Index

A

Absorptionmetry techniques, 86-88, 95-97

Acquired immune deficiency syndrome (AIDS), 71

Acromegaly, 91

Activities of Daily Living, 26, 160, 225, 269

Acute care, 23-24, 25

Adrenergic receptors, 59

Advertising, cigarette, 199

Affective disorders. See Depression

Age.

See also Elderly

and bone loss, 83, 89-91, 94

and calcium absorption, 90

and cancer screening, 148

and cardiovascular risk, 174

and drug effects, 59, 60

and falling, 82, 84, 264, 266, 275

and fractures, 78, 79

and high blood pressure, 34-35, 38, 40, 42

and infections, 65

and muscle impairment, 229

and nutrition requirements, 161

and oral diseases, 120, 121, 124

and physical inactivity, 225, 226, 228, 229

and renal and hepatic function, 54

and risk of cancer, 121, 137

and sensory loss, 101

Aging, attitudes toward, 210-211

Aging Population in the Twenty-first Century: Statistics for Health Policy, 26

Alameda County Study, 13-14, 228, 249-250

Alcohol use, 172

and bone loss, 92-93

offset effect and, 213

and oral diseases, 121, 127, 131

and osteoporosis, 95

and risk of cancer, 171

Alphamethyldopa, 39, 43

Alzheimer's disease, 109, 126, 216, 246

Amantadine, 68, 69, 71

American Arthritis Foundation, 180

American Association of Retired Persons, 180

American Cancer Society, 180

American College of Physicians, 67

American College of Sports Medicine, 232

Amputation, 177, 183

Angina, 250

Anthropometry, 162

Antibiotics, 66-67, 71

Anticonvulsant use, 91

Anticoronary Club of New York, 178



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The Second Fifty Years: Promoting Health and Preventing Disability Index A Absorptionmetry techniques, 86-88, 95-97 Acquired immune deficiency syndrome (AIDS), 71 Acromegaly, 91 Activities of Daily Living, 26, 160, 225, 269 Acute care, 23-24, 25 Adrenergic receptors, 59 Advertising, cigarette, 199 Affective disorders. See Depression Age. See also Elderly and bone loss, 83, 89-91, 94 and calcium absorption, 90 and cancer screening, 148 and cardiovascular risk, 174 and drug effects, 59, 60 and falling, 82, 84, 264, 266, 275 and fractures, 78, 79 and high blood pressure, 34-35, 38, 40, 42 and infections, 65 and muscle impairment, 229 and nutrition requirements, 161 and oral diseases, 120, 121, 124 and physical inactivity, 225, 226, 228, 229 and renal and hepatic function, 54 and risk of cancer, 121, 137 and sensory loss, 101 Aging, attitudes toward, 210-211 Aging Population in the Twenty-first Century: Statistics for Health Policy, 26 Alameda County Study, 13-14, 228, 249-250 Alcohol use, 172 and bone loss, 92-93 offset effect and, 213 and oral diseases, 121, 127, 131 and osteoporosis, 95 and risk of cancer, 171 Alphamethyldopa, 39, 43 Alzheimer's disease, 109, 126, 216, 246 Amantadine, 68, 69, 71 American Arthritis Foundation, 180 American Association of Retired Persons, 180 American Cancer Society, 180 American College of Physicians, 67 American College of Sports Medicine, 232 Amputation, 177, 183 Angina, 250 Anthropometry, 162 Antibiotics, 66-67, 71 Anticonvulsant use, 91 Anticoronary Club of New York, 178

