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Brocklehurst's Textbook of Geriatric Medicine and Gerontology has been a staple of medical education since it's first edition in 1973.  In the USA, geriatrics has been a specialty working hard to find a credible home, sometimes thought brimming with ideology but wanting in science and evidence.  Generalists have often seen geriatricians as proffering a difference without a real distinction, hard pressed to make their case in the real world of clinical medicine.

   Much progress has been made and editors of Brocklehurst have emphasized in great detail, the important differences between geriatric and general medicine.  Authors from both sides of the Atlantic have produced an impressive breadth and depth of coverage with topics carefully reviewed and referenced without belaboring the common ground.  The Gerontology section provides an extensive introduction and, as with other sections, presents a formidable undertaking for the general medicine reader or trainee.  This is a textbook for the serious student and may be perused with considerable gain by even the most knowledgeable practitioner.

   Brocklehurst's 1st edition was presented "as an authoritative statement on research and current medical practice on all matters relating to aging and old age in man".  Although more than 30 years later, this goal may be unrealistic.  The editors and authors are to be commended for undertaking this daunting but important challenge.  Their contributions to this goal are noteworthy and the resulting 6th edition retains its position in the forefront of textbooks of geriatric medicine.  It can be recommended to all serious readers and resource libraries.

Ratings:

Organization of information:    3

Usefulness of book:     4

Suitable for intended audience:    3

Author’s objectives met:      3

Number of illustrations:     3

Quality of illustrations:    4

Table of Contents: 

