Exercise-Based Interventions as a Management of Frailty Syndrome in Older Populations

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Publisher :
ISBN 13 :
Total Pages : 0 pages
Book Rating : 4.:/5 (139 download)

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Book Synopsis Exercise-Based Interventions as a Management of Frailty Syndrome in Older Populations by : Guilherme Furtado

Download or read book Exercise-Based Interventions as a Management of Frailty Syndrome in Older Populations written by Guilherme Furtado and published by . This book was released on 2018 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Exercise-based interventions emerged as the best alternative for treating frailty syndrome (FS). Recognized as a complex phenotype, the FS is a multifaceted aging expression determined by biologic, environment, and behaviors factors. The biological theories of human development perceive aging process as an accumulation of harmful biochemical changes, whose occurrence attends the course of life. The progressive losses of functional reserves that occur in the body systems are a hallmark of this negative process. Despite the biological effects of physical and cognitive decline, more contemporary studies have identified that the environmental and behavior factors such as malnutrition and negative psychological adjustment across the life span also contribute to the early appearance of FS. Notwithstanding the latest findings that consistently demonstrate an overall positive benefit of long-term-based exercise in the decrease and/or reversal of the FS with a substantial impact on their correlated outcomes, the focus of this chapter is to present strategies for designing exercise programs for this type of population, taking into account their practical application in the field.

Frailty in the Elderly

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Publisher : BoD – Books on Demand
ISBN 13 : 1839682183
Total Pages : 148 pages
Book Rating : 4.8/5 (396 download)

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Book Synopsis Frailty in the Elderly by : Sara Palermo

Download or read book Frailty in the Elderly written by Sara Palermo and published by BoD – Books on Demand. This book was released on 2021-03-31 with total page 148 pages. Available in PDF, EPUB and Kindle. Book excerpt: The progressive growth in the number of older adults worldwide has led to a modification of the current healthcare scenario and a parallel increase in the use of public resources. In this book, we propose a conceptual framework within which aging, frailty, and care are analyzed through the lens of complexity medicine. Therefore, we present a multidimensional perspective that takes into account biomedical, (neuro)psychological, and socio-ecological vulnerability. The theses presented are the result of an inductive approach, based on many years of experience in the field, which has made it possible to identify strategies for frailty recognition and effective responses even in complicated clinical settings. The book is intended to be a tool of concrete and easy consultation, rich in reflections and suggestions.

Fragility Fracture Nursing

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Publisher : Springer
ISBN 13 : 3319766813
Total Pages : 169 pages
Book Rating : 4.3/5 (197 download)

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Book Synopsis Fragility Fracture Nursing by : Karen Hertz

Download or read book Fragility Fracture Nursing written by Karen Hertz and published by Springer. This book was released on 2018-06-15 with total page 169 pages. Available in PDF, EPUB and Kindle. Book excerpt: This open access book aims to provide a comprehensive but practical overview of the knowledge required for the assessment and management of the older adult with or at risk of fragility fracture. It considers this from the perspectives of all of the settings in which this group of patients receive nursing care. Globally, a fragility fracture is estimated to occur every 3 seconds. This amounts to 25 000 fractures per day or 9 million per year. The financial costs are reported to be: 32 billion EUR per year in Europe and 20 billon USD in the United States. As the population of China ages, the cost of hip fracture care there is likely to reach 1.25 billion USD by 2020 and 265 billion by 2050 (International Osteoporosis Foundation 2016). Consequently, the need for nursing for patients with fragility fracture across the world is immense. Fragility fracture is one of the foremost challenges for health care providers, and the impact of each one of those expected 9 million hip fractures is significant pain, disability, reduced quality of life, loss of independence and decreased life expectancy. There is a need for coordinated, multi-disciplinary models of care for secondary fracture prevention based on the increasing evidence that such models make a difference. There is also a need to promote and facilitate high quality, evidence-based effective care to those who suffer a fragility fracture with a focus on the best outcomes for recovery, rehabilitation and secondary prevention of further fracture. The care community has to understand better the experience of fragility fracture from the perspective of the patient so that direct improvements in care can be based on the perspectives of the users. This book supports these needs by providing a comprehensive approach to nursing practice in fragility fracture care.