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The Second Fifty Years: Promoting Health and Preventing Disability Antidepressant medication, 129, 206, 208-209, 210, 219 Antihypertensive medication adverse effects of, 42-44, 206 benefits of, 38-40 and risk of falls, 272, 281 Arrhythmias, 208 Arthritis, 36 drug treatment of, 56-57 and hearing impairment, 107 and risk of falls, 271, 272 Asians bone mass, 85 fracture risk, 94 Aspirin, 57 Atherosclerosis, 168, 176, 184 Australian Trial on Mild Hypertension, 38, 39, 40 B Baby boom cohort, 11 Bacteremia, 65, 66, 69, 71 Balance and gait training, 276 Bantu people, fracture rates, 85 Baroreceptor reflex, 42 Barthel Index, 164 Beck Depression Inventory, 217 Behavioral changes, and prevention of falls, 277-278 Behavioral Risk Factor Surveillance System, 225 Benfluorothiazide, 39 Benzodiazepines, 54 and cognitive function, 59 and risk of falls, 272 Bereavement, 210, 217-218, 254 Beta-blockers, 39, 42, 59 Bioethicists, 31 Blacks bone mass, 85 cancer screening and, 149 fracture risk, 94 glaucoma and, 104 high blood pressure in, 34, 35, 36, 47 physical inactivity, 227, 228 sodium sensitivity, 44 Blindness causes of, 104, 105, 177 prevalence of, 102 prevention of, 111 Bone loss, 76 age-related, 89-91, 94 hypogonadal, 86-89 risk factors for, 85, 91-93 therapies, 89, 94, 280 Bone mass, 85 and fractures, 82-84, 92-93, 274 measurement, 86-88, 95-97 screening tests, 93 therapies, 89, 91, 275 Bone pain, cancer, 140 Boorse, Christopher, 302 Breast cancer estrogen therapy and, 89 impairment, 140 prevalence, 139 screening, 136, 141-143, 147, 148, 149, 150 British Medical Research Council, 45 Bronchitis, 66 Butler, Robert, 113 C Caffeine, 171 Calcitonin, 89 Calcium, and bone loss, 89, 90, 94, 171 Canadian Task Force on the Periodic Health Examination, 16 Cancer breast, 89, 139, 141-143 diet and, 158, 168 estrogen and, 89 impairment, 140 incidence and mortality, 137-140 lung, 194, 198 oral, 119, 121, 127, 130 risks for, 78, 231 screening, 130, 136-137, 141-151 smoking and, 171, 193, 194-195, 196 surgery, 163 therapy, 126, 136 Carbohydrates, 170-171 Cardiovascular disease, 46, 172 cholesterol and, 57 diet and, 173 estrogen and, 58, 89 morbidity and mortality, 35, 38-42, 45-46 physical activity and, 179 risk factors, 33, 166, 174, 176, 177 smoking and, 195, 196 Cardiovascular system, oxygen delivery, 229 Caries, 120, 121-122, 124 prevention of, 128 radiation, 126 research on, 131

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The Second Fifty Years: Promoting Health and Preventing Disability Carter Center Health Policy Project, 14 Case-control studies, 137 Cataracts, 103-104, 111, 112, 218, 272 Catastrophic Health Care Program, 292-293 Centers for Disease Control, 14, 67, 224, 225 Cerebral perfusion, 42-43 Cerebrovascular disease, 41, 172 morbidity and mortality, 38, 38, 45-46 Cervical cancer screening, 144-145, 147, 148 Chewing disorders, 119 Children health care policy and, 296 social supports and, 253 Chlorothiazide, 39 Chlorthalidone, 39 Cholesterol levels, 35, 43 reduction, 57, 173, 174-176, 185 screening, 173-174 Chronic illness prevention, 12, 25 Chronic obstructive lung disease, 91, 193, 194 Cognitive-behavioral therapies, 210 Cognitive impairment, 184 diabetes and, 177 diet and, 158 medications and, 44, 59 and risk of falls, 272, 281 sensory loss and, 107, 109, 112 Colon and rectal cancer, 139-140, 145, 150-151, 230-231 Community intervention, exercise programs, 235 Comprehensive Assessment and Referral Evaluation, 108 Connective tissue diseases, 123 Cooper, A. F., 108 Coronary Artery Surgery Study, 195-196 Coronary heart disease cholesterol and, 174-175 diet and, 158, 166 exercise and, 231, 232 high blood pressure treatment and, 41 morbidity and mortality, 36 risk factors, 14, 248 smoking and, 193, 194, 195 social supports and, 250 Corticosteroid use, 91 Cost-effectiveness dietary cholesterol reduction, 175 estrogen therapy, 88 exercise programs, 236-237 high blood pressure treatment, 45 Costs bone mass measurement, 96, 97 dental services, 126-127 depression, 210, 211-213 drug-induced disability, 55-56, 59-60 falls, 268-269, 282 health care, 11-12, 36, 182, 211, 235, 291-294, 296, 297 infections, 66, 67, 68 nutrition-related diseases, 166 osteoporosis, 76, 81-82 social isolation, 246-247 Council on Health Fraud, 180 Cushing's disease, 91 D Deafness, 109 Decubitus ulcers, 70 Dementia, 36, 109 Dentures, 124-125, 164 Depression, 42, 80 age and, 59 costs of, 211-213 definition and prevalence, 202-204 and nutritional status, 168 recommendations, 217-219 risk factors for, 205-206 and risk of falls, 272 sensory loss and, 107, 108, 109, 112 and suicide, 213-215 treatment of, 206-211, 215-217 Descartes, René, 315-317 Diabetes mellitus, 92 and exercise, 232 nutrition and, 168, 177-178, 184 Diabetic nephropathy, 176 Diabetic retinopathy, 103-104, 105, 177 Diabetics, 115 glaucoma and, 104 oral infection and, 126 physical limitations, 231 Dialysis, 176, 293 Diastolic blood pressure, 33, 34, 35, 38, 45-46 treatment of, 40, 42, 44-45, 46-47 Diet, 159, 193 calcium in, 90 cholesterol reduction, 174, 175 and drug metabolism, 179 and nutritional status, 161-162 and oral health, 126 vitamin D in, 90-91

