriatric and Gerontological Research and Training; Computers and computer science Institute for Scientific Information, 125–127 Institute of Medicine, 2, 4, 37, 42, 58, 67 Institutionalized persons, 22, 75, 92–93, 102 demented, 64 ethical issues, 23, 108, 110 Instrumental activities of daily living, see Activities of daily living Interdisciplinary approach, see Multidisciplinary approach J Robert Wood Johnson Foundation, 123, 124 K Henry J. Kaiser Family Foundation, 123 L Laboratories, 33, 54 construction of, 26, 34–35 see also Centers of Excellence in Geriatric and Gerontological Research and Training Learning, 17, 18, 75, 77 Legal issues litigation, 110 mandatory retirement 19, 76, 79–80 see also Competency issues; Informed consent; Regulations Life expectancy, 6, 7, 11, 45–46 behavioral/social factors, 74 chronic illness and, 8, 77–78 gender differences, 78 methodological issues, 51 nutrition, 51 Litigation, 110 Longitudinal studies, 34, 45, 103–104 behavioral/social, 17, 19, 71, 81, 82, 83 biomedical research, basic, 11–12, 53–55 clinical research, 13 gender differences, 78 Long-term care, 57, 89, 90–94, 95 behavioral interventions, 81 costs, 21, 101, 111 defined, 90 ethical issues, research, 23, 108, 110, 114–115 family providers, 90, 91–92, 93–94, 96 financing, 21, 82, 90 institutionalized persons, 22, 23, 64, 75, 92–93, 102, 108, 110 methodology, 92–93 models, 102 nursing homes, 7, 8, 14, 93–94, 99, 109, 110, 114–115, 124, 126 personnel, 93, 96 quality of life, 91, 92, 94

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Extending Life, Enhancing Life: A National Research Agenda on Aging rehabilitation, 13, 57, 58–59, 76, 111 research, priority, 21, 101 M John D. and Catherine T. MacArthur Foundation, 123 Medicare, 120 costs, 7, 111, 120 data about, 96 ethical issues, 111 Medications, see Pharmacological agents Memory, 18, 75, 76, 77, 84–85 Mental health and illness, 21 chronic illness, 20, 81 delirium, 14, 62 research, priority, 22, 101, 102 research, secondary, 89 services delivery, 22, 89, 99–100 see also Cognitive abilities; Dementia; Psychology and psychiatry Metabolic disorders, 16, 66 Methodology behavioral/social, 81–82 biomedical, basic, 9–10 field studies, 72, 82 long-term care research, 92–93 molecular biology and genetics, 48–49 of present study, 2–4, 42–44 senescence research, 51 see also Longitudinal studies; Multidisciplinary approach Minorities, see Race/ethnicity Mobility, 13, 60–61 Models, 52 aging and lifespan, 11 animal, 11, 24, 33, 34, 48, 51, 53 behavioral/social research, 81 long-term care, 102 reproductive system as, 51 Molecular genetics, see Genetics Morbidity and mortality, 3, 6, 7–8, 18–19, 68, 77–78 databases, 11–12, 78, 96 demography and, 3, 6, 7–8, 18–19, 77–78, 81 drug mismanagement, 61 epidemiology, 53, 77–78, 81–82, 103 funding, 30–31 geriatric syndromes, 61, 62, 63 postponed morbidity, 18–19, 75, 77–78 senescence, general, 9, 10, 11, 47, 51, 54–55, 65 see also Disabilities; Life expectancy Multidisciplinary approach, 4, 24–25, 44–45, 48 aging process, 9, 49 behavioral/social research, 25, 46, 58, 71, 72, 73, 81–82, 83–85 biomedical, basic, 24, 55, 58 clinical research, 24–25, 57–58, 68–69 construction of centers, 22, 34 dementia, 15 drug management, 61, 97 health services delivery, 22, 25, 58, 103–104 professional education, 24, 55 quality of life index, 19–20, 80–81 see also Centers of Excellence in Geriatric and Gerontological Research and Training Musculoskeletal system, 13, 15, 16, 50, 60–61, 64–65, 66 disease costs, 15, 64 genetics, 15, 16, 65 osteoarthritis, 10, 15, 49, 54, 64 osteoporosis, 8, 15, 59, 64, 64, 127 N National Center for Human Genome Research, 24 National Health Interview Survey, 58 National Institute of Aging, 5, 11–12, 28–30, 35, 43, 119–120, 123 behavioral/social research, 83 biomedical research, basic, 53 clinical research, 67 homeostasis research, 49 professional education, 40 see also Centers of Excellence in Geriatric and Gerontological Research and Training National Institute of Child Health and Human Development, 5, 34 National Institute of Mental Health, 5 National Institutes of Health, 5, 26, 28, 29–30, 103, 119–120, 121 behavioral/social research, 20, 83 biomedical research, basic, 52 clinical research, 16 ethical issues, 24 Neoplasia, see Cancer; Tumors, benign Neurosciences, 5, 50 aging, general, 10, 66

