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The Second Fifty Years: Promoting Health and Preventing Disability
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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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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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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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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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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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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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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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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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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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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
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