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The Second Fifty Years: Promoting Health and Preventing Disability Dietary status, 157, 160-161 Dietary therapies, 172, 176 Digestive system, 164 Disability cancer, 140 classification of, 22-31, 316, 318 drug-induced, 55-56, 58, 59 falls, 268 fracture-related, 94 nutrition and, 165-166, 170-171 oral, 120 osteoporosis, 78-81 prevention of, 15-16, 53 sensory loss, 107-111, 112, 114 Disease classification of, 24, 28, 316 consequences of, 314-317, 318 definition of, 300-305, 316 prevention, 15 social isolation and, 248-249, 250-251, 252-253 Disease model of care, 23-25, 26, 28, 303, 306-308 Disuse atrophy, 179, 225 Diuretics, 41, 42, 44 and risk of falls, 272, 281 Driving, 110 Dual-energy x-ray absorptiometry, 86-88, 96-97 Dual-photon absorptiometry, 86-88, 95, 96 Duke Longitudinal Study, 196 Dysgeusia, 179 Dysphoria, 218 E Ecologic studies, 137 Education cancer screening, 151 depression, 219 exercise programs, 239 falls, 282-283 infections, 72 medication use, 60-62 nutritional, 185 oral health, 131-132 osteoporosis, 94-95 social isolation, 258-259 Efficacy, cancer screening, 141-150 Elderly anthropometry and, 162 and cancer screening, 148, 149-150 chewing disorders, 119 cholesterol and, 173, 175 demographics, 11, 82, 295-296 depression in, 202, 203-204, 207, 218 falls, 263, 264-265, 274, 275 health care costs and, 211, 291-292 health care rationing and, 292, 294-298 health care utilization, 22, 256, 314 health promotion and disability prevention, 12-17, 23, 308 high blood pressure in, 33-34, 35, 36, 37, 40, 42-43, 44 infections and, 65-66, 67-68, 71 medication use, 53-55, 56-59, 60, 61, 172, 178, 179, 276 nutritional assistance, 169, 174, 181-184 nutrition fraud and, 167, 180 physical inactivity, 224, 231, 232-233, 238 and sensory loss, 114 smoking rate, 194 social isolation, 246, 254, 256, 257, 259 suicide risk, 214-215 vitamin D deficiency in, 90-91 Electroconvulsive therapy, 209-210, 219 Electrolyte disturbance, 208 Emotional state, 27, 44 End Stage Renal Disease Program, 293-294 Environmental factors, in falls, 274, 277, 280 Estrogen, and breast cancer, 143 Estrogen replacement therapy (ERT), 58, 86, 88-89, 94, 171, 185 Etiology, 28 caries, 122 hearing impairments, 105-107 visual impairments, 103-105 European Working Party on Hypertension in the Elderly, 38, 39, 43, 45 Evolution, 302 Exercise, 44, 224, 231, 232-235 cost-effectiveness of, 236-237 and prevention of falls, 275-276, 280, 284 recommendations, 237-240 F Falls, 263-264 costs of, 268-269 determinants of, 269-275 and fractures, 42, 82, 84-85, 265-267, 268, 274-275 frequency of, 267-268

