Practical Issues in Geriatrics – serie

After introductory chapters devoted to the safe production and distribution of vaccines, the book addresses the question of adult vaccination in the framework of a life-course approach to vaccination. It presents the proceedings of multidisciplinary expert discussions with an excellent summary of the current state of knowledge on adult vaccination in various diseases, as well as an overview of the professionals involved and the obstacles to achieving greater vaccine uptake, and how these may be addressed.The book systematically discusses the major vaccine-preventable diseases, as well as regulatory issues in vaccine provision, and presents the results of an expert meeting designed to identify the obstacles to vaccination, and solutions for addressing these barriers. It goes on to extend the discussion beyond the traditional boundaries of human health to encompass the “one health” concept.The book is intended for all those with an interest in vaccination, including physicians (from a wide range of disciplines including geriatrics/gerontology, infectious diseases, pediatrics, internal medicine, and other non-organ specialties), other healthcare professionals, pharmacists, representatives of the pharmaceutical industry and regulatory bodies (EMEA, national authorities), policymakers, the media and the general public.

This book explains how to promote and prolong “healthy ageing,” which constitutes maintaining daily functioning and well-being until the end of life.In this context, the editor of the book and the international team of authors, all of whom are experts on the various aspects of ageing, demonstrate the value of this new approach in clinical practice. The systematic integration of a functional assessment, if not a complete and comprehensive geriatric assessment, is fundamental in daily clinical practice. Identifying risk factors at midlife will help to promote health at any age. Moreover, randomized control trials are making it increasingly clear that interventions could help ageing and elderly adults enjoy their remaining years without disability. Indeed, wellbeing will also increase, allowing elderly adults to stay independent until a very advanced age. The book also shows how considerable societal benefits can be easily forecast when more lifetime is spent without disability, followed by a dignified end of life.  This book will be of interest to all medical doctors, general practitioners and organ specialists as well as geriatricians who want to have a complete overview of what healthy ageing means.

This book illustrates the role of Mediterranean diet in connection with well-being and particularly its impact on health and elderly care, as well as on the mechanisms of aging. Aging is a natural process of human life. The knowledge that a healthy dietary regimen like the Mediterranean diet can effectively prevent or delay many diseases typically affecting aging people may help to better manage the aging process. From this point of view, knowledge of the numerous benefits of the Mediterranean-style diet may effectively promote better management of the burden of elderly care.As early as the 1950s, Ancel Keys pointed out the effectiveness of the Mediterranean diet in helping to control, and possibly avoid, myocardial infarction and/or cholesterol metabolism. Quite soon after the first studies were published, it became clear that the Mediterranean diet was beneficial not only in connection with cardiovascular disease but also many other diseases, from diabetesto hypertension, from cancer and thrombosis to neurodegenerative diseases, including dementia.  Examining those benefits in detail, this book offers a valuable educational tool for young professionals and caregivers, as well as for students and trainees in Geriatrics and Nutrition.

This book describes the fundamental process of senescence, and reviews a new concept developed by a number of research groups that is based on cellular senescence and its secretome. This concept provides a basic explanation of the main physiological and pathological features of senescence, and delineates possibilities for “treating” it.Following an introduction to the emerging medical landscape, the increasing incidence of a new epidemiological group (age-related “chronic non-transmissible diseases”), and the multiple origins of aging, the book explores and characterizes the senescent cell, which is linked to benign and pathological age-related manifestations. In turn, the closing chapters discuss how to “treat” or “prevent” the aging process, underscoring the central role of physical exercise and caloric reduction as compared to new senolytic approaches. Appendices are also provided, and address circadian rhythms, telomere shortening, diabetic cardiomyopathy, and senescence in plants and bacteria.Given its scope, the book will primarily be of interest to geriatricians, but will also appeal to a wider range of clinicians.

This book describes the fundamental process of senescence, and reviews a new concept developed by a number of research groups that is based on cellular senescence and its secretome. This concept provides a basic explanation of the main physiological and pathological features of senescence, and delineates possibilities for “treating” it.Following an introduction to the emerging medical landscape, the increasing incidence of a new epidemiological group (age-related “chronic non-transmissible diseases”), and the multiple origins of aging, the book explores and characterizes the senescent cell, which is linked to benign and pathological age-related manifestations. In turn, the closing chapters discuss how to “treat” or “prevent” the aging process, underscoring the central role of physical exercise and caloric reduction as compared to new senolytic approaches. Appendices are also provided, and address circadian rhythms, telomere shortening, diabetic cardiomyopathy, and senescence in plants and bacteria.Given its scope, the book will primarily be of interest to geriatricians, but will also appeal to a wider range of clinicians.

