JOURNAL OF ANTI-AGING MEDICINE Volume 6, Number 2, 2003 © Mary Ann Liebert, Inc.
Book Review Cassel CK, Leipzig RM, Cohen HJ, Larson EB, Meier DE (Eds.): Geriatric Medicine: An Evidence-Based Approach, 4th Ed., 2003. Published by Springer-Verlag; ISBN: 0-387-955143; pages 1318; price $230.95 USD.
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among medical subspecialists and have had a limited role in caring for the frail elderly population, largely because of their small numbers. Internists and family practitioners, therefore, will continue to be relied upon to provide the majority of primary care to our growing population of older adults, including those with multiple and complex medical problems. Physicians who practice geriatric medicine must have a thorough knowledge of adult medicine as well as familiarity with geriatric syndromes (falls, cognitive impairment, failure to thrive, and others), atypical presentation of disease, interdisciplinary care management, and changes in physiology that accompany aging. Expert management of frail elders also requires adherence to an outcomes-oriented paradigm that recognizes the interplay between the patient’s life expectancy, qualify of life, functional status, and their unique psychosocial dynamics. Cassel’s latest textbook offers clinicians an invaluable resource to understand these multifaceted issues so that the care they render to older adults across the spectrum of health and functional ability will be optimal. The fourth edition of Geriatric Medicine covers basic gerontology, contexts of care and clinical approaches in geriatric medicine, medical care, neurologic and psychiatric disorders, and ethics and health policy issues. Enhancements in the updated edition include an extensive evidence-based review of the diagnostic and treatment recommendations contained in each chapter; the addition of a new section on palliaERIATRICIA NS ARE UNDERREPRESENTED
tive care; expanded coverage of pre and post surgical care; and added sections on medical care management, prevention, and drug prescribing. Clearly and consistently throughout the textbook, the tenets and principles of geriatric medicine are highlighted as they apply to patients commonly encountered in clinical practice. Specific disease states and therapeutic interventions are surveyed, using clear and concise language and examples. Practical and very usable clinical information is abundantly presented, particularly in the chapters covering palliative care, pain management, falls, cardiovascular disease, posture and movement disorders, and decision-making capacity. The book’s greatest shortcoming is that it has few figures, tables, and photographs to illustrate specific ideas. The absence of illustrations keeps the cost of the book down, but well-chosen images could add significantly to the points being made. Also, three noteworthy topics were omitted or cursorily reviewed that deal with issues that many clinicians encounter in their practices: cultural and religious influences on medical care, management of HIV in the elderly, and assessment of the older driver. Overall, this is an impressive book, whose contents recognize and reflect the key aspects and most recent developments in geriatric medicine. Although not a reference for providers in search of a quick answer, it is exceptionally well written and will prove useful to both seasoned practitioners and physicians in training.
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Kevin Foley, M.D. Advantage Health Physicians Grand Rapids, MI 49503 E-mail:
[email protected]
