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Book and Media Reviews
November 28, 2007

Aging and Chronic Disorders

Author Affiliations

Book and Media Reviews Section Editor: John L. Zeller, MD, PhD, Contributing Editor.

JAMA. 2007;298(20):2422-2427. doi:10.1001/jama.298.20.2425

This book by Stephen Morewitz and Mark Goldstein examines chronic conditions disproportionately affecting elderly persons and how such conditions affect health care utilization, costs, coping, disability, and quality of life.

The first 5 chapters provide an overview of a number of topics pertaining to elderly persons, including the epidemiology of chronic disorders, quality of life, psychological problems, and cognitive changes associated with aging. The last 4 chapters then focus on chronic conditions commonly affecting elderly persons. The overview chapters begin with an examination of the literature related to the epidemiology of chronic disorders in aging populations. Chapter 1 provides a review of the recent literature examining general demographic characteristics of aging populations in the United States; overviews of the epidemiology of diabetes, arthritis, osteoarthritis, rheumatoid arthritis, osteoporosis, fibromyalgia, low back pain, cardiovascular disease, and cancer; and lifestyle, behavioral, and environmental risk factors related to chronic conditions. Chapter 2 reviews literature on the utilization of health care services by older adults and their associated costs in general, for each of the above-noted chronic conditions as well as by selected lifestyle and behavioral risk factors. The following chapter examines the recent literature pertaining to studies of the quality of life of older adults in the context of health, functional, and psychosocial factors. This chapter also includes 2 brief case studies illustrating the declines in quality of life that may be experienced by older adults. Chapter 4 then focuses on common psychological problems that elderly persons experience, with an emphasis on depression in later life. This chapter also includes 3 case studies that are intended to illustrate some of the ways older adults may respond to life stressors. Chapter 5 examines selected literature on cognitive changes in older adults, covering topics including processing and problem-solving speed, memory, learning, and the effects of diseases affecting cognition in older adults. This is the last chapter that has case studies and includes 2 brief examples demonstrating the impact of nonproblematic cognitive aging and early-stage Alzheimer disease.