This book provides basic knowledge and skills for non-dental healthcare practitioners, helping them recognize the importance of oral health, perform initial oral health assessments, consult dentists when necessary, and offer preventive advice and counseling. As people age, they tend to refrain from routine dental care, while the number of consultations with non-dental healthcare providers (physicians, nurses, pharmacists, physician assistants, physical therapists, occupational therapists etc.) increases. However, few healthcare providers are adequately trained to assess oral problems.The relevance of this book is underscored by the recently published European policy recommendations on oral health in older adults by the European College of Gerodontology and the European Geriatric Medicine Society, which highlight the importance of the active involvement of non-dental primary care practitioners in oral health assessment and promotion. These two respected European Societies have identified a significant gap in education, practice and health policies and described the necessary action plans. This book helps to fill the educational gap identified in the recommendations and will be an invaluable tool for all healthcare providers working with older people.

This book provides basic knowledge and skills for non-dental healthcare practitioners, helping them recognize the importance of oral health, perform initial oral health assessments, consult dentists when necessary, and offer preventive advice and counseling. As people age, they tend to refrain from routine dental care, while the number of consultations with non-dental healthcare providers (physicians, nurses, pharmacists, physician assistants, physical therapists, occupational therapists etc.) increases. However, few healthcare providers are adequately trained to assess oral problems.The relevance of this book is underscored by the recently published European policy recommendations on oral health in older adults by the European College of Gerodontology and the European Geriatric Medicine Society, which highlight the importance of the active involvement of non-dental primary care practitioners in oral health assessment and promotion. These two respected European Societies have identified a significant gap in education, practice and health policies and described the necessary action plans. This book helps to fill the educational gap identified in the recommendations and will be an invaluable tool for all healthcare providers working with older people.

Open access publication has been possible through an unconditional educational grant from UCB.This new open access edition supported by the Fragility Fracture Network aims at giving the widest possible dissemination on fragility fracture (especially hip fracture) management and notably in countries where this expertise is sorely needed. It has been extensively revised and updated by the experts of this network to provide a unique and reliable content in one single volume. Throughout the book, attention is given to the difficult question of how to provide best practice in countries where the discipline of geriatric medicine is not well established and resources for secondary prevention are scarce.  The revised and updated chapters on the epidemiology of hip fractures, osteoporosis, sarcopenia, surgery, anaesthesia, medical management of frailty, peri-operative complications, rehabilitation and nursing are supplemented by six new chapters. These include an overview of the multidisciplinary approach to fragility fractures and new contributions on pre-hospital care, treatment in the emergency room, falls prevention, nutrition and systems for audit. The reader will have an exhaustive overview and will gain essential, practical knowledge on how best to manage fractures in elderly patients and how to develop clinical systems that do so reliably.

Open access publication has been possible through an unconditional educational grant from UCB.This new open access edition supported by the Fragility Fracture Network aims at giving the widest possible dissemination on fragility fracture (especially hip fracture) management and notably in countries where this expertise is sorely needed. It has been extensively revised and updated by the experts of this network to provide a unique and reliable content in one single volume. Throughout the book, attention is given to the difficult question of how to provide best practice in countries where the discipline of geriatric medicine is not well established and resources for secondary prevention are scarce.  The revised and updated chapters on the epidemiology of hip fractures, osteoporosis, sarcopenia, surgery, anaesthesia, medical management of frailty, peri-operative complications, rehabilitation and nursing are supplemented by six new chapters. These include an overview of the multidisciplinary approach to fragility fractures and new contributions on pre-hospital care, treatment in the emergency room, falls prevention, nutrition and systems for audit. The reader will have an exhaustive overview and will gain essential, practical knowledge on how best to manage fractures in elderly patients and how to develop clinical systems that do so reliably.

