Aging and Chronic Disorders

Transcription

1 Aging and Chronic Disorders

2 Stephen J. Morewitz Mark L. Goldstein Aging and Chronic Disorders

3 Stephen J. Morewitz, PhD Stephen J. Morewitz, PhD & Associates Buffalo Grove, IL USA Mark L. Goldstein, PhD Northbrook, IL USA Library of Congress Control Number: ISBN-10: e-isbn-10: X ISBN-13: e-isbn-13: Printed on acid-free paper Springer Science +Business Media, LLC All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Springer Science + Business Media, LLC, 233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden. The use in this publication of trade names, trademarks, service marks and similar terms, even if they are not identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights springer.com

4 This book is dedicated to Dad and Lora, Sharone, Lisa, Ashley, and Jonathan

5 Preface Five of the six leading causes of death among older Americans in 2004 were chronic diseases, such as cardiovascular disease, cancer, cerebrovascular disease (stroke), chronic pulmonary disease, and diabetes mellitus. All of these diseases negatively affect quality of life, contributing to reduced functioning and the increased eventuality of having to move to a nursing home or retirement community. The increased birth rate after World War II and the significant increase in life expectancy since the early twentieth century have resulted in an increased prevalence of disabling and costly chronic diseases. There are many questions still to be addressed in the fields of aging and chronic disease. What are the risk factors associated with the increased prevalence of chronic diseases in older populations? What are the major complications that contribute to disability and increased health care utilization and costs? What impact do chronic diseases have on disability and quality of life? What are the most effective treatments and rehabilitation programs? What steps can be taken to avoid overuse and/or misuse of drugs? How can patient education and self-management activities be improved to help these patients and their caregivers better understand and cope with their conditions? How can caregiver burden be reduced? This book addresses these questions by focusing on how major chronic disorders, such as diabetes, arthritis, cardiovascular disease, and cancer, affect health care utilization, costs, coping, disability, and quality of life in aging populations. Research studies are used to illustrate a wide range of topics from the epidemiology of chronic diseases in older populations, health care utilization and costs, to quality of life concerns, treatment outcomes, and caregiver burden. Case studies from a clinical psychologist s private practice are used to clarify some psychosocial issues underlying chronic diseases and health care. vii

6 viii Preface Chapter 1 analyzes the epidemiology of eight chronic diseases in older adults. Data on the prevalence of diseases and associated risk factors are stressed in this chapter. Health care planners can use these analyses to improve primary and secondary health care prevention activities through more effective uses of health care resources. Chapter 2 examines the latest information on health care utilization and costs for older adults that can point to a more efficient means of reducing the rising health care costs associated with the treatment of chronic diseases. In Chaps. 3-5, Dr. Mark L. Goldstein, a clinical psychologist, reviews the literature and uses composite case studies from his practice to illustrate quality of life issues, psychosocial problems, and cognitive difficulties in older adults. In the remaining chapters, each of the eight chronic diseases is evaluated in terms of five major issues. First, the latest trends in complications associated with each chronic condition are explored. Second, the impact of each disease on disability and quality of life is analyzed. Third, the processes of stress, coping, and social support are described. Fourth, the latest information on treatment and rehabilitation outcomes is discussed. Last, new trends in patient education and self-management are presented. The information in this book will be relevant to a wide range of professionals and students in the fields of gerontology, medicine, nursing, public health, mental health, social work, education, health administration, health policy, and social sciences. Buffalo Grove, Illinois Northbrook, Illinois Stephen J. Morewitz Mark L. Goldstein

7 Acknowledgments I would like to thank Mrs. Myra Kalkin Morewitz and Dr. Harry A. Morewitz for their advice and support. I also want to thank Bill Tucker, Executive Editor, Health and Behavior, at Springer, who has been supportive as well as thorough and thoughtful. Buffalo Grove, Illinois Northbrook, Illinois Stephen J. Morewitz Mark L. Goldstein ix

8 List of Abbreviations and Acronyms ACE angiotensin-converting enzyme AD Alzheimer s disease ADLs activities of daily living AF atrial fibrillation AIDES Assessment, Individualization, Documentation, Education, Supervision ALOS average length of stay AMI acute myocardial infarction BMD bone mineral density BP back pain CAD coronary artery disease CAM complementary and alternative medicines CDC Centers for Disease Control and Prevention CGA comprehensive geriatric assessment CHD coronary heart disease CHF congestive heart failure CLBP chronic low back pain CR cardiac rehabilitation CT computerized tomography DM diabetes mellitus DMARD disease modifying anti-rheumatic drugs EEG electroencephalogram EPESE Established Population for the Epidemiological Study of the Elderly EPIC European Prospective Investigation of Cancer ESRD end-stage renal disease FDA Food and Drug Administration FFS fee-for-service FM fibromylgia HABC Health, Aging and Body Composition Study HEARTFELT Heart Failure Effectiveness & Leadership HF heart failure HMO health maintenance organizations HRQL health-related quality of life IA inflammatory arthritis IADLs instrumental activities of daily living IVR Interactive Voice Response LAC laparoscopic assisted colectomy LBP low back pain LED lower extremity disease LPN licensed practical nurse MC managed care xi

9 xii List of Abbreviations and Acronyms MI myocardial infarction MMN mismatch negativity MMWR Morbidity & Mortality Weekly Report MRIs magnetic resonance imaging MS multiple sclerosis NA nursing assistant NCHS National Center for Health Statistics NHANES National Health and Nutrition Examination Survey NIH National Institutes of Health NSAIDS non-steroidal anti-inflammatory drugs NSCLC non-small-cell lung cancer OA osteoarthritis OP osteoporosis OTC over-the-counter PAD peripheral arterial disease PAID Problem Areas in Diabetes Protocol PENS percutaneous electrical nerve stimulation PET positron emission tomography PM particulate matter PPO preferred provider organizations PSA prostate-specific antigen PTH parathyroid hormone PTSD post traumatic stress disorder QSD-R Questionnaire on Stress in Patients with DM RA rheumatoid arthritis REM rapid eye movement SCLC small-cell lung cancer SES socioeconomic status SF-36 Short-Form-36 Health Survey SHAPE Screening for Heart Attack Prevention and Education SLUMD St. Louis Mental Status Exam STEMI ST elevation myocardial infarction TEMS transanal endoscopic microsurgery TM transcendental meditation TME total mesorectal excision TNF tumor necrosis factor UFT-tegafur/uracil USDHHS U.S. Department of Health and Human Services VA Department of Veterans Affairs VATS video-assisted thoracoscopic resection

10 Contents Preface Acknowledgments List of Abbreviations and Acronyms vii ix xi 1. Chronic Disorders in an Aging Population: Epidemiology Elders and Health Care Utilization and Costs Chronic Disease and Quality of Life in Older Adults Psychological Problems in the Elderly Cognitive Changes in Older Adults Seniors with Diabetes Mellitus Rheumatoid Arthritis, Osteoarthritis, Osteoporosis, Fibromyalgia, and Low Back Pain in Older Adults Cardiovascular Disease in the Elderly Seniors with Cancer References About the Authors xiii

11 xiv Contents Author Index Subject Index