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The Second Fifty Years: Promoting Health and Preventing Disability mortality, 78, 264-265 preventability of, 85, 269, 273, 275-280 recommendations, 280-284 Families, social support, 258-259 Fecal occult blood testing, 145, 149, 150-151 Federal Trade Commission, 180 Fever, 71 Fluorides, 89, 128, 130, 131 Foley catheters, 70 Food and Drug Administration, 61, 184 and health fraud, 179, 180 Food programs, 181-184 Fractures, 79, 263, 265-267, 268 costs of, 81-82 determinants of, 82-85 menopause and, 86 morbidity and mortality, 77-78 prevention, 88-89 recommendations, 93 risk of, 76, 94, 274 Framingham Eye Study, 104 Framingham Heart Study Cohort, 102-103 Framingham studies, 13-14, 34, 35, 173, 195, 250 Friendly Visitor Program, 254 Functional limitations, 27 medications and, 57-58, 60 nutrition and, 160 tooth loss, 125 G Gastel, Barbara, 113 Gastrectomy, 91 Gastrointestinal disorders, 168 Geiger, H. Jack, 298-299 Gender and fractures, 79 and high blood pressure treatment, 38 Geriatric Depression Scale, 217 Gingivitis, 128 Glaucoma, 103-104, 111, 115, 218 Gonadal function, 86 H Handicaps, 28, 29-30 Harvard Alumni Study, 228, 229 Health burden cancer, 137-140 depression, 202-204 falls, 264-269 high blood pressure, 34-36 infections, 65-66 malnutrition, 166-167 medication use, 55-59 oral health problems, 120-126 osteoporosis, 77-82 physical inactivity, 225-231 smoking, 194-196 social isolation, 246-251 Health care, 317-318 costs, 11-12, 36, 182, 211, 235, 291-294, 296, 297 demedicalization of, 296 disease model of, 23-25, 26, 28, 303, 306-308 goals of, 23-24, 298-300, 305, 313-314 rationing, 292, 294-298 technologies, 293-294, 296 utilization by the elderly, 22, 256, 314 Health Care Financing Administration, 16, 68 Health insurance blood pressure screening reimbursement, 47 lack of, 291 national, 295 psychiatric care reimbursement, 215-216, 217 Health Insurance Plan of Greater New York, 143 Health interview surveys, 25-26 Health maintenance organizations, 80 Health Objectives for the Nation: Year 2000, 14, 247, 249 Health professionals, 13, 298-299. See also Physicians and disability classification, 22, 23, 27, 31 and exercise programs, 239 and medications, 60-61 and oral health, 130 and sensory loss, 114-115 and social supports, 258 Health promotion and disability prevention, 12, 13, 14, 15, 17, 25 , 57, 308, 311, 313, 314 Healthy People (USDHEW), 183 Hearing aids, 112 Hearing Handicap Inventory for the Elderly, 112 Hearing impairments, 101, 102-103 disabilities, 107-110, 112 etiology, 105-107 prevention, 111-112, 115 Hepatic function, age and, 54

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The Second Fifty Years: Promoting Health and Preventing Disability Hepatitis, 65 immunization, 15-16 Herpes virus, 121 High blood pressure, 33-36 and life expectancy 175 nonpharmacologic therapy, 44, 47, 172, 184 nutrition and, 158, 167-172, 176 pathophysiology, 36 prevalence of, 33, 34-35 screening, 36-37, 46, 47 treatment of, 16, 35, 37-45, 46-47, 56, 57-58 Hip (femur) fractures, 28, 58, 77, 78-80, 81, 82, 83-84, 264, 265-266, 267 calcium and, 90 fluoride and, 89 prevention of, 86, 88 smoking and, 92-93 visual impairment and, 110 Hispanics fracture risk, 85, 94 mental health care and, 211 Honolulu Heart Program, 251 Hospitalization costs, 81, 213, 235 diabetes education and, 177-178 drug-induced, 55, 58 falls and fractures, 77, 80, 81, 266-267, 268 and infection, 65 Medicare coverage, 215 and nutrition, 183-184 suicide prevention, 215 Housing developments, 256 Hydrochlorothiazide, 39 Hypercholesterolemia, 173-176 Hyperlipidemia, 166, 168, 173 Hyperopia, 105 Hypertension Detection and Follow-up Program, 36-37, 38, 39, 40, 43 Hyperthyroidism, 91 Hypertriglyceridemia, 176 Hypogonadal bone loss, 83, 86-89 Hypokalemia, 42 Hyponatremia, 42 Hypopituitarianism, 91 Hypothyroidism, 208 I Illness behavior, 29 Immune system, 65, 253-254 Immunizations, Medicare reimbursement, 15-16 Impairment, disability, and handicap, 28-30. See also Disability cancer, 140 drug-induced, 59 nutritional, 165-166 oral, 120, 121-126 physical inactivity, 228-231 social isolation, 247-251 visual and hearing, 101-107 Incontinence, 58, 272 Infections, 65-66, 123-124 influenza, 67-69 nosocomial, 69-70 pneumococcal disease, 66-67 recommendations, 71-72 Influenza, 65, 67-69, 70 Injuries, from falls, 265-267, 274-275 Injury in America, 77-78, 93, 282 Institute of Medicine, 14, 77-78, 172, 282 Division of Health Promotion and Disease Prevention, 16 Committee on Health Promotion and Disability Prevention for the Second Fifty, 12-13, 30 Instrumental Activities of Daily Living, 26, 110, 160 Insurance private, 47, 215-216, 291 social, 25, 26 INSURE project, 16 International Classification of Diseases, 28, 282 International Classification of Impairments, Disabilities, and Handicaps , 22, 27-31, 228, 230, 247, 249, 311, 313, 314-317 Intraocular pressure, 104, 111 Ischemic heart disease, 38 Isoniazid prophylaxis, 70, 71 J Johns Hopkins Hearing and Speech Clinic, 108-109 Johnson and Johnson Live for Life project, 235 K Katz index, 164 Kenney system, 164 Koop, C. Everett, 295 Kuhn, Thomas, 317-318