This book provides family doctors with a wealth of evidence-based indications and tips regarding geriatric medicine and approaches for the management of older patients, to be applied in daily practice.After discussing old and new features of healthy ageing and the approaches required in Family Medicine Consultation, the text introduces key elements of geriatric medicine such as frailty, sarcopenia, and the comprehensive geriatric assessment (CGA), before describing a range of characteristics unique to older patients in different contexts, with a dedicated section on Palliative Care. The role of polypharmacy and the importance of quaternary prevention and deprescribing are also addressed.Finally, the book emphasizes both the importance of a humanistic approach in caring and the approach of research and meta-research in geriatrics. Though many texts explore the role of primary care professionals in geriatric medicine, the role of family doctors in older people care has not yet been clearly addressed, despite the growing burden of ageing, which has been dubbed the “silver tsunami.” Family physicians care for individuals in the context of their family, community, and culture, respecting the autonomy of their patients. In negotiating management plans with their patients, family doctors integrate physical, psychological, social, cultural and existential factors, utilizing the knowledge and trust engendered by repeated visits. They do so by promoting health, preventing disease, providing cures, care, or palliation and promoting patient empowerment and self-management.This will likely become all the more important, since we are witnessing a global demographic shift and family doctors will be responsible for and involved in caring for a growing population of older patients.This book is intended for family medicine trainees and professionals, but can also be a useful tool for geriatricians, helpingthem to better understand some features of primary care and to more fruitfully interact with family doctors.

This book provides family doctors with a wealth of evidence-based indications and tips regarding geriatric medicine and approaches for the management of older patients, to be applied in daily practice.After discussing old and new features of healthy ageing and the approaches required in Family Medicine Consultation, the text introduces key elements of geriatric medicine such as frailty, sarcopenia, and the comprehensive geriatric assessment (CGA), before describing a range of characteristics unique to older patients in different contexts, with a dedicated section on Palliative Care. The role of polypharmacy and the importance of quaternary prevention and deprescribing are also addressed.Finally, the book emphasizes both the importance of a humanistic approach in caring and the approach of research and meta-research in geriatrics. Though many texts explore the role of primary care professionals in geriatric medicine, the role of family doctors in older people care has not yet been clearly addressed, despite the growing burden of ageing, which has been dubbed the “silver tsunami.” Family physicians care for individuals in the context of their family, community, and culture, respecting the autonomy of their patients. In negotiating management plans with their patients, family doctors integrate physical, psychological, social, cultural and existential factors, utilizing the knowledge and trust engendered by repeated visits. They do so by promoting health, preventing disease, providing cures, care, or palliation and promoting patient empowerment and self-management.This will likely become all the more important, since we are witnessing a global demographic shift and family doctors will be responsible for and involved in caring for a growing population of older patients.This book is intended for family medicine trainees and professionals, but can also be a useful tool for geriatricians, helpingthem to better understand some features of primary care and to more fruitfully interact with family doctors.

This book offers a concise and updated guide for all readers (physicians and non-physicians) interested in gaining a comprehensive and precise understanding of sarcopenia. Over the last several years, sarcopenia has increasingly developed from being a concept known only in research settings to one that is commonly explored in journals and scientific meetings for various disciplines, such as geriatrics, rheumatology and rehabilitation medicine. Thus, all domains of sarcopenia, from molecular aspects to clinical management, represent highly active areas of research and clinical practice for health professionals in a variety of fields, including geriatric medicine, nutrition, and epidemiology. Despite being a relatively new concept in medicine, sarcopenia is increasingly being recognized as an important determinant of other health conditions, including mortality and disability.This book, written by experts from around the globe, covers several core aspects of sarcopeniamanagement, from molecular mechanisms to genetics, epidemiology, diagnosis and finally treatment, including the clinical impact of sarcopenia as a risk factor, the known genetic and molecular aspects that can aid in predicting sarcopenia, and selected treatment and therapy concepts, including indications for nutrition and physical exercise. Sharing data from the latest studies, it will be of considerable interest not only for geriatricians, but also for a wide range of other readers.

This book offers a concise and updated guide for all readers (physicians and non-physicians) interested in gaining a comprehensive and precise understanding of sarcopenia. Over the last several years, sarcopenia has increasingly developed from being a concept known only in research settings to one that is commonly explored in journals and scientific meetings for various disciplines, such as geriatrics, rheumatology and rehabilitation medicine. Thus, all domains of sarcopenia, from molecular aspects to clinical management, represent highly active areas of research and clinical practice for health professionals in a variety of fields, including geriatric medicine, nutrition, and epidemiology. Despite being a relatively new concept in medicine, sarcopenia is increasingly being recognized as an important determinant of other health conditions, including mortality and disability.This book, written by experts from around the globe, covers several core aspects of sarcopeniamanagement, from molecular mechanisms to genetics, epidemiology, diagnosis and finally treatment, including the clinical impact of sarcopenia as a risk factor, the known genetic and molecular aspects that can aid in predicting sarcopenia, and selected treatment and therapy concepts, including indications for nutrition and physical exercise. Sharing data from the latest studies, it will be of considerable interest not only for geriatricians, but also for a wide range of other readers.

