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1 Chapter 0Table 1 The Joseph T. Freeman Award of the Medical Sciences Section of The G...Table 2 The IAGG Task Force recommends the following.

2 Chapter 1Table 1.1 Components of biological ageing.

3 Chapter 2Table 2.1 Age‐related changes in dopaminergic synapses.Table 2.2 Changes in hormone levels with age.Table 2.3 Changes in the immune system with age.

4 Chapter 4Table 4.1 Strategies to combat ageism.Table 4.2 Communication strategies for speaking to patients with hearing lo...Table 4.3 Common scams targeting older adults.Table 4.4 Care plan for emergencies: record the answers and keep them in a ...

5 Chapter 5Table 5.1 Therapies for women with vaginal dryness and vulvovaginal atrophy...

6 Chapter 6Table 6.1 Common structural age‐related changes detectable on anatomic brai...Table 6.2 Changes in the neurological examination with ageing.Table 6.3 Age‐related changes in attention and memory functions.

7 Chapter 7Table 7.1 Changes in exercise capacity due to ageing or disuse, potentially... Table 7.2 Changes in cardiorespiratory function due to ageing or disuse, potent... Table 7.3 Changes in metabolism and body composition due to ageing or disuse, p...Table 7.4 Changes in the central and peripheral nervous system due to agein...Table 7.5 Exercise recommendations targeting optimal body composition for o...Table 7.6 Potential mechanisms by which exercise can prevent disease.Table 7.7 Exercise and disease treatment.Table 7.8 Major randomised controlled trials including resistance training ...Table 7.9 Exercise recommendations for optimal ageing and prevention and tr...

8 Chapter 8Table 8.1 Common factors affecting health literacy.Table 8.2 Consequences of low health literacy.Table 8.3 Educational techniques to improve health literacy.Table 8.4 Cultural factors that affect health care.Table 8.5 Barriers to successful, culturally appropriate health care delive...Table 8.6 Common areas of cultural conflict.Table 8.7 ETHNIC(S) mnemonic for improving communication.

9 Chapter 9Table 9.1 The Health Maintenance Clinical Glidepath.

10 Chapter 10Table 10.1 Age‐related changes pertinent to geropharmacology.Table 10.2 Practical tool to identify drugs that interact with Cytochrome P...Table 10.3 Tools to aid in the reduction of inappropriate medication use an...Table 10.4 Mnemonics for medication management.

11 Chapter 11Table 11.1 International adverse events studies, showing data for older pat...Table 11.2 Methods of measuring errors and adverse events.Table 11.3 Methods of understanding errors and adverse events.Table 11.4 Examples of some cognitive biases and heuristics that commonly a...Table 11.5 The seven‐level framework.

12 Chapter 12Table 12.1 Dietary and nutrient biomarker patterns associated with cognitiv...

13 Chapter 14Table 14.1 Malnutrition criteria according to the GLIM consensus.Table 14.2 Distinguishing starvation from cachexia.Table 14.3 Comprehensive gerontological assessment (CGA) to address weight ...

14 Chapter 16Table 16.1 Medical factors related to insufficient nutrient or energy intak...Table 16.2 Medication and nutrient interactions.Table 16.3 Function, deficiency, age‐related changes, food sources, and sup...

15 Chapter 17Table 17.1 Oesophageal causes of dysphagia.Table 17.2 Causes of delayed gastric emptying.Table 17.3 Medications that affect gastrointestinal motility.

16 Chapter 19Table 19.1 Medications associated with faecal incontinence.Table 19.2 The assessment of faecal incontinence.

17 Chapter 20Table 20.1 Anatomical distribution of changes associated with constipation.Table 20.2 Medications commonly associated with constipation.Table 20.3 Medical conditions commonly associated with constipation.Table 20.4 Medications used in the treatment of constipation.

18 Chapter 21Table 21.1 Pancreatic endocrine tumours.

19 Chapter 23Table 23.1 Mechanisms and precipitating factors in DIC.Table 23.2 Laboratory diagnosis of DIC.

20 Chapter 24Table 24.1 Coagulation tests.Table 24.2 Causes of acquired platelet functional defects other than due to...Table 24.3 Causes of acquired coagulation defects.Table 24.4 Haemorrhagic vascular defects.Table 24.5 INR ranges in various conditions.Table 24.6 Thrombophilic conditions.