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The Second Fifty Years: Promoting Health and Preventing Disability L Leukoplakia, 121 Life expectancy, 11 cancer screening and, 149 cholesterol reduction and, 175 estrogen therapy and, 88 high blood pressure and, 172 indices of, 164 men, 11 nutrition and, 158 physical activity and, 231, 233 smoking and, 194, 195, 196 women, 11, 148 Lipid-lowering therapy, 57 Lipophilic medications, 54 Lithium, 54 Longitudinal studies, 13-14, 113, 238 Long-term care facilities admissions, ambulation and fractures, 80 costs, 81, 82, 215 and depression, 204 falls in, 268, 269 infections in, 65, 69, 70, 71 medications in, 60, 61-62, 276 mental health screening, 216 nutrition in, 158-159, 182, 183, 184 quality of life in, 307 Lung cancer, 140 screening for, 146, 151 smoking and, 136, 194, 198 M Macular degeneration, 103-105, 111, 115 Malnutrition, 157-158, 171, 299 diseases and, 165-166, 167, 168-169 health effects of, 183-184 long-term care facilities and, 183 Mammography, 136, 143, 147, 149, 150 Marital status, 250 Massachusetts Health Care Panel Study, 110 Meals on Wheels, 181-182, 184 Medicaid, 11, 59-60, 215, 295 Medicare, 11-12, 15-16, 17, 295, 314 blood pressure screening reimbursement, 47 Catastrophic Health Care Program, 292-293 End Stage Renal Disease Program, 293-294 and nutritional assessments, 184 psychiatric care coverage, 215, 217 vaccination reimbursement, 67, 68, 72 Medications, 53-55, 172 adverse reactions, 55, 58-59, 60, 62 antidepressant, 129, 206, 208-209, 210, 219 antihypertensive, 38-40, 42-44, 206, 272, 281 disability effects, 56-62 and nutrition, 164-165, 178 and oral health, 125-126 osteoporosis, 82 over-the-counter, 59 prescribing practices, 54, 56, 59-60, 61, 89, 277 and risk of falls, 272, 276-277, 280, 281, 284 and sensory impairment, 115 side effects, 42, 43, 53, 61, 119, 123-124, 179, 208-209 toxicity, 42, 43, 57, 208 Melanoma, 145-146 Men, 254 bone loss, 85, 86, 91-92 calcium RDA, 90 cholesterol reduction, 174, 175 fractures, 77, 78, 86 hearing impairments, 102 high blood pressure, 35 life expectancy, 11 oral cancer and, 121 risk of falls, 264, 266-267 social isolation, 250 suicide prevention, 215 Meningitis, 66 Menopause and bone loss, 83, 86, 93 and breast cancer, 143 and cholesterol levels, 174 Mental health services, 211, 314 Mercury sphygmomanometer blood pressure measurement, 37 Meta-analysis, 42 Mind/body paradox, 249, 315 Mini-Mental State Examination, 217 Minorities, 211, 233. See also Blacks; Hispanics Monoamine oxidase inhibitors, 209 Morbidity and mortality cancer, 121, 136-140, 141-143, 144, 146, 147, 151 cardiovascular, blood pressure and, 35, 36, 45-46 cardiovascular, treatment and, 38-42, 56 cholesterol levels and, 174-175 depression therapy and, 210