This book addresses in a structured and multidisciplinary way the medical issues related to aging, paying particular attention to the role of diagnostic imaging in the field of cardiovascular, musculoskeletal, respiratory, neurological, urogenital and gastrointestinal diseases.The progressive increase of the average age of the population, of life expectancy and the improvement of the quality of life are common phenomena in many countries of the World.Over the years, the management of older persons seems to have had an increasing impact both on the socio-economic and on the medical-health level. Medicine, in all its branches, has in fact focused more and more on the health conditions of the elderly patient and its protection and, in this context, due to the increasing progress in the field of technology and imaging methods, the radiologist occupies a front-line position.Unlike the young or middle-aged patients, the elderly need special care and attention, especiallybecause of the involutive-degenerative senile processes they have to face, which must be taken into account to avoid incurring into misdiagnosis.Radiology, in fact, aims more and more at developing imaging techniques that are on the one hand satisfactory and comprehensive, but at the same time that do not represent any risk and/or obstacle for the elderly patient.The aim of this book is to provide the radiologist, and not only, with an adequate and complete geriatric preparation, thus to improve the diagnostic-therapeutic management of those patients who, to date, constitute the most conspicuous part of the medical-health users.

This book addresses in a structured and multidisciplinary way the medical issues related to aging, paying particular attention to the role of diagnostic imaging in the field of cardiovascular, musculoskeletal, respiratory, neurological, urogenital and gastrointestinal diseases.The progressive increase of the average age of the population, of life expectancy and the improvement of the quality of life are common phenomena in many countries of the World.Over the years, the management of older persons seems to have had an increasing impact both on the socio-economic and on the medical-health level. Medicine, in all its branches, has in fact focused more and more on the health conditions of the elderly patient and its protection and, in this context, due to the increasing progress in the field of technology and imaging methods, the radiologist occupies a front-line position.Unlike the young or middle-aged patients, the elderly need special care and attention, especiallybecause of the involutive-degenerative senile processes they have to face, which must be taken into account to avoid incurring into misdiagnosis.Radiology, in fact, aims more and more at developing imaging techniques that are on the one hand satisfactory and comprehensive, but at the same time that do not represent any risk and/or obstacle for the elderly patient.The aim of this book is to provide the radiologist, and not only, with an adequate and complete geriatric preparation, thus to improve the diagnostic-therapeutic management of those patients who, to date, constitute the most conspicuous part of the medical-health users.

This book provides a comprehensive overview for those interested in research and promoting sexual health in older people, as well as a “go-to” guide on the topic of sexual behaviour in older adults.Sexual activity is an essential part of intimate relationships, though it tends to decline in frequency as people grow older. Nevertheless, for many older people, sex still remains an important part of their life. There’s a common misconception that as people age, they lose their interest in sex and capacity for sexual behaviour. This is not the case, as a number of national surveys show.The new research presented here indicates that the less sex older people have, the more likely they are to experience mental and physical health problems. Men and women who reported a decrease in the frequency of sexual activities were also more likely to report a deterioration in self-perceived health. Additionally, men with erectile dysfunction were also more likely to be diagnosed with cancer or coronary heart disease. This research has also determined that older adults who experience a decline in sexual activity report poorer well-being than those who maintain their levels of sexual desire, activity and function in later life, and that men who remain sexually active in later life continue to have better cognitive performance compared to those who don’t. Despite these health benefits, medical professionals do little to promote sexual activity in older adults, and the literature suggests that there is a lack of knowledge on how to approach the subject and how to promote such activities.This is the first comprehensive book specifically exploring all areas of sexual behaviour and health in older adults, and drawing on the latest research in this area. It offers a valuable resource for researchers and clinicians in various health fields (medicine, nursing, occupational therapy, psychology, public health, etc.), as well as students in undergraduate and graduate programs.