Section 1:  Gerontology

Basic Concepts

Chapter 2.     The Epidemiology of Aging

Chapter 3.     The Future of Old Age

Chapter 4.     Evolution Theory and the Mechanisms of Aging

Chapter 5.     Methodological problems in Research on Aging

Chapter 6.     Biology of Aging

Chapter 7.     Genetic Mechanisms of Aging

Chapter 8.     Cellular Mechanisms of Aging

Chapter 9.     Physiology of Aging

Systems

Chapter 10.   Connective Tissues and Aging

Chapter 11.   Clinical Immunology of Aging

Chapter 12.   Normal Cognitive Aging

Chapter 13.   The Aging Personality and Self: Diversity and Health Issues

Chapter 14.   The Pharmacology of Aging

Chapter 15.   Anti-Aging Interventions

Social Gerontology

Chapter 16.   Successful Aging

Chapter 17.   Social Gerontology

Chapter 18.   Productive Aging

Section 2:  Geriatric Medicine

General Issues

Chapter 19.   Health promotion and Physical Activity

Chapter 20.   Preventative and Anticipatory Care

Chapter 21.   Rehabilitation:  General Principles

Chapter 22.   Rehabilitation:  Therapy Techniques

Chapter 23.   Palliative Care

Chapter 24.   Ethical Issues in Geriatric Medicine

Chapter 25.   Presentation of Disease in Old Age

Chapter 26.   Multidimensional Geriatric Assessment

Chapter 27.   Biochemical Tests

Chapter 28.   Social Assessment of Geriatric Patients

Chapter 29.   Surgery and Anesthesia in Old Age

Cardiovascular Disease

Chapter 30.   Effects of Aging on the Heart

Chapter 31.  Atypical Manifestations of Cardiac Disorders

Chapter 32.   Atherosclerosis and Lipid Metabolism

Chapter 33.   Chronic Cardiac Failure

Chapter 34.   Diagnosis and Management of Coronary Artery Disease

Chapter 35.   Hypertension

Chapter 36.   Valvular Heart Disease

Chapter 37.   Cardiac Arrhythmias

Chapter 38.   Syncope

Chapter 39.   Vascular Surgery

Chapter 40.   Thromboembolic Disease

The Respiratory System

Chapter 41.   Age-Related Changes in the Respiratory System

Chapter 42.   Asthma and Chronic Obstructive Pulmonary Disease

Chapter 43.   Nonobstructive Lung Disease and Thoracic Tumors

The Nervous System

Chapter 44.   Neurobiology of Aging

Chapter 45.   Neurological Signs in Old Age

Chapter 46.   Epilepsy

Chapter 47.   Headache and Facial Pain

Chapter 48.   Stroke:  Pathology and Epidemology

Chapter 49.   Stroke:  Clinical Presentation and Management

Chapter 50.   Stroke: Organization of Services

Chapter 51.   Disorders of the Autonomic Nervous System

Chapter 52.   Parkinsonism and Other Movement Disorders

Chapter 53.   Neuromuscular Diseases including Myasthenic Disorders

Chapter 54.   Peripheral Neuropathies

Chapter 55.   Intracranial Tumors

Chapter 56.   Infections of the Central Nervous System

Chapter 59.   Aging and Disorders of the Eye

Chapter 60.   Disorders of Hearing

Chapter 61.   Delirium

Chapter 62.   Classification of the Dementias

Chapter 63.   Presentation and Clinical Management of Dementia

Chapter 64.   Alzeheimer's Disease

Chapter 65.   Vascular Dementia

Chapter 66.   Psychology in the Diagnosis and Treatment of the Dementias

Chapter 67.   Functional Psychiatric Illnesses in Old Age

Musculoskeletal Disease

Chapter 68.   Exercise for Successful Aging

Chapter 69.   Bone and Joint Aging

Chapter 70.   Metabolic Bone Disease

Chapter 71.   Arthritis in the Elderly

Chapter 72.   Connective Tissue Disease

Chapter 73.   Orthopedic Geriatrics

Chapter 74.   Injury in Elderly People

Chapter 75.   Podiatry

Gastroenterology

Chapter 76.   Geriatric Gastroenterology:  Overview

Chapter 77.   Aging and the Orofacial Tissues

Chapter 78.   The Upper Gastrointestinal Tract

Chapter 79.   The Pancreas

Chapter 80.   The Liver

Chapter 81.   Biliary Tract Diseases

Chapter 82.   The Small Bowel

Chapter 83.   The Large Bowel

Chapter 84    Nutrition

Chapter 85.   Obesity

The Urinary Tract

Chapter 86.   Aging of the Urinary Tract

Chapter 87.   Diseases of the Aging Kidney

Chapter 88.   Disorders of Water and Electrolyte Metabolism

Chapter 89.   The Prostate Gland

Women's Health

Chapter 90.   Gynecological Disorders

Chapter 91.   Carcinoma of  the Breast

Endocrinology

Chapter 92.   Aging and the Endocrine System

Chapter 93.   Adrenal and Pituitary Disorders

Chapter 94.   Disorders of the Thyroid

Chapter 95.   Disorders of the Parathyroids

Chapter 96.   Diabetes Mellitis

Hematology

Chapter 97.   Aging and the Blood

Chapter 98.   Blood Disorders and their Management in Old Age

Dermatology

Chapter 99.   Aging of the Skin

Chapter 100. Skin Diseases and Old Age

Section 3:  Problem-Based Geriatric Medicine

Chapter 101. Geriatric Pharmacotherapy

Chapter 102. Geriatric Oncology

Chapter 103. Constipation and Fecal Incontinence in Old Age

Chapter 104. Urinary Incontinence

Chapter 105. Falls

Chapter 106. Pressure Sores

Chapter 107. Sleep, Aging, and Late-Life Insomnia

Chapter 108. Eating Disorders

Chapter 109. Pain in Old Age

Chapter 110. Elder Abuse

Chapter 111. Sexuality in Old Age

Section 4:  Health Systems & Geriatric Medicine

Chapter 112. The Elderly in Society:  An International Perspective

Chapter 113. Geriatric Medicine:  History and Current Practice in Europe

Chapter 114. Geriatrics in North America

Chapter 115. Prospects for Geriatric Medicine in Developing Countries

Chapter 116. Long-Term Care in the United Kingdom

Chapter 117. Institutional Long-Term Care Services in the USA

Chapter 118. Improving Quality of Care in the United Kingdom

Chapter 119. Quality Improvement in the USA

Chapter 120. Managed Care for Elderly People in the USA