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The Second Fifty Years: Promoting Health and Preventing Disability falls, 264-265 infections, 66, 67-68, 69 medications and, 53, 54 nutrition and, 158, 162-164, 166 osteoporosis, 77-78 social isolation and, 247-248, 249-250 physical inactivity and, 228, 229 smoking, 195, 196 suicide, 213 technology improvements and, 296 Multiple Risk Factor Intervention Trial, 173 Muscle impairment, 229-230 Myeloma, 91 Myocardial infarction, 41, 176, 250 N Nagi system, 27 National Cancer Institute, 14 National Center for Health Statistics, 36, 109-110 National Cholesterol Education Program Adult Treatment Panel, 173 National health insurance, 295 National Health Interview Survey, 102, 194, 225, 227, 267, 268, 269 National Health and Nutrition Examination Survey (NHANES), 14, 34 -35, 104, 181 National Heart, Lung and Blood Institute, 33 National Institute on Aging, 113, 218 National Institute of Mental Health, 255 Program on Mental Health of the Aging, 218 National Institutes of Health, 14-15, 132, 280, 293 Committee of Prevention Coordinators, 16 National Research Council, 26, 77-78, 161-162, 185, 282 National Survey of Black Americans, 227 Neuroendocrine mechanisms, 252 Neuroleptics, 59 Neurological problems, 126 New England Deaconess Hospital, 163 Nicotine gum, 197, 198 Nonpharmacological treatment, 44, 47, 172, 184 Nonsteroidal anti-inflammatory drugs (NSAID), 56-57 Normativism, 301-303, 304, 305 Nosocomial (hospital-acquired) infections, 65, 66, 69-70, 71 Nursing homes. See Long-term care facilities Nutritional Programs for Older Adults, 182 Nutritional quackery and fraud, 166-167, 179-180, 184 Nutritional Risk Index, 164-165 Nutritional status, 157-158 dietary indices of, 161-162 food programs and, 181-184 functional indices of, 159-161 oral health and, 180-181 prognostic indicators, 162-164 and quality of life, 158-159 recommendations, 184-185 relation to diseases, 166-178 risk screening, 164-165 O Office of Technology Assessment, 104, 111 Offset effects, 212-213 Omnibus Budget Reconciliation Act (1987), 216 On Lok project, 16 Oophorectomy, 86 Oral cancer, 121, 126 prevention of, 127, 130 screening, 146 Oral health problems, 119-126 nutrition and, 168, 170-171, 180-181 prevention of, 126-130 recommendations, 130-132 Organ and tissue transplantation, 294 Orofacial pain, 119, 126, 128-129 Osteoarthritis, 56-57, 169 Osteoblasts, 89-90, 93 Osteoporosis, 28, 30, 58, 76 costs of, 81-82, 268 determinants of fractures, 82-85, 263, 265 disability, 78-81 morbidity and mortality, 77-78 nutrition and, 169, 171, 184 physical activity and, 179 preventability of, 85-93 recommendations, 93-95 screening tests, 88, 95-97 secondary, 83, 91-93 smoking and, 196 Otitis media, 107

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The Second Fifty Years: Promoting Health and Preventing Disability Oxygen delivery, 229 Oxygen uptake, 230, 232, 233 P Papilloma, 121 Pap testing, 144-145, 147, 149, 150 Parkinson's disease, 272 Parsons, Talcott, 303 Passive smoking, 198 Pathology, 28 Pemphigus, 121 Perfusion, blood pressure and, 42-43 Periodontal disease, 119, 120, 122-123, 124, 126, 128 Peripheral arterial disease, 195 Pharmaceutical industry, 61, 69, 219 Physical functioning, 44 Physical inactivity, 179, 224-225 and bone loss, 89, 91 cost-effectiveness of interventions, 236-237 and falls, 275-276 impairment, disability, and handicap, 228-231 nutrition and, 161, 170, 173, 184 prevalence of, 225-228 preventability of burden, 231-235 recommendations, 237-240 Physical work capacity, 230 Physicians, 30, 47, 303. See also Health professionals and exercise programs, 233 and kidney disease, 293 prescribing practices, 54, 56, 59-60, 61, 89, 277 and smoking cessation, 197, 198 and treatment of depression, 207, 210, 217-218, 219 Pneumococcal disease, 66-67, 70 vaccines, 15-16, 66-67, 69, 71, 72 Pneumonia, 65, 66, 68, 69 Polar drugs, 54 Polypharmacy, 170, 179 Prepayment arrangements, 16 Presbycusis, 105-107, 112 Preventive interventions cancer, 136-137, 141-146 diabetes mellitus, 177-178 falls, 263, 275-280, 282-283 high blood pressure, 167-172 hypercholesterolemia, 173-176 hypertriglyceridemia, 176 nutritional, 167-178 oral diseases, 126-130 osteoporosis, 76, 85-93 physical inactivity, 231-235 sensory loss, 105, 111-113 social isolation, 252-255 suicide, 214-215 smoking, 193-194 renal disease, 176 research on, 15-16 weight reduction, 178 Primary prevention, 23-24 Professional societies, 114 Progesterone, 89 Progestins, 185 Prognostic Nutritional Index, 163 Prospective payment, 80 Prostate cancer, 140 screening, 146, 151 Prozac, 209 Psychiatric illnesses, 108-109, 203 treatment, 213, 215 Psychoactive drugs, 58, 59, 60 Psychoses, 107, 108, 126 Psychosocial therapies, 210-211 Psychosomatic medicine, 249 Psychotropic drugs, 276-277 Public health interventions, 235, 236 Public policy, 26, 301, 302 depression, 217, 218 exercise programs, 239-240 health care rationing, 292, 294-298 high blood pressure, 47 medications, 61-62 oral health, 131 osteoporosis, 94-95 sensory loss, 113-114 smoking, 198-199 Public transportation, 110 Pulmonary function, 230 Pure tone audiometry, 111-112 Q Quality-adjusted life year (QALY), 58, 88-89 Quality of life, 17, 26, 147, 305-306, 307 depression and, 202-203 fractures and, 80 hypertension therapy and, 43-44 infections and, 65 medications and, 53, 58 nutrition and, 158-159, 182 oral health and, 131 sensory loss and, 110-111 Quantitative computed tomography, 86-88, 95, 97