This book provides a comprehensive overview for those interested in research and promoting sexual health in older people, as well as a “go-to” guide on the topic of sexual behaviour in older adults.Sexual activity is an essential part of intimate relationships, though it tends to decline in frequency as people grow older. Nevertheless, for many older people, sex still remains an important part of their life. There’s a common misconception that as people age, they lose their interest in sex and capacity for sexual behaviour. This is not the case, as a number of national surveys show.The new research presented here indicates that the less sex older people have, the more likely they are to experience mental and physical health problems. Men and women who reported a decrease in the frequency of sexual activities were also more likely to report a deterioration in self-perceived health. Additionally, men with erectile dysfunction were also more likely to be diagnosed with cancer or coronary heart disease. This research has also determined that older adults who experience a decline in sexual activity report poorer well-being than those who maintain their levels of sexual desire, activity and function in later life, and that men who remain sexually active in later life continue to have better cognitive performance compared to those who don’t. Despite these health benefits, medical professionals do little to promote sexual activity in older adults, and the literature suggests that there is a lack of knowledge on how to approach the subject and how to promote such activities.This is the first comprehensive book specifically exploring all areas of sexual behaviour and health in older adults, and drawing on the latest research in this area. It offers a valuable resource for researchers and clinicians in various health fields (medicine, nursing, occupational therapy, psychology, public health, etc.), as well as students in undergraduate and graduate programs.

This book summarizes the broad and rapidly evolving field of geriatric pharmacotherapy, which is becoming increasingly relevant for practicing physicians who care and prescribe medications for older patients. Around the globe, ageing populations are associated with an increased prevalence of chronic diseases. Older adults are often affected by multimorbidity, i.e., suffer from more than one chronic disease. The main consequence of multimorbidity is polypharmacy, which is commonly defined as the regular use of five or more medicines. Polypharmacy has now reached epidemic proportions in our societies, and is associated with an increased risk of drug-drug interactions, drug-disease interactions and adverse drug reactions. The management of polypharmacy in older patients with complex multimorbidity poses several challenges and needs to be based on specific knowledge and prescribing expertise.The aim of this book is to provide a comprehensive update on thefield, and to share the expertise needed to optimize the management of pharmacotherapy in older patients.

This book summarizes the broad and rapidly evolving field of geriatric pharmacotherapy, which is becoming increasingly relevant for practicing physicians who care and prescribe medications for older patients. Around the globe, ageing populations are associated with an increased prevalence of chronic diseases. Older adults are often affected by multimorbidity, i.e., suffer from more than one chronic disease. The main consequence of multimorbidity is polypharmacy, which is commonly defined as the regular use of five or more medicines. Polypharmacy has now reached epidemic proportions in our societies, and is associated with an increased risk of drug-drug interactions, drug-disease interactions and adverse drug reactions. The management of polypharmacy in older patients with complex multimorbidity poses several challenges and needs to be based on specific knowledge and prescribing expertise.The aim of this book is to provide a comprehensive update on thefield, and to share the expertise needed to optimize the management of pharmacotherapy in older patients.

This book aims at disseminating information and knowledge in Gerontechnology, a topic that is still considered a specific area of interest for techno-experts (i.e. informatics, engineers, bio-engineers, bio-statistics, etc.) while there is a relatively low diffusion of technological expertise among clinicians and other health professionals who are involved in the care of older people.In many parts of the world, average life expectancy is rising consistently, and at the same time technology is developing at a dramatic pace. This means having completely new options for the diagnosis, treatment and follow-up of diseases and disabilities of older people but also a new challenge to improve the quality of life by promoting an active and healthy aging at population level. This book explores the technical developments that are beginning to change the management of diseases and disabilities of geriatric patients. These include advanced Information and Communication Technologies (ICT), i.e. the new online services in healthcare and electronic medical-health records, Assistive Technologies (AT), i.e. behavior and motility monitoring sensorial tools, smart homes tools and telemedicine tools as well as Human–Computer Interaction technologies (HCI), i.e. robots for supporting people with mobility or cognitive limitations, humanoid robots, exoskeletons and rehabilitation robots. The Work is divided into three main parts: 1) Technology in a world of aging people, 2) Clinical applications of technologies in older people, and 3) Older people and technologies interaction including privacy issues, acceptability of technologies by older people and education and training of healthcare professionals in gerontechnology. The book will be an invaluable tool for geriatricians and other health professionals who are involved in the care of older people.

