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Drug Research and Development for Adults Across the Older Age Span

Drug Research and Development for Adults Across the Older Age Span
Author: National Academies of Sciences Engineering and Medicine
Publisher:
Total Pages:
Release: 2021-10-22
Genre:
ISBN: 9780309685689

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There is a void in evidence-based information for making informed decisions on how to optimize care for older adults, particularly those 80 years and over. Because older adults are vastly underrepresented in clinical trials, there is a dearth of information about the appropriate use of drugs in this population. Yet older adults have higher rates of comorbidities and simultaneous use of multiple medications than the general population, and are the majority users of many medications. Additionally, age-related physiological and pathological changes, particularly for adults 80 years of age and older, can lead to significant differences in the pharmacokinetics (PK)2 and pharmacodynamics (PD)3 of a given drug compared to the general population. On August 5 and 6, 2020, the National Academies of Sciences, Engineering, and Medicine hosted a workshop titled Drug Research and Development for Adults Across the Older Age Span. The workshop was designed to examine the challenges and opportunities in drug research and development for older adult populations, explore barriers that impede safety and efficacy studies in these populations, and share lessons learned for better understanding clinical pharmacology for populations over age 65. This publication summarizes the presentation and discussion of the workshop.


Pathy's Principles and Practice of Geriatric Medicine

Pathy's Principles and Practice of Geriatric Medicine
Author: Alan J. Sinclair
Publisher: John Wiley & Sons
Total Pages: 3453
Release: 2012-03-13
Genre: Medical
ISBN: 1119954142

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This new edition of the comprehensive and renowned textbook Principles and Practice of Geriatric Medicine offers a fully revised and updated review of geriatric medicine. It covers the full spectrum of the subject, features 41 new chapters, and provides up-to-date, evidence-based, and practical information about the varied medical problems of ageing citizens. The three editors, from UK, USA and France, have ensured that updated chapters provide a global perspective of geriatric medicine, as well as reflect the changes in treatment options and medical conditions which have emerged since publication of the 4th edition in 2006. The book includes expanded sections on acute stroke, dementia, cardiovascular disease, and respiratory diseases, and features a new section on end-of-life care. In the tradition of previous editions, this all-encompassing text continues to be a must-have text for all clinicians who deal with older people, particularly geriatric medical specialists, gerontologists, researchers, and general practitioners. This title is also available as a mobile App from MedHand Mobile Libraries. Buy it now from Google Play or the MedHand Store. Praise for the 4th edition: "...an excellent reference for learners at all clinical and preclinical levels and a useful contribution to the geriatric medical literature." —Journal of the American Medical Association, November 2006 5th edition selected for 2012 Edition of Doody's Core TitlesTM


Clinical Trials in Older Adults

Clinical Trials in Older Adults
Author: Antonio Cherubini
Publisher: John Wiley & Sons
Total Pages: 280
Release: 2016-01-13
Genre: Medical
ISBN: 1118323475

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Clinical Trials in Older Adults is the first book to consider the methodological issues underlying the evaluation of new treatments in older people. Provides information on the methodology, monitoring and regulations for those planning to conduct a clinical trials involving older adults Contains examples of ongoing trials involving older adults, and presents the main characteristics of many recently published Depicts how the issues regarding older adults in clinical trials could be properly addressed with the appropriate study design and conduct Identifies key issues in performing clinical trials in older patients with common geriatric conditions, i.e. Alzheimer’s dementia, depression, low muscle mass, cancer


Cancer and Aging

Cancer and Aging
Author: M. Extermann
Publisher: Karger Medical and Scientific Publishers
Total Pages: 179
Release: 2013-01-18
Genre: Medical
ISBN: 3318023078

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Cancer is clearly an age-related disease. Recent research in both aging and cancer has demonstrated the complex interaction between the two phenomena. This affects a wide spectrum of research and practice, anywhere from basic research to health care organization. Core examples of these close associations are addressed in this book. Starting with basic research, the first chapters cover cancer development, mTOR inhibition, senescent cells altering the tumor microenvironment, and immune senescence affecting cancer vaccine response. Taking into account the multidisciplinarity of geriatric oncology, several chapters focus on geriatric and oncologic aspects in patient assessment, treatment options, nursing and exercise programs. The book is rounded off by a discussion on the impact of the metabolic syndrome illustrating the interactions between comorbidity and cancer and a chapter on frailty.This book provides the reader with insights that will hopefully foster his or her reflection in their own research and practice to further the development of this most exciting field. Given the aging of the population worldwide and the high prevalence of cancer, it is essential reading not only for oncologists and geriatricians but for all health practitioners.


The Prevention and Treatment of Missing Data in Clinical Trials

The Prevention and Treatment of Missing Data in Clinical Trials
Author: National Research Council
Publisher: National Academies Press
Total Pages: 163
Release: 2010-12-21
Genre: Medical
ISBN: 030918651X

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Randomized clinical trials are the primary tool for evaluating new medical interventions. Randomization provides for a fair comparison between treatment and control groups, balancing out, on average, distributions of known and unknown factors among the participants. Unfortunately, these studies often lack a substantial percentage of data. This missing data reduces the benefit provided by the randomization and introduces potential biases in the comparison of the treatment groups. Missing data can arise for a variety of reasons, including the inability or unwillingness of participants to meet appointments for evaluation. And in some studies, some or all of data collection ceases when participants discontinue study treatment. Existing guidelines for the design and conduct of clinical trials, and the analysis of the resulting data, provide only limited advice on how to handle missing data. Thus, approaches to the analysis of data with an appreciable amount of missing values tend to be ad hoc and variable. The Prevention and Treatment of Missing Data in Clinical Trials concludes that a more principled approach to design and analysis in the presence of missing data is both needed and possible. Such an approach needs to focus on two critical elements: (1) careful design and conduct to limit the amount and impact of missing data and (2) analysis that makes full use of information on all randomized participants and is based on careful attention to the assumptions about the nature of the missing data underlying estimates of treatment effects. In addition to the highest priority recommendations, the book offers more detailed recommendations on the conduct of clinical trials and techniques for analysis of trial data.