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The Second Fifty Years: Promoting Health and Preventing Disability R Race and bone mass, 85 and fractures, 78 and hearing loss, 103 high blood pressure and, 34, 38 and vision loss, 104 Radiation caries, 126 RAND Corporation, 211-212 Randomized controlled trials, 59, 114, 276, 280 high blood pressure treatment, 39, 40-41, 42, 46 Reagan, Ronald, 292 Receptors, age and, 54-55 Recommendations cancer screening, 150-151 depression, 217-219 falls, 280-284 high blood pressure treatment, 46-47 infections, 67, 68-69, 70, 71-72 medications, 60-62 nutrition, 184-185 oral health, 130-132 osteoporosis, 93-95 physical inactivity, 237-240 sensory loss, 113-115 smoking, 198-199 social isolation, 256-259 Recommended daily allowances, 90 Recommended Dietary Allowances, 161-162 Rectal cancer, 139-140, 145, 150-151 Rehabilitative therapies, 276 Reimbursement, 59-60 blood pressure screening, 47 psychiatric care, 215-216, 217 vaccination, 67, 68, 72 Relaxation therapy, 44 Renal function, 42, 54 End Stage Renal Disease Program, 293-294 nutrition and, 168, 176 Renin levels, 36 Research, 12, 13-15, 17, 18 cancer screening, 150-151 depression, 216-217, 218-219 drug effects, 58 exercise, 233-235, 238 falls, 272, 280-282, 284 high blood pressure, 47 infections, 72 medications, 60 nutrition, 184 oral health, 130-131 osteoporosis, 93-94 sensory loss, 113-114 smoking, 199 social support, 257-258 Reserpine, 39 Respiratory infections, 65 Retirement communities, 256 Rimantadine, 69 Risk factors, 13-15, 16, 17-18 blood pressure, 45-46 for bone loss, 85 for cancer, 127, 137 cardiovascular, 35-36, 166, 173 for caries, 122 for depression, 205-206 for falls, 84, 263, 269-274, 278-279, 281 for fractures, 82, 84, 89 infections, 65-66, 67, 69, 71 nutrition and, 167, 173 for osteoporosis, 91-93, 94 social isolation, 243, 248-249, 252, 256, 257 S Salivary gland dysfunction, 120, 123-124, 125-126 Salmonella, 65, 70 Screening blood pressure, 36-37 bone mass, 93 cancer, 136-137, 141-151 cholesterol, 173-174 glaucoma, 115 hearing impairment, 111-112 mental health, 216 nutritional, 164-165, 184 oral cancer, 127, 130 osteoporosis, 88, 95-97 triglyceride, 176 visual impairments, 111 Secondary osteoporosis, 83, 91-93 Secondary prevention, 111, 136 Select Committee on Aging, 179-180 Self-reports, 26 Seneca, Lucius Annaeus, 11 Sensory loss disabilities, 107-111 etiology, 103-107 and falls, 280 prevalence, 101-103 prevention of, 111-113 recommendations, 113-115