This book aims at disseminating information and knowledge in Gerontechnology, a topic that is still considered a specific area of interest for techno-experts (i.e. informatics, engineers, bio-engineers, bio-statistics, etc.) while there is a relatively low diffusion of technological expertise among clinicians and other health professionals who are involved in the care of older people.In many parts of the world, average life expectancy is rising consistently, and at the same time technology is developing at a dramatic pace. This means having completely new options for the diagnosis, treatment and follow-up of diseases and disabilities of older people but also a new challenge to improve the quality of life by promoting an active and healthy aging at population level. This book explores the technical developments that are beginning to change the management of diseases and disabilities of geriatric patients. These include advanced Information and Communication Technologies (ICT), i.e. the new online services in healthcare and electronic medical-health records, Assistive Technologies (AT), i.e. behavior and motility monitoring sensorial tools, smart homes tools and telemedicine tools as well as Human–Computer Interaction technologies (HCI), i.e. robots for supporting people with mobility or cognitive limitations, humanoid robots, exoskeletons and rehabilitation robots. The Work is divided into three main parts: 1) Technology in a world of aging people, 2) Clinical applications of technologies in older people, and 3) Older people and technologies interaction including privacy issues, acceptability of technologies by older people and education and training of healthcare professionals in gerontechnology. The book will be an invaluable tool for geriatricians and other health professionals who are involved in the care of older people.

The book offers a must-have tool primarily for psychiatrists, geriatricians, neurologists, and psychologists, but will also be of interest to general practitioners for first line assessment.The aim of this book is to establish a gold standard: a reference work to be used as a clinical guide to the assessment of mental illness in older persons in the field. Psychogeriatrics is generally a very specific field in the midst of different disciplines, where there is hardly a clinical consensus on how to best assess and treat elderly subjects with mental or behavioral symptoms, possibly resulting from psychiatric disorders. This book provides clear and practical indications, prepared by a panel of international experts in the field with extensive scientific and clinical experience. Boxes with first and second line actions for assessing and treating mental illness in the elderly are included, and all chapters are uniformly divided into sections on epidemiology, etiopathogenesis, differential diagnosis, assessment, and treatment.

The book offers a must-have tool primarily for psychiatrists, geriatricians, neurologists, and psychologists, but will also be of interest to general practitioners for first line assessment.The aim of this book is to establish a gold standard: a reference work to be used as a clinical guide to the assessment of mental illness in older persons in the field. Psychogeriatrics is generally a very specific field in the midst of different disciplines, where there is hardly a clinical consensus on how to best assess and treat elderly subjects with mental or behavioral symptoms, possibly resulting from psychiatric disorders. This book provides clear and practical indications, prepared by a panel of international experts in the field with extensive scientific and clinical experience. Boxes with first and second line actions for assessing and treating mental illness in the elderly are included, and all chapters are uniformly divided into sections on epidemiology, etiopathogenesis, differential diagnosis, assessment, and treatment.

This book explores the transdisciplinary approach to general surgery for the frail patient, promoting the use of a geriatric model of care in general surgical settings and thus proposing a “gerosurgery” approach in frail persons beyond chronological age. Aging, frailty, and surgical needs are increasing dramatically worldwide while surgeons are daily facing with the trouble of the trade-off between short-term outcomes and efficacy of surgery in older persons. However, recent studies have clearly shown that age itself is not a prognostic risk factor for complications after elective surgery in older patients, whereas cognitive or functional frailty is. Neither a referring physician nor an assessing surgeon should deny patients surgery purely based on chronological age. Instead, decisions should be based on a CGA (comprehensive geriatric assessment) with a precise picture of the patient considering the cognitive, functional, nutritional, socioeconomic, and affective status. Recent studies examining the use of preparative CGA in surgical patients showed encouraging results on postoperative outcomes in old and/or frail patients. The most compelling current evidence comes from the orthopaedic community, which has embraced the idea of multidisciplinary team care. Preoperative evaluation, postoperative care, pain control, nutritional support, delirium prevention, mobilization, and rehabilitation are necessary also in general surgery. An expert multidisciplinary team, including geriatricians, anaesthesiologists, specialist nurses, physiotherapists, and nutritionists should mandatorily support surgeons.With this book, the reader will have an exhaustive overview and will gain essential, practical knowledge on how best to manage the surgical and frail patient and how to develop clinical systems that do so reliably.