World Report on Ageing and Health

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Publisher : World Health Organization
ISBN 13 : 9241565047
Total Pages : 260 pages
Book Rating : 4.2/5 (415 download)

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Book Synopsis World Report on Ageing and Health by : World Health Organization

Download or read book World Report on Ageing and Health written by World Health Organization and published by World Health Organization. This book was released on 2015-10-22 with total page 260 pages. Available in PDF, EPUB and Kindle. Book excerpt: The WHO World report on ageing and health is not for the book shelf it is a living breathing testament to all older people who have fought for their voice to be heard at all levels of government across disciplines and sectors. - Mr Bjarne Hastrup President International Federation on Ageing and CEO DaneAge This report outlines a framework for action to foster Healthy Ageing built around the new concept of functional ability. This will require a transformation of health systems away from disease based curative models and towards the provision of older-person-centred and integrated care. It will require the development sometimes from nothing of comprehensive systems of long term care. It will require a coordinated response from many other sectors and multiple levels of government. And it will need to draw on better ways of measuring and monitoring the health and functioning of older populations. These actions are likely to be a sound investment in society's future. A future that gives older people the freedom to live lives that previous generations might never have imagined. The World report on ageing and health responds to these challenges by recommending equally profound changes in the way health policies for ageing populations are formulated and services are provided. As the foundation for its recommendations the report looks at what the latest evidence has to say about the ageing process noting that many common perceptions and assumptions about older people are based on outdated stereotypes. The report's recommendations are anchored in the evidence comprehensive and forward-looking yet eminently practical. Throughout examples of experiences from different countries are used to illustrate how specific problems can be addressed through innovation solutions. Topics explored range from strategies to deliver comprehensive and person-centred services to older populations to policies that enable older people to live in comfort and safety to ways to correct the problems and injustices inherent in current systems for long-term care.

Physical Fitness in Hospitalized Frail Elderly Patients

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Publisher : Linköping University Electronic Press
ISBN 13 : 9179298907
Total Pages : 90 pages
Book Rating : 4.1/5 (792 download)

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Book Synopsis Physical Fitness in Hospitalized Frail Elderly Patients by : Kristina Åhlund

Download or read book Physical Fitness in Hospitalized Frail Elderly Patients written by Kristina Åhlund and published by Linköping University Electronic Press. This book was released on 2020-04-07 with total page 90 pages. Available in PDF, EPUB and Kindle. Book excerpt: Demographic research shows that the proportion of older people in society is increasing. More people age well, but there are also more people getting old with disability and multimorbidity. The large diversity in functioning illustrates the heterogeneity of aging. Accelerated aging may lead to frailty, which is a geriatric syndrome, often used as a marker of biologic age and associated with decreased physiologic reserves, increased vulnerability and the risk of adverse health out- comes. Frail elderly people are frequent visitors within emergency hospital care and physical decline is common. Unfortunately, elderly patients with substantial multimorbidity are often excluded from clinical trials. Physical fitness comprises a set of measurable health- and skill-related outcomes, such as cardiorespiratory endurance and muscle strength. A decrease in physical fitness may affect the prognosis negatively. However, previous research indicates that it may be possible to reverse frailty and improve physical fitness. It is therefore of the utmost interest to identify frailty and study how care is best provided, in order to prevent, reduce and postpone adverse health consequences. The overall aim of this thesis is to study physical fitness in a group of frail elderly patients, within clinical hospital health care. The patients’ physical fitness will be evaluated and compared in different care settings during and after hospitalization. The aim is also to study the long-term consequences of changes in physical fitness in relation to mortality. To better understand the underlying factors for partici- pation in physical activity and exercise, patients’ perceptions of the phenomena will be explored. This thesis consists of four papers based on two studies comprising frail elderly patients with substantial multimorbidity, in connection with an in-hospital episode. Paper 1 was an observational study with a cross-sectional design (n=408). Different components of physical fitness were measured during an index hospital stay and the results showed that hospitalized frail elderly patients performed below previously described age-related reference values. Furthermore, physical fitness was associated with the degree of frailty, rather than the chronological age. Paper 2 was a prospective controlled trial, with two parallel groups. The patients included in the intervention group (n=206) were cared for at an emergency medical care unit providing care according to Comprehensive Geriatric Assessment and care (CGA). The control group (n=202) was cared for at conventional emergency medical care units. The multi-professional care approach at the CGA unit was shown to be beneficial, in terms of a greater proportion of patients who preserved or improved their function during the first three months after discharge from hospital, compared with conventional care. Paper 3 had a prospective approach when evaluating the association between physical fitness and oneyear mortality in those 390 patients discharged alive from a hospital care episode. The results showed that physical fitness during in-hospital care and the change in physical fitness during the first months after discharge were associated with one-year mortality. In Paper 4, the patients’ perspective in terms of physical activity and exercise was explored. The theme of “Meaningfulness and risk of harm in an aging body” emerged, followed by the three categories of physical activity as part of daily life, goals of physical activity and exercise and prerequisites for physical activity and exercise. These studies highlight the importance of a greater focus on physical fitness in hospitalized elderly patients. A careful assessment and a multi-professional approach may lead to beneficial results and better survival even in a group of frail elderly patients with severe multimorbidity. To increase physical activity and exercise in this group of patients, health care probably needs to improve the means of communicating the benefits and goals of exercise and facilitating them so that the risk of harm is reduced.