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The Second Fifty Years: Promoting Health and Preventing Disability Services cancer screening, 150 depression, 217-218 exercise programs, 237-238 falls, 282-283 high blood pressure, 46 infections, 71 medication use, 60 nutritional, 184-185 oral health, 130 osteoporosis, 93 smoking, 198 social isolation, 256-257 Sexuality, and depression, 206 Sialoadenitis, 123 Sigmoidoscopy, 145, 147, 150-151 Single-photon absorptiometry, 86-88, 95, 96 Sjogren's syndrome, 123 Skin cancer screening, 145-146, 147, 150 Sleep disorders, 126, 206 Smoking, 131, 136, 177, 193-194 benefits of quitting, 175, 196-97 cessation techniques, 197 health effects, 194-196 and nutrition, 164, 169, 171 and oral diseases, 121, 127 and osteoporosis, 95 passive, 198 prevalence, 194 recommendations, 198-199 risk factor for bone loss, 92-93 Social insurance programs, 25, 26 Social interaction, 44, 123 Social isolation, 14 costs of, 246-247 defining, 243-244 and depression, 206 impairment, disability, and handicap, 247-251, 257 measuring, 244-246 prevalence of, 246 preventability of burden, 252-255 recommendations, 256-259 sensory loss and, 107-108, 112 Social Readjustment Rating Scale, 245 Social stressors, 205-206, 248 Socioeconomic status, 14, 213, 233 Sodium, 36, 44, 172 Sodium fluoride, 89 Stair use, 235, 236 Staphylococcus aureus, 70n Streptoccus pneumoniae, 66 Stress, 248, 257 Stroke hypertension and, 35, 38, 45, 56, 167 nutrition and, 158, 169 and risk of falls, 272 smoking and, 193, 194, 195 Structure of Scientific Revolutions, The (Kuhn), 317-318 Suicide, depression and, 205, 213-215 Surgery cancer, 140 malnutrition and, 163 visual impairments, 112 Surveillance, Epidemiology, and End Results (SEER) program, 137, 139 Systolic blood pressure, 33, 34, 35, 38, 45-46 Systolic/diastolic hypertension, 33, 34, 35, 36, 43, 45-46 treatment of, 37, 38-40, 44-45 Systolic hypertension, isolated, 33, 34, 35, 36, 45-46, 47 treatment of, 40-41, 45 Systolic Hypertension in the Elderly Program, 41 T Tecumseh County Health Survey, 250 Temporomandibular joint dysfunction, 126 Tetanus vaccine, 70 Thiazides, 43, 58 Three-Generation Black Family Study, 227 Thyroid disease, 107 Tinnitus, 57 Tooth loss, 77, 119, 120, 121, 122, 124-125, 181 Trauma bone, 82, 84-85 tooth, 123 Trazadone, 209 Treatment. See also Medications adverse drug reactions, 55, 58-59, 60, 62 antibiotic, 66-67 bone loss, 94 cancer, 126, 136 depression, 202, 206-211, 215-216, 217, 219 high blood pressure, 35, 37-45, 46-47, 172 influenza, 68 nutritional, 160 nonpharmacological, 44, 47, 172, 184 vision loss, 105

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The Second Fifty Years: Promoting Health and Preventing Disability Triamterene, 39, 43 Tricyclic antidepressants, 208-209, 210 Triglyceride screening, 176 Tuberculosis, 23, 65, 71 U Ultrasound screening, 151 United States cancer prevalence, 139 falls, deaths and injuries, 264, 265-266 dental care costs, 126-127 Department of Health, Education, and Welfare, 193 elderly population, 11, 82, 295-296 health care costs, 291-298, 305, 306 oral cancer deaths, 121 osteoporosis fractures, 76 smoking prevalence, 194 social insurance programs, 25, 26 suicides in, 213 United States Congress, 16, 216, 292 United States Postal Service, 180 United States Preventive Services Task Force, 14-15, 16, 93-94 United States Public Health Service, 14, 132, 224, 247 University of Minnesota, 307 Urinary tract infections, 65, 69 V Vaccines influenza, 68-69, 70, 71, 72 pneumococcal polysaccharide, 66-67, 70, 71 Vancomycin treatment, 70n Vascular disease, 107, 177 Vascular resistance, 36 Ventricular hypertrophy, 35-36 Vertebral (spine) fractures, 77, 78, 81, 83-84, 86, 89, 92-93 Veterans Administration, 38, 39, 40, 215 Vision impairments, 101-102 disabilities, 107-108, 109-110 etiology, 103-105, 107 prevention, 111, 115 and risk of falls, 271 Vitamin A, 162 Vitamin D, 95, 171 alcohol use and, 93 and bone loss, 89, 90-91 Vitamin deficiencies, 89, 90-91, 170, 185 W Weight age and, 54 reduction, 44, 168, 170, 172, 177, 178 Wellbutrin, 209 Whites bone mass, 85 and falling, 264 fracture risk, 94 high blood pressure, 34, 35 Women bone loss, 83, 85, 86, 91-92 calcium RDA, 90 and cancer screening, 143, 144-145 cholesterol levels, 173, 174, 175 fractures, 77, 78, 88-89 hearing impairments, 102 high blood pressure, 35 life expectancy, 11 nutritional status, 181 oral health, 121, 123 osteoporosis, 58, 81-82, 95 physical inactivity, 225, 226, 233 risk of falling, 84, 264, 266 smoking rates, 194, 197 social supports and, 253 Workshop on Health Promotion and Aging, 283-284 Worksite, exercise promotion, 235 World Health Organization, 249, 299 International Classification of Diseases, 28, 282 International Classification of Impairments, Disabilities, and Handicaps , 22, 27-31, 228, 230, 247, 249, 311, 313, 314-317 Wrist (Colles) fractures, 77, 78, 81, 83-84, 86, 265-266 X Xerostomia (dry mouth), 123-124, 125-126