This book explores the transdisciplinary approach to general surgery for the frail patient, promoting the use of a geriatric model of care in general surgical settings and thus proposing a “gerosurgery” approach in frail persons beyond chronological age. Aging, frailty, and surgical needs are increasing dramatically worldwide while surgeons are daily facing with the trouble of the trade-off between short-term outcomes and efficacy of surgery in older persons. However, recent studies have clearly shown that age itself is not a prognostic risk factor for complications after elective surgery in older patients, whereas cognitive or functional frailty is. Neither a referring physician nor an assessing surgeon should deny patients surgery purely based on chronological age. Instead, decisions should be based on a CGA (comprehensive geriatric assessment) with a precise picture of the patient considering the cognitive, functional, nutritional, socioeconomic, and affective status. Recent studies examining the use of preparative CGA in surgical patients showed encouraging results on postoperative outcomes in old and/or frail patients. The most compelling current evidence comes from the orthopaedic community, which has embraced the idea of multidisciplinary team care. Preoperative evaluation, postoperative care, pain control, nutritional support, delirium prevention, mobilization, and rehabilitation are necessary also in general surgery. An expert multidisciplinary team, including geriatricians, anaesthesiologists, specialist nurses, physiotherapists, and nutritionists should mandatorily support surgeons.With this book, the reader will have an exhaustive overview and will gain essential, practical knowledge on how best to manage the surgical and frail patient and how to develop clinical systems that do so reliably.

This second edition offers an important update on the principles and practice of multidimensional assessment and management of the older individual, which represent the cornerstone of modern clinical practice in older people.During the last eight years a great number of scientific data and clinical experiences have consolidated the information on the usefulness of a CGA-based multidimensional approach to older people in different clinical settings and with specific clinical conditions. Moreover, during this period important innovations have occurred in this scientific and clinical area, i.e. i)  the recognition that CGA is a key clinical method for the assessment and management of the older people in geriatric and also in non-geriatric setting; ii) the publication (in 2023 and 2024) of the first Guidelines on CGA by the National Health Authorities of Italy and Germany; iii) the implementation in clinical practice of ICT and digital technologies (including AI) that can potentially modify assessment tools and interpretation of CGA in clinical practice.For all these reasons the publication of an updated second edition is fundamental.In this 2nd new Edition of the Book all chapters have been updated with five chapters completely renewed by new authors. In addition four completely new chapters have been included in the Book that now includes 19 chapters (instead of 15 chapters of the first edition).   The book, written by the best known and widely published experts in their respective fields, will be relevant to students, scholars and a wide range of clinicians.

This book clearly explains when and how different rehabilitation techniques should be applied in the aging patient, thereby enabling readers to identify and apply those rehabilitation strategies that will maximize quality of life and functional independence in individual cases. It is specifically designed for ease of consultation and rapid retrieval of the information most relevant to clinical practice. Prominence is given to the benefits of a multidisciplinary approach to rehabilitation, with discussion of a very wide range of aspects of rehabilitation in different disease settings. The breadth of coverage is illustrated by the attention paid to less commonly addressed topics such as visual and hearing rehabilitation, the role of robotics and 3D imaging techniques, variations in approach among health care systems, and rehabilitation in end-of-life care. The authors are international academic experts in their fields, guaranteeing a high scientific standard throughout. This manual will be an invaluable tool and source of knowledge for geriatricians and physiatrists but will also appeal to a wider range of clinicians, practitioners, and students.

This textbook presents hands-on training material for medical students. The style reflects the need for practice-based teaching with a modern edge in daily clinical routine; accordingly, it also employs online material and pocket cards. Each chapter begins with specific learning objectives, which are cross-referenced with the European curriculum for undergraduate medical education released by the European Union of Medical Specialists (UEMS) together with the European Union Geriatric Medicine Society (EUGMS), as well as the minimum geriatric competences for medical students established by the American Geriatrics Society (AGS).  World-renowned European experts in practicing and teaching the interdisciplinary field of Geriatrics contributed to this work, with the aim of offering the new generation of health professionals a global perspective on one of the greatest public health challenges of our time: the management of the steadily increasing number of older, multimorbid, and vulnerable persons.  The major strength of this book – published under the auspices of the EUGMS – is its pragmatic, goal-oriented approach, which makes it suitable for bedside learning and patient-centered medicine; further, all of the chapters are firmly based on the pillars of the ageing process in all of its biological aspects, helping readers understand the pathophysiology of and rationale behind interventions for the main geriatric syndromes and disorders.

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.