Frailty and Sarcopenia

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Publisher : BoD – Books on Demand
ISBN 13 : 9535134833
Total Pages : 256 pages
Book Rating : 4.5/5 (351 download)

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Book Synopsis Frailty and Sarcopenia by : Yannis Dionyssiotis

Download or read book Frailty and Sarcopenia written by Yannis Dionyssiotis and published by BoD – Books on Demand. This book was released on 2017-08-30 with total page 256 pages. Available in PDF, EPUB and Kindle. Book excerpt: Frailty is considered a multisystem impairment that makes an individual vulnerable to external or internal stressors. Sarcopenia, the age-dependent loss of muscle mass and function, is proposed as the biological substrate and the pathway whereby the consequences of physical frailty develop. These syndromes are associated with a negative impact in quality of life and can lead to the occurrence of disability, institutionalization, and even mortality. The book focuses upon all the related aspects of frailty and sarcopenia and the new advancements in the related treatments including complex issues and research. It includes high-quality chapters in all related aspects for the syndromes of sarcopenia and frailty, which adversely affect the function and overall effectiveness of the musculoskeletal system and interventions to promote rehabilitation.

Development and Evaluation of a Home-based Exercise Intervention for Frail Older People

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ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (829 download)

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Book Synopsis Development and Evaluation of a Home-based Exercise Intervention for Frail Older People by : A. P. Clegg

Download or read book Development and Evaluation of a Home-based Exercise Intervention for Frail Older People written by A. P. Clegg and published by . This book was released on 2012 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Background: Frailty is common and is associated with important adverse health outcomes. There is evidence that exercise may influence the biological mechanisms of frailty and improve adverse outcomes. This thesis describes the development and evaluation of the Home-Based Older People's Exercise (HOPE) programme - a home-based exercise intervention for frail older people. Methods: The MRC framework for the development and evaluation of complex interventions was used to develop and evaluate the HOPE programme. The development process synthesised information from four key domains: a systematic literature review; a process of intervention modelling work incorporating multiperspective focus group meetings; a review of behaviour change techniques and a review of international exercise guidelines. Following development, the HOPE programme was evaluated in a pilot randomised controlled trial. The primary outcome was mobility, measured using the Timed-Up-and-Go test (TUGT). Secondary outcomes included activities of daily living (ADL), quality of life and depression. Results: The systematic review identified preliminary evidence that exercise may improve outcomes for frail older people. A grounded theory analysis of the multiperspective focus group meetings identified the important challenges faced by frail older people, along with motivators and barriers to exercise. The results were synthesised into the HOPE programme, which is a 12 week home-based exercise intervention. 60 participants were recruited to the HOPE trial. Mean age was 78 years. Baseline characteristics were similar in the two groups. There was a nonsignificant trend towards an improved outcome in the intervention group (mean adjusted between group difference in TUGT 16.7s, 95% CI -33.3, 66.6s). There were no differences in any of the secondary outcomes. Discussion: The HOPE trial has provided valuable process, resource, management and scientific data to guide the development of a future definitive RCT and has provided important information to help inform future research involving frail older people.