Social Isolation and Loneliness in Older Adults

Social Isolation and Loneliness in Older Adults
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
Total Pages: 317
Release: 2020-05-14
Genre: Social Science
ISBN: 0309671035

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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.


Geriatric Medicine

Geriatric Medicine
Author: Frank Lally
Publisher: Oxford University Press, USA
Total Pages: 237
Release: 2014
Genre: Medical
ISBN: 0199689644

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People are living longer and the population over the age of 60 is burgeoning, with repercussions for health services and healthcare expenditure in developed countries. Crucially, disease aetiology, diagnosis, and treatment in older people differ from the general adult population. Older people often have complicated co-morbidities and respond to treatment in different ways compared to younger people. Evidence of efficacy of different treatments is often lacking because older people are under-represented in clinical trials, and the specific needs of older people are rarely discussed specifically in more general texts. Geriatric medicine: an evidence based approach is a clinical reference for health care professionals who manage older patients, and summarizes up-to-date research literature in a style that can be directly applied by busy healthcare professionals and provide a useful resource for reference.


Contemporary Perspectives on Ageism

Contemporary Perspectives on Ageism
Author: Liat Ayalon
Publisher: Springer
Total Pages: 564
Release: 2018-05-22
Genre: Social Science
ISBN: 3319738208

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This open access book provides a comprehensive perspective on the concept of ageism, its origins, the manifestation and consequences of ageism, as well as ways to respond to and research ageism. The book represents a collaborative effort of researchers from over 20 countries and a variety of disciplines, including, psychology, sociology, gerontology, geriatrics, pharmacology, law, geography, design, engineering, policy and media studies. The contributors have collaborated to produce a truly stimulating and educating book on ageism which brings a clear overview of the state of the art in the field. The book serves as a catalyst to generate research, policy and public interest in the field of ageism and to reconstruct the image of old age and will be of interest to researchers and students in gerontology and geriatrics.


Delivering High-Quality Cancer Care

Delivering High-Quality Cancer Care
Author: Committee on Improving the Quality of Cancer Care: Addressing the Challenges of an Aging Population
Publisher: National Academies Press
Total Pages: 0
Release: 2014-01-10
Genre: Medical
ISBN: 9780309286602

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In the United States, approximately 14 million people have had cancer and more than 1.6 million new cases are diagnosed each year. However, more than a decade after the Institute of Medicine (IOM) first studied the quality of cancer care, the barriers to achieving excellent care for all cancer patients remain daunting. Care often is not patient-centered, many patients do not receive palliative care to manage their symptoms and side effects from treatment, and decisions about care often are not based on the latest scientific evidence. The cost of cancer care also is rising faster than many sectors of medicine--having increased to $125 billion in 2010 from $72 billion in 2004--and is projected to reach $173 billion by 2020. Rising costs are making cancer care less affordable for patients and their families and are creating disparities in patients' access to high-quality cancer care. There also are growing shortages of health professionals skilled in providing cancer care, and the number of adults age 65 and older--the group most susceptible to cancer--is expected to double by 2030, contributing to a 45 percent increase in the number of people developing cancer. The current care delivery system is poorly prepared to address the care needs of this population, which are complex due to altered physiology, functional and cognitive impairment, multiple coexisting diseases, increased side effects from treatment, and greater need for social support. Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis presents a conceptual framework for improving the quality of cancer care. This study proposes improvements to six interconnected components of care: (1) engaged patients; (2) an adequately staffed, trained, and coordinated workforce; (3) evidence-based care; (4) learning health care information technology (IT); (5) translation of evidence into clinical practice, quality measurement and performance improvement; and (6) accessible and affordable care. This report recommends changes across the board in these areas to improve the quality of care. Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis provides information for cancer care teams, patients and their families, researchers, quality metrics developers, and payers, as well as HHS, other federal agencies, and industry to reevaluate their current roles and responsibilities in cancer care and work together to develop a higher quality care delivery system. By working toward this shared goal, the cancer care community can improve the quality of life and outcomes for people facing a cancer diagnosis.


Families Caring for an Aging America

Families Caring for an Aging America
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
Total Pages: 367
Release: 2016-11-08
Genre: Medical
ISBN: 0309448093

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Family caregiving affects millions of Americans every day, in all walks of life. At least 17.7 million individuals in the United States are caregivers of an older adult with a health or functional limitation. The nation's family caregivers provide the lion's share of long-term care for our older adult population. They are also central to older adults' access to and receipt of health care and community-based social services. Yet the need to recognize and support caregivers is among the least appreciated challenges facing the aging U.S. population. Families Caring for an Aging America examines the prevalence and nature of family caregiving of older adults and the available evidence on the effectiveness of programs, supports, and other interventions designed to support family caregivers. This report also assesses and recommends policies to address the needs of family caregivers and to minimize the barriers that they encounter in trying to meet the needs of older adults.