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Extending Life, Enhancing Life: A National Research Agenda on Aging behavioral, 18, 73, 76 brain, 10, 18, 73, 84–85 cellular, 11, 50 endocrinology, 11, 50, 76 pain, 16, 66 postural/mobility disorders, 13, 60–61 sensory deficiencies, 13, 16, 77 urinary incontinence, 14, 62 see also Dementia Nonprofit organizations, see Foundations Nursing homes, 7, 93–94, 124, 126 costs, 8 ethical issues, 109, 110, 114–115 mental disorders, 99 urinary incontinence, 14 Nutrition, 16, 51 genetics and, 63, 66 musculoskeletal disorders, 15 O Oral cavity, see Dental and oral diseases Osteoarthritis, 10, 15, 49, 54, 64 Osteoporosis, 8, 15, 59, 64, 127 Our Future Selves, 43 P Pain, 16, 66 Panel for Statistics for an Aging Population, 91 Pepper Commission, 26 see also Centers of Excellence in Geriatric and Gerontological Research and Training Pew Charitable Trusts, vii, 123 Pharmacological agents, 3, 21, 89 costs, 96, 98 epidemiology, 103 ethical issues, 69 medication mismanagement, 13–14, 21, 51, 61, 96–97, 101 polypharmacy, 61, 97 private sector, 143 standards, 63 Pneumonia, 65 Postural stability, 13, 60–61 Poverty, 2, 18, 74, 78, 93, 95, 113 Preventive medicine, see Health promotion Private sector, 26, 122, 143 innovation, 36–37 see also Foundations Professional education, 4–5, 6, 31–32, 36, 40, 41, 124, 127–130 academic research, 4–5, 124, 129–130 behavioral/social, 20 biomedical, 12, 24, 54 clinical, 16, 67–68 health services, 88–89, 93, 103 multidisciplinary approach, 24, 55 Prostate gland, 10, 49, 54 Psychology and psychiatry, 16, 45, 46, 63–64, 76, 78, 81, 85, 99–100 differential aging, 73–74, 77 disease, concomitants, 20, 103 research, priority, 17–18 research, secondary, 20 see also Mental health and illness Publications, 40–41, 43, 125–127, 128, 129 see also specific publications Q Quality of life, 2, 4, 6, 7–8, 9, 89 drug mismanagement and, 61 index of, 19–20, 80–81 long-term care, 91, 92, 94 quality of care vs, 24, 92, 94, 115 social factors, 19 see also Dependence/independence R Race/ethnicity, 17, 25, 45, 53, 68, 72, 74, 78, 79, 84, 95, 103 Regulations drugs, 21 see also Standards Rehabilitation, 13, 57, 58–59, 76, 111 Reproductive system, 51 Retirement, 19, 76–77, 79–80, 82 Risk factors, 13, 22, 55, 59, 96, 100, 102 cognitive impairments, 18 dementia, 99 social, 18, 79 Robotics, 22 S Self-care, see Dependence/independence Sensory deficiencies, 13, 16, 77 Sex differences, see Gender differences; Women Skin diseases, 16, 66

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Extending Life, Enhancing Life: A National Research Agenda on Aging Social sciences and services, 2, 3, 16, 25, 45, 46, 71–75, 127, 138–139 cultural factors, 17, 25, 45, 53, 72– 73, 77–78, 84 differential aging, 17, 51, 71, 72, 73–74, 77 drug effects, 21 funding, 20, 30, 82–83 longitudinal studies, 17, 19, 71, 81, 82, 83 long-term care, 95 methodology, 81–82 multidisciplinary approach, 25, 46, 58, 71, 72, 73, 81–82, 83–85 research, priority, 18–19, 75–80 research, secondary, 19–20, 80–81 risk factors, general, 18, 79 technological innovations, effects, 19, 80, 94 see alsoDemographic factors; Employment and unemploy- ment; Families Socioeconomic status, 78, 79, 84, 103 and allocation of health care resources, 95 poverty, 2, 18, 74, 78, 93, 95, 113 Standards of care, 24, 111 drugs, 63 equity and access, 111–112 long-term care, 94 see alsoBiomedical ethics T Technological innovation behavioral/social effects, 19, 80, 94 ethical issues, 24 effectiveness, 22, 94 imaging, 15 industry support, 36–37 long-term care, 94 Tissue studies, 11, 53, 55 Toward an Independent Old Age: A National Plan for Research on Aging, 2, 3, 43 Tumors, benign, 54 prostatic, 10, 49, 54 U Urinary system incontinence, 14, 61–62 infections, 65 V Vaccines, 15, 65 W Weingart Foundation, 123 Women, 74, 79, 95 hypertension, 25, 68 osteoporosis, 8 workforce, 89, 93 see alsoGender differences