Exercise Medicine for the Frailty Syndrome

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Publisher : Taylor & Francis
ISBN 13 : 1000688127
Total Pages : 166 pages
Book Rating : 4.0/5 (6 download)

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Book Synopsis Exercise Medicine for the Frailty Syndrome by : Tommy Boone

Download or read book Exercise Medicine for the Frailty Syndrome written by Tommy Boone and published by Taylor & Francis. This book was released on 2022-09-30 with total page 166 pages. Available in PDF, EPUB and Kindle. Book excerpt: Frailty is a clinical syndrome caused by multiple chronic conditions that makes it difficult to maintain homeostasis. In part, it is the result of the body’s inability to regulate normal inflammatory responses that lead to muscle loss, decrease in strength, and independence. Regular exercise helps to optimize physiological performance. It is a profound influence, especially in the presence of physical inactivity, where the lack of exercise leads to poor health and decreased longevity. Unfortunately, a high percentage of Americans fail to engage in daily exercise with the older population becoming increasingly frail, which is a syndrome characterized by declines in musculoskeletal and physiologic reserve and function. It has been documented that exercise is medicine and can be better than the effects induced by drugs. Exercise physiologists are healthcare professionals. They are key professionals in developing and applying an exercise medicine prescription for frail adults. Exercise Medicine for the Frailty Syndrome speaks to the benefits of exercise medicine as the best therapy to prevent or reverse the age-related muscle loss and functional deficits that are predictive of an increase in falls, hospitalization, institutionalization, and mortality. This book is a proactive step to help increase the functional independence of older frail adults. It highlights Board Certification by the American Society of Exercise Physiologists as the professional qualification to improve society’s understanding of the biological treatment and complexity of the frailty syndrome and is key reading for Exercise Physiologists.

Comprehensive Geriatric Assessment

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Publisher : Springer
ISBN 13 : 3319625039
Total Pages : 182 pages
Book Rating : 4.3/5 (196 download)

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Book Synopsis Comprehensive Geriatric Assessment by : Alberto Pilotto

Download or read book Comprehensive Geriatric Assessment written by Alberto Pilotto and published by Springer. This book was released on 2017-12-29 with total page 182 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book offers an up-to-date review on the principles and practice of multidimensional assessment and management of the older individual, which represents the cornerstone of modern clinical practice in the elderly. The early chapters cover the main elements and scope of the comprehensive geriatric approach and explain the pathways of care from screening and case finding through to in-depth assessment and treatment planning. Subsequent chapters review the evidence of how best to apply the multidimensional assessment and management approach in defined healthcare settings and within specific clinical areas, such as cancer and surgery. Finally, the education and training challenges are reviewed and the prospects for future clinical service and research in this important field are examined. The book is very timely given the recent advances in application of this approach, which reflect the growing international realization that older people are “core business” in many clinical areas where the role of specialist geriatric medicine has hitherto been limited. Accordingly, the book will be relevant to a wide range of clinicians. The authorship comprises many of the best known and widely published experts in their respective fields.

Promoting Exercise and Behavior Change in Older Adults

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Publisher : Springer Publishing Company
ISBN 13 : 0826197221
Total Pages : 340 pages
Book Rating : 4.8/5 (261 download)

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Book Synopsis Promoting Exercise and Behavior Change in Older Adults by : Patricia M. Burbank, DNSc, RN

Download or read book Promoting Exercise and Behavior Change in Older Adults written by Patricia M. Burbank, DNSc, RN and published by Springer Publishing Company. This book was released on 2001-11-26 with total page 340 pages. Available in PDF, EPUB and Kindle. Book excerpt: Exercise in later life is important for health and well-being, yet motivating older adults to exercise can be difficult. This book addresses that need by tailoring "The Transtheoretical Model" of behavior change to the client's level of readiness for change. The contributors show how TTM can be used to help older adults with varying needs and abilities to change their exercise behaviors. This book is essential for health care professionals including nurses, exercise specialists, occupational therapists, social workers, and others interested in helping older adults incorporate exercise into their daily lives.

Exercise for Aging Adults

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Publisher : Springer
ISBN 13 : 3319160958
Total Pages : 163 pages
Book Rating : 4.3/5 (191 download)

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Book Synopsis Exercise for Aging Adults by : Gail M. Sullivan

Download or read book Exercise for Aging Adults written by Gail M. Sullivan and published by Springer. This book was released on 2015-08-10 with total page 163 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book translates the new findings in exercise research for the elderly for busy practitioners, trainees, students and administrators. This book provides practical strategies that can be implemented immediately in the common settings in which practitioners care for adults. The format includes key points and case examples which showcase the strong evidence supporting exercise by older adults as a key tool to enhance health, prevent serious outcomes, such as hospitalization and functional loss, and as part of the treatment plan for diseases that are common in older adults. Written by experts in the field of exercise in older persons, this book is a guide to maintaining quality of life and functional independence from frail to healthy aging adults. Strategies and exercises are discussed for specific care settings and illustrated via links to video examples, to ensure readers can immediately apply described techniques. Exercise for Aging Adults: A Guide for Practitioners is a useful tool for physicians, residents in training, medical students, physical therapists, gerontology advance practice nurse practitioners, assisted living facility administrators, directors of recreation, and long-term care directors.

