Beneficiaries of the Medicare program have three rehabilitation-related benefits established by federal statute: physical therapy rehabilitation, occupational therapy, and speech-language therapy (speech-language pathology). All therapists, who must be graduates of accredited programs, must pass a national examination and be licensed, certified, or registered in their respective professions within the state in which the services are furnished. Medicare covers services that are necessary and likely to result in improvement in a reasonable period of time. Medicare does not currently regard prevention services provided by therapists as falling under therapy benefits and will not cover services intended to maintain a current level of function. (more…)

Weight loss improves many of the adverse health outcomes associated with obesity, including preventing or delaying the onset of diabetes, improving blood sugar control in those with diabetes, reducing low-density lipoprotein (bad cholesterol), raising high-density lipoprotein (good cholesterol), improving hypertension, improving symptoms of osteoarthritis, and providing an improved sense of well-being. (more…)

Aging is associated with progressive fibrosis of the sinoatrial node and AV conduction system, resulting in bradycardia, which may be further exacerbated by disease and medications, resulting in symptoms requiring permanent pacemaker implantation. More than 80% of pacemaker recipients in the United States are older than 65 years, and the median age is 75 years. As the population ages, it is anticipated that the number of older persons requiring permanent cardiac pacemakers, as well as the associated costs, will continue to rise. (more…)

The majority associated with leading cause of deaths in America are due to medical health issues, not accidents, regardless of what your mother told you. The National Center for Health Statistics compiles the listing of killers and leading causes of death in America. A number of on the list you can not manage but others you can. There are several things that you can do to minimize getting the risk of the leading causes of death. If you eat right, exercise, don’t smoke, keep your weight under control, and manage your stress, then you are having a big change to live longer and having prolonged life than average American. (more…)

The overarching goal of physical therapy rehabilitation is to return the individual to as close to the premorbid level of function as possible or, alternatively, to maximize a person’s current potential for function and maintain it as long as possible. This goal is achieved by promoting changes in the individual, by altering his or her physical health elderly or social environments, or by implementing a combination of both strategies. (more…)

There are a number of issues that must be considered in geriatric pain assessment. The major issues that merit attention are presence of comorbidities, mental status, depression in late life, limitations in ADLs, medications, and the importance of family and other support systems (see Depression; Social Networks, Support, and Integration). (more…)

Altered cellular metabolism and intracellular and intercellular signaling with advancing age result in widespread changes in endocrine function. Several mechanisms interact in most systems to bring about the observed changes. Aging is associated with anatomic changes of the endocrine glands. In addition, with age, changes in hormone secretion occur, including alterations in circadian or seasonal biorhythms, changes in pulsatile frequency or amplitude of hormone secretion, as well as absolute changes in mean serum hormonal levels. (more…)

There is strong consensus among geriatricians and gerontologists that frailty is a clinical state of increased vulnerability and decreased ability to maintain homeostasis that is age-related problems and centrally characterized by declines in functional reserves across multiple physiologic systems. This vulnerability is age-related and also related to, but distinct from, disability and elderly disease states. (more…)

Altered cellular metabolism and intracellular and intercellular signaling with advancing age result in widespread changes in endocrine function. Several mechanisms interact in most systems to bring about the observed changes. Aging is associated with anatomic changes of the endocrine glands. In addition, with age, changes in hormone replacement secretion occur, including alterations in circadian or seasonal biorhythms, changes in pulsatile frequency or amplitude of growth hormone secretion, as well as absolute changes in mean serum hormonal levels. The three main hormone systems that show decline with age are the gonadal hormones (menopause and andropause), the adrenal steroids DHEA and DHEA-S (adrenopause), and the GH/IGF-1 axis (somatopause). (more…)

