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March 26, 1982

Rheumatic and Metabolic Bone Diseases in the Elderly

JAMA. 1982;247(12):1765. doi:10.1001/jama.1982.03320370067044

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This short volume attempts to assist the practicing physician and the physician in training with recognition and management of bone and joint diseases in elderly patients. With an ever enlarging older population, such an emphasis is welcome. However, in many instances, the only difference between the disease in a younger person and in an older person is that one is younger and the other is older. Thus, much of the content of the book would be the same were the title to have been shortened by elimination of its last three words. This is an important distinction, especially in discussing medication, as the metabolism of drugs and the effects on the individual are influenced by changes that accompany aging. Cardiac output tends to be reduced in an elderly person, renal function decreases, and plasma proteins change, thus shifting the equilibrium between concentrations of bound and unbound drugs. Pharmacokinetics reflect these