Social Isolation and Loneliness in Older Adults

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Publisher : National Academies Press
ISBN 13 : 0309671035
Total Pages : 317 pages
Book Rating : 4.3/5 (96 download)

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Book Synopsis Social Isolation and Loneliness in Older Adults by : National Academies of Sciences, Engineering, and Medicine

Download or read book Social Isolation and Loneliness in Older Adults written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2020-05-14 with total page 317 pages. Available in PDF, EPUB and Kindle. Book excerpt: Social isolation and loneliness are serious yet underappreciated public health risks that affect a significant portion of the older adult population. Approximately one-quarter of community-dwelling Americans aged 65 and older are considered to be socially isolated, and a significant proportion of adults in the United States report feeling lonely. People who are 50 years of age or older are more likely to experience many of the risk factors that can cause or exacerbate social isolation or loneliness, such as living alone, the loss of family or friends, chronic illness, and sensory impairments. Over a life course, social isolation and loneliness may be episodic or chronic, depending upon an individual's circumstances and perceptions. A substantial body of evidence demonstrates that social isolation presents a major risk for premature mortality, comparable to other risk factors such as high blood pressure, smoking, or obesity. As older adults are particularly high-volume and high-frequency users of the health care system, there is an opportunity for health care professionals to identify, prevent, and mitigate the adverse health impacts of social isolation and loneliness in older adults. Social Isolation and Loneliness in Older Adults summarizes the evidence base and explores how social isolation and loneliness affect health and quality of life in adults aged 50 and older, particularly among low income, underserved, and vulnerable populations. This report makes recommendations specifically for clinical settings of health care to identify those who suffer the resultant negative health impacts of social isolation and loneliness and target interventions to improve their social conditions. Social Isolation and Loneliness in Older Adults considers clinical tools and methodologies, better education and training for the health care workforce, and dissemination and implementation that will be important for translating research into practice, especially as the evidence base for effective interventions continues to flourish.

The Frailty Fighter

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Publisher : Independently Published
ISBN 13 :
Total Pages : 0 pages
Book Rating : 4.3/5 (887 download)

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Book Synopsis The Frailty Fighter by : Barbara C Drake

Download or read book The Frailty Fighter written by Barbara C Drake and published by Independently Published. This book was released on 2023-03-27 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Are you or a loved one struggling with frailty syndrome? This cookbook is designed specifically for older adults looking to manage their health through nutrition. Packed with mouth-watering recipes that are both healthy and delicious, this cookbook will help you stay strong and active in your golden years. Are you concerned about losing your independence as you age due to frailty syndrome? Do you want to live an active and fulfilling life, free from limitations? Look no further than "The Frailty Fighter" - a comprehensive guide to exercises designed to combat frailty syndrome in aging adults. This book provides a step-by-step program for building strength and balance, including easy-to-follow exercises that can be done at home or at a gym. With expert guidance and illustrations, you'll learn how to improve your mobility, reduce the risk of falls, and increase your overall quality of life. In "The Frailty Fighter," you'll discover: The science behind frailty syndrome and its impact on aging adults A complete exercise program, tailored to your needs and abilities Tips for incorporating physical activity into your daily routine Ways to track your progress and stay motivated Guidance for making healthy lifestyle choices that complement your exercise routine. Whether you're just starting out or looking to enhance your current fitness regimen, "The Frailty Fighter" is the perfect resource for anyone looking to stay strong, active, and independent as they age.

