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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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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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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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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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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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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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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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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
Representative terms from entire chapter:
ethical issues