21 Chapter 25Table 25.1 Characteristics of bleeding risk assessment tools.Table 25.2 Usual and adjusted dosages for DOACs.

22 Chapter 26Table 26.1 Cytopenia thresholds according to the WHO 2016 Classification.Table 26.2 Classification scheme of myelodysplastic syndromes (MDS) in the ...Table 26.3 WHO 2016 classification.Table 26.4 Differential diagnosis of clonal or idiopathic cytopenias and my...Table 26.5 International Prognosis Scoring System (IPSS) for MDS.Table 26.6 IPSS Survival for MDS and evolution to AML.Table 26.7 Cytogenetic prognostic groups in the IPSS‐R.Table 26.8 Prognostic models for ESA response in MDS.

23 Chapter 27Table 27.1 WHO classification of peripheral blood and bone marrow findings ...Table 27.2 Revised International Prognosis Scoring System (IPSS‐R).Table 27.3 Cytogenetics MDS score in the Revised International Prognosis Scoring...Table 27.4 WHO (2016) classification of acute myeloid leukaemias.

24 Chapter 28Table 28.1 Association between cardiovascular disease and frailty.Table 28.2 Association between heart failure and risk factors from case/con...

25 Chapter 29Table 29.1 Causes of bradycardia.Table 29.2 Duration of ambulatory monitoring.Table 29.3 Characteristics of trials comparing ventricular and physiologica...Table 29.4 Randomized controlled trials of rate versus rhythm control in AF...Table 29.5 Factors that increase the risk of sotalol‐induced QT prolongatio...Table 29.6 CHA₂DS₂‐VASc risk factor‐based scoring system.Table 29.7 Common medications that interact with warfarin.

26 Chapter 30Table 30.1 Advantage and cautions with IHD medications in older people.Table 30.2 Considerations in older people with IHD.

27 Chapter 31Table 31.1 Cholesterol metabolism and ageing.Table 31.2 Phenotypes and genetic features of primary hyperlipoproteinaemia...Table 31.3 Modification of lipid patterns by lifestyle change and drugs.Table 31.4 RCTs with statins and benefit for ASCVD prevention in subjects a...Table 31.5 Very high risk for future ASCVD events.Table 31.6 Common secondary causes of hyperlipidaemia.Table 31.7 Pharmacologic characteristics of statins.

28 Chapter 32Table 32.1 Organ‐specific symptoms of hypoperfusion.Table 32.2 Causes of hypotension.Table 32.3 Diagnostic criteria for carotid sinus syndrome.

29 Chapter 33Table 33.1 Classifications of hypertension.Table 33.2 Main secondary causes of hypertension in older people.Table 33.3 Common types of hypertension in older people.Table 33.4 Main studies on hypertension management in older people ≥75.

30 Chapter 34Table 34.1 Principle effects of ageing on cardiovascular structure and func...Table 34.2 Effects of ageing on other organ systems.Table 34.3 Classifications and types of heart failure (HF).Table 34.4 Causes of heart failure in older people.Table 34.5 Precipitants of HF in older people.Table 34.6 Common comorbidities in older HF patients and management.Table 34.7 Pharmacological treatments for HFrEF.Table 34.8 Treatment of HFpEF: key trials.

31 Chapter 35Table 35.1 Weighted risk factors relevant to a specific individual patient ...Table 35.2 Frailty markers.Table 35.3 Factors used for shared decision‐making about type of valve pros...Table 35.4 An illustrative list of interactive factors that influence the e...Table 35.5 Target International Normalised Ratio (INR) for mechanical prost...Table 35.6 Stroke risk scoring system with acronym CHA₂DS₂‐VASc.

32 Chapter 36Table 36.1 Stages and symptoms of PAD.

33 Chapter 37Table 37.1 Two‐level Wells score for DVT.Table 37.2 Revised Geneva score for PE.Table 37.3 Direct oral anticoagulants for venous thromboembolism.

34 Chapter 39Table 39.1 Conditions that favour respiratory infections in the elderly.Table 39.2 Main findings in bronchitis and pneumonia.Table 39.3 The CRB‐65 four‐item scale to assess the severity of community‐a...Table 39.4 Pneumonia severity index (PSI) simplified for patients age ≥65, ...Table 39.5 First‐line antimicrobial therapy recommended for patients with c...Table 39.6 Choice of first‐line antibiotics for treatment of community‐acqu...Table 39.7 Prevention of pneumonia in the elderly.

35 Chapter 40Table 40.1 Aspiration syndromes.Table 40.2 Aspiration screening tests.Table 40.3 Maneuvers and exercises to prevent aspiration.

36 Chapter 41Table 41.1 Clinical characteristics of the SARS‐CoV, MERS‐CoV, and SARS‐CoV...Table 41.2 COVID‐19 death rates by age in China and Italy.Table 41.3 Benefits and pitfalls of diagnostic tests for Covid‐19.

37 Chapter 42Table 42.1 Main age‐related changes in the respiratory system.Table 42.2 Main conditions potentially affecting the quality of spirometry ...Table 42.3 Differential diagnosis of COPD.Table 42.4 Comorbid conditions classified according to their relationship w...Table 42.5 International classification of airflow obstruction severity.Table 42.6 Commonest pitfalls in the diagnosis of asthma in the elderly.Table 42.7 Differential diagnosis of asthma in the elderly.

38 Chapter 44Table 44.1 Topographical overview of age‐related neurological signs.

39 Chapter 45Table 45.1 Main sleep disorders and their key characteristics.Table 45.2 Basic sleep‐related medical history questions older people.Table 45.3 Sleep hygiene measures.Table 45.4 Pharmacological treatments.

40 Chapter 47Table 47.1 Classification of causes of stroke.Table 47.2 Differential diagnosis – stroke and TIA ‘mimics’.Table 47.3 The Barthel Index.Table 47.4 The modified Rankin Scale.Table 47.5 Contraindications to thrombolysis with rt‐PA.Table 47.6 Inclusion criteria for mechanical thrombectomy in acute ischaemi...Table 47.7 Early management and investigation of TIA.Table 47.8 Derived figures for Doppler ultrasound criteria for grading ICA ...Table 47.9 Management of symptomatic carotid stenosis.

41 Chapter 48Table 48.1 A summary of rehabilitation techniques in stroke.

42 Chapter 49Table 49.1 Speech symptoms associated with underlying pathology.

43 Chapter 51Table 51.1 Seizure and epilepsy data in the elderly according to IEA classi...Table 51.2 Variables that distinguish between common events and seizures in...Table 51.3 Classification of antiepileptic drug (AED) indications, doses, a...Table 51.4 Recommendations and treatment with comorbidities.Table 51.5 Relevant side effects in the elderly.

44 Chapter 52Table 52.1 Differential diagnosis of blackouts and funny turns.Table 52.2 Classification of syncope.

45 Chapter 53Table 53.1 Cardinal signs of Parkinson’s disease.Table 53.2 Causes of extrapyramidal syndrome other than Parkinson’s disease...Table 53.3 Diagnosis criteria for Parkinson’s disease of the Queen Square B...Table 53.4 Methods for treating non‐motor symptoms and complications in Par...

46 Chapter 54Table 54.1 Overview and phenomenological features of non‐parkinsonian movem...Table 54.2 Myoclonus classification system based on clinical presentation.Table 54.3 Overview of drug‐induced non‐parkinsonian movement disorders. Table 54.4 Overview of treatment options for non‐parkinsonian movement disorder...

47 Chapter 56Table 56.1 Drugs that may worsen MG (see www.myaware.org/drugs‐to‐avoid for...Table 56.2 Evidence that MG is an antibody‐mediated autoimmune disease.Table 56.3 Immune disorders reported in association with MG.

48 Chapter 57Table 57.1 Acquired myopathies.Table 57.2 Inherited myopathies.Table 57.3 Patterns of drug‐induced myopathy.Table 57.4 Drugs causing painless myopathy.Table 57.5 Drugs causing painful myopathy.Table 57.6 Drugs causing acute rhabdomyolysis.Table 57.7 Classification of the muscular dystrophies.Table 57.8 Differential diagnosis of chronic progressive external ophthalmo...

49 Chapter 59Table 59.1 Classification of pain.Table 59.2 Assessment.

50 Chapter 61Table 61.1 Potential predisposing and precipitating factors (also called pot...Table 61.2 Examples of non‐pharmacologic measures to manage delirium.

51 Chapter 62Table 62.1 Potential benefits of memory clinics.Table 62.2 Diagnoses to be considered in people presenting to memory clinics...Table 62.3 Stages in memory clinic evaluation and management.Table 62.4 Examples of commonly used cognitive tests.Table 62.5 Recommendations for telling patients and family about a diagnosis...

52 Chapter 63Table 63.1 Risk factors for dementia and Alzheimer’s disease across the life...Table 63.2 AD concept in the different diagnosis criteria since 1984.Table 63.3 Cholinesterase inhibitors and memantine in AD.Table 63.4 Single domain and multidomain RCTs in the prevention of cognitive...

53 Chapter 65Table 65.1 Causes of pure vascular dementia.Table 65.2 Proposed terms and definitions for neuroimaging features of SVD.

54 Chapter 66Table 66.1 Participation in mentally stimulating activities and risk of cogn...Table 66.2 Levels of prevention.

55 Chapter 67Table 67.1 Observational epidemiological studies on physical activity and ri...Table 67.2 Randomized controlled trials on physical activity.Table 67.3 Suggested rules for physical activity programmes for demented pat...

56 Chapter 68Table 68.1 Anti‐amyloid monoclonal antibodies in Alzheimer’s disease.Table 68.2 Ongoing AD trials with anti‐tau drugs.Table 68.3 Ongoing clinical trials in AD with mesenchymal stem cells.Table 68.4 Ongoing Trials in preclinical stages of AD.

57 Chapter 69Table 69.1 Causes of dementia other than Alzheimer’s disease.Table 69.2 Subtypes of vascular dementia (VaD).Table 69.3 NINDS‐AIREN criteria for probable and possible vascular dementia ...Table 69.4 Characteristics of cortical and subcortical dementia.Table 69.5 Diagnostic criteria for dementia with Lewy bodies (DLB).Table 69.6 Diagnostic criteria for Parkinson’s disease with dementia (PDD).Table 69.7 Distinguishing features between frontotemporal dementia and Alzhe...Table 69.8 Causes of parkinsonism with cognitive impairment in the elderly.

58 Chapter 70Table 70.1 Provisional IPA definition criteria for agitation.Table 70.2 Summary of recommended pharmacological treatments for neuropsychi...Table 70.3 The DICE approach.

59 Chapter 71Table 71.1 Adaptations of psychotherapy for older adults.

60 Chapter 72Table 72.1 Common mental health disorders in older adults.Table 72.2 Common standardized scales recommended in primary care.Table 72.3 CAGE questionnaire.Table 72.4 Members of an ideal interdisciplinary mental health team.Table 72.5 Clinical pearls regarding psychological aspects of rational depre...Table 72.6 ATMAN approach to management of chronic non‐cancer pain.Table 72.7 Examples of evidence‐based prevention in geriatric psychiatry.

61 Chapter 74Table 74.1 Conditions that occur commonly in adults with Down syndrome.Table 74.2 Presentation of spinal cord compression in people with Down syndr...Table 74.3 Approximate prevalence of Alzheimer’s disease in people with Down...

62 Chapter 75Table 75.1 Causes of dizziness in the elderly.Table 75.2 Characteristics of positional nystagmus.Table 75.3 Drugs causing dizziness/vertigo.

63 Chapter 76Table 76.1 Classification of smell disorders.

64 Chapter 78Table 78.1 Medication classes associated with an increased risk of falls in ...Table 78.2 Fall risk factors.

65 Chapter 79Table 79.1 Recommendations for avoiding the dislocation of a hip prosthesis.Table 79.2 Summary of fall risk assessment and appropriate interventions.

66 Chapter 81Table 81.1 Trends in total circulating content of some major hormones with a...Table 81.2 Effects of obesity and positive energy balance on nine hallmarks ...Table 81.3 Effects of testosterone in older men and postmenopausal women.Table 81.4 Lessons from growth hormone studies in older people.Table 81.5 Ghrelin and ageing.

67 Chapter 82Table 82.1 Pituitary cell types, their hormones, and their percentages.Table 82.2 Symptoms of acromegaly in older people with GH secreting tumours.Table 82.3 Symptoms of hypopituitarism in older adults.Table 82.4 Causes of hypopituitarism.Table 82.5 Changes reported in hormones.Table 82.6 Causes of central diabetes insipidus.

68 Chapter 83Table 83.1 Agents that inhibit thyroid hormone synthesis and secretion.Table 83.2 Compounds that affect thyroid hormone transport proteins in serum...Table 83.3 Agents that alter the extrathyroidal metabolism of thyroid hormon...Table 83.4 Drugs that cause false results for thyroid tests in euthyroid peo...Table 83.5 Possible mechanisms of nonthyroidal illness (NTI).Table 83.6 Categories and risk of malignancy of thyroid nodules ultrasound f...

69 Chapter 84Table 84.1 The dose range commonly used in hormone therapy for estradiol and...

70 Chapter 85Table 85.1 Androgen Deficiency in Aging Male (ADAM) questionnaire.Table 85.2 Contraindications for TRT.

71 Chapter 86Table 86.1 Risk factors for diabetes mellitus in older subjects.Table 86.2 Varying presentation of diabetes in older people.Table 86.3 Risk factors for foot ulceration in the elderly.Table 86.4 Benefits of early recognition of cognitive impairment in diabetes...Table 86.5 Benefits of functional assessment: diabetes‐related.Table 86.6 Criteria for targeting patients with type 2 diabetes for comprehe...Table 86.7 Modern aims in managing older people with diabetes.Table 86.8 Care plan for initial management of diabetes in an elderly person...Table 86.9 Key intensive glucose control and other studies with relevance to...Table 86.10 Concerns and deficiencies in diabetes care – institutional facil...Table 86.11 Importance of early detection of diabetes mellitus in care homes...Table A.1 Clinical guidelines and guidance for diabetes care in care homes.

72 Chapter 87Table 87.1 Approved T2DM antiglycaemic therapies.Table 87.2 GLP‐1 agonist and DPP4 inhibitor comparisons.Table 87.3 GLP‐1 agonist comparisons.Table 87.4 Effects of antiglycaemic drugs on hypoglycaemia, weight, and CVD ...Table 87.5 Multifactorial approach to diabetes treatment (ESC 2019 guideline...Table 87.6 Antiglycaemics in development.

73 Chapter 88Table 88.1 Causes of postmenopausal bleeding.Table 88.2 Causes of discharge per vagina.Table 88.3 Health factors that inhibit sexual activity in elderly people.

74 Chapter 89Table 89.1 AUA benign prostatic hyperplasia symptom score.Table 89.2 Table of corresponding Gleason score and ISUP grade.Table 89.3 Groups of D’Amico et al.Table 89.4 Prostate tumour node metastasis (TNM) classification.

75 Chapter 90Table 90.1 Anatomical changes of the ageing bladder.Table 90.2 Bladder receptors and ageing.

76 Chapter 92Table 92.1 Recommendations for cancer screening in older adults.

77 Chapter 93Table 93.1 Summary of oncological emergencies.Table 93.2 Initial antibiotic therapy of neutropenic fever.Table 93.3 Diagnostic criteria of the syndrome of inappropriate antidiuretic...Table 93.4 Main predisposing and precipitating factors of delirium.

78 Chapter 94Table 94.1 TNM stage (%) with age at presentation.Table 94.2 Result of UK breast cancer screening.Table 94.3 Rates of examination and mammography by intervention.

79 Chapter 95Table 95.1 Five leading causes of death: US men and women age 60 and older,...Table 95.2 Five most common sites of cancer mortality: US adults, 2009.Table 95.3 Percentage 5+ year survival by cancer site, US adults 1996–2004.Table 95.4 A proposed algorithm for exercise prescription for older adult c...

80 Chapter 96Table 96.1 Measurable dimensions of geriatric assessment with examples of s...

81 Chapter 97Table 97.1 Comparison of three frailty scales.Table 97.2 MEALS‐ON‐WHEELS mnemonic for treatable causes of weight loss.Table 97.3 Selective androgen receptor molecules.Table 97.4 An approach to the management of frailty using the FRAIL screen.

82 Chapter 98Table 98.1 Determinants of activity and participation restrictions.Table 98.2 Steps in the rehabilitation process.Table 98.3 Standardised functional assessment scales for elderly patients.Table 98.4 The four phases of cardiac rehabilitation.Table 98.5 Elements of pulmonary rehabilitation.

83 Chapter 100Table 100.1 WHO ICOPE screening tool.Table 100.2 Approach, assessment and intervention in each intrinsic capacit...

84 Chapter 102Table 102.1 Specific antimicrobial therapy for meningitis.Table 102.2 Recommended dosages of selected antimicrobial agents for centra...Table 102.3 Empirical antimicrobial therapy of bacterial brain abscess.Table 102.4 Antimicrobial therapy of brain abscess.

85 Chapter 104Table 104.1 Hazard ratios (with 95% CI) of dementia according to alcohol co...Table 104.2 Odds (with 95% CI) of incident dementia according to alcohol co...

86 Chapter 106Table 106.1 Example of monitoring criteria for treatment follow‐up.

87 Chapter 107Table 107.1 Sample diseases for which appropriate assessment and remediatio...Table 107.2 Schematic outline of a driving assessment.

88 Chapter 109Table 109.1 Potential biomarkers for frailty, sarcopenia, and intrinsic cap...Table 109.2 Recently terminated or ongoing studies investigating biomarkers...

89 Chapter 113Table 113.1 Mortality associated with surgery and anaesthesia.Table 113.2 ASA grading of physical status.Table 113.3 Predictive factors for postoperative cardiovascular morbidity.Table 113.4 Risk factors for the development of postoperative confusion.Table 113.5 Risk factors for postoperative stroke in the elderly.Table 113.6 Effects of perioperative hypothermia.Table 113.7 Pharmacological analgesic options.Table 113.8 Summary of the anaesthetic management of elderly patients.Table 113.9 Risk factors for the development of perioperative decubitus ulc...

90 Chapter 114Table 114.1 Signs and symptoms of menopause.

91 Chapter 115Table 115.1 Mechanisms proposed to explain the lifespan‐extension effects o...Table 115.2 Cellular processes regulated by FOXOs in response to stress, po...Table 115.3 Ageing effects in different body systems and corresponding oppo...

92 Chapter 118Table 118.1 Effects of immobility.Table 118.2 Negative effects of physical restraints and siderails.

93 Chapter 119Table 119.1 The main studies evaluating cognitive impairment in centenarian...

94 Chapter 120Table 120.1 Palliative care domains.Table 120.2 REMAP physician statements.Table 120.3 Treatment of common aetiologies of nausea and vomiting.

95 Chapter 122Table 122.1 The Minimum Standard: American College of Surgeons (1917).Table 122.2 The Fundamental Standards: The Care Quality Commission.Table 122.3 Nursing home quality measures.Table 122.4 QAPI report example.

96 Chapter 123Table 123.1 The five Ws.

97 Chapter 125Table 125.1 Macro‐level societal/governance characteristics.Table 125.2 Meso‐level organisational structure.Table 125.3 Micro‐level resident characteristics.

98 Chapter 127Table 127.1 Recognition of geriatric medicine in different European countri...Table 127.2 European undergraduate sections of geriatric medicine curriculu...Table 127.3 Minimum geriatric competencies for medical students (US).Table 127.4 Internal medicine and family medicine resident competencies.

99 Chapter 128Table 128.1 Geriatrics emergency department components.Table 128.2 Components of an acute care for the elderly unit.Table 128.3 Requirements for stroke centre certification.

100 Chapter 133Table 133.1 Some data on healthcare in the European Union.

101 Chapter 134Table 134.1 Pros and cons of different animal models in research on ageing.Table 134.2 Structural and functional changes associated with ageing in the...