Rehabilitation Medicine for Elderly Patients

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Publisher : Springer
ISBN 13 : 331957406X
Total Pages : 533 pages
Book Rating : 4.3/5 (195 download)

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Book Synopsis Rehabilitation Medicine for Elderly Patients by : Stefano Masiero

Download or read book Rehabilitation Medicine for Elderly Patients written by Stefano Masiero and published by Springer. This book was released on 2017-09-04 with total page 533 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book clearly explains when and how different rehabilitation techniques should be applied in the aging patient, thereby enabling readers to identify and apply those rehabilitation strategies that will maximize quality of life and functional independence in individual cases. It is specifically designed for ease of consultation and rapid retrieval of the information most relevant to clinical practice. Prominence is given to the benefits of a multidisciplinary approach to rehabilitation, with discussion of a very wide range of aspects of rehabilitation in different disease settings. The breadth of coverage is illustrated by the attention paid to less commonly addressed topics such as visual and hearing rehabilitation, the role of robotics and 3D imaging techniques, variations in approach among health care systems, and rehabilitation in end-of-life care. The authors are international academic experts in their fields, guaranteeing a high scientific standard throughout. This manual will be an invaluable tool and source of knowledge for geriatricians and physiatrists but will also appeal to a wider range of clinicians, practitioners, and students.

Frailty

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Publisher : Springer Nature
ISBN 13 : 3031573617
Total Pages : 403 pages
Book Rating : 4.0/5 (315 download)

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Book Synopsis Frailty by : Jorge G. Ruiz

Download or read book Frailty written by Jorge G. Ruiz and published by Springer Nature. This book was released on with total page 403 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Osteosarcopenia

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Publisher : Elsevier
ISBN 13 : 0128204206
Total Pages : 350 pages
Book Rating : 4.1/5 (282 download)

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Book Synopsis Osteosarcopenia by : Gustavo Duque

Download or read book Osteosarcopenia written by Gustavo Duque and published by Elsevier. This book was released on 2022-03-04 with total page 350 pages. Available in PDF, EPUB and Kindle. Book excerpt: Falls, fractures, frailty, osteoporosis and sarcopenia are highly prevalent in older persons. While the concept of osteosarcopenia is new, it is a rapidly evolving and cross-disciplinary problem. Prevention and treatment are challenging and a combined therapeutic approach is needed. Osteosarcopenia provides evidence-based information on how to prevent and treat these conditions at multiple settings, including multiple illustrations, care pathways and tips to easily understand the pathophysiology, diagnostic methods and therapeutic approach to these conditions. This work evaluates the potential for a link between osteoporosis, sarcopenia and obesity. Presents diagnostic and therapeutic tips that facilitate the design and implementation of new care pathways, impacting the wellbeing of our older population Provides cross-disciplinary understanding by experts from the bone/osteoporosis field and the muscle/sarcopenia field Covers muscle and bone biology, mesenchymal stem cells, age-related changes and cross-talk between muscle, fat and bone, falls and fracture risk, glucose metabolism, diagnosis, imaging, and genetics of osteosarcopenia

Primary Care for Older People

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Publisher :
ISBN 13 :
Total Pages : 284 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Primary Care for Older People by : Steve Iliffe

Download or read book Primary Care for Older People written by Steve Iliffe and published by . This book was released on 2000 with total page 284 pages. Available in PDF, EPUB and Kindle. Book excerpt: Primary Care for Older People is a contemporary reference work on health problems in later life written exclusively by primary care professionals for primary care professionals that: integrates nursing and medical perspectives on clinical practice and service organisation. understands that well-intentioned changes in practice and service provision can have harmful effects on patients, professionals and the health service is still able to offer positive guidance to individual practitioners, practices and Primary Care Groups, about best practice and innovative multi-disciplinary care for an ageing population. It is aimed at doctors, nurses, health visitors and social workers who are trying to combine care of individuals with an understanding of the needs of whole communities. Its themes are relevant to teachers in different professional disciplines, to members of Primary Care Group and Trust Boards, to planners and managers of primary care services, as well as to practitioners. The authors bring to this book their experience in general practice and community nursing, their expertise in service development and management, and their awareness of primary care research. Dr. Steve Iliffe has been an inner-city general practitioner in London since 1978, and is Reader in General Practice at the Royal Free and University College Medical School, where he is co-director of the Centre for Ageing Population Studies (CAPS) and manages the Primary Care for Older People research and development programme. He can be contacted at [email protected]. Vari Drennan has been a community health service manager , specialist health visitor for older people and health visitor since 1980 and is currently a senior lecturer in primary care nursing in the Department of Primary Care and Population Sciences at the Royal Free and University College Medical School. She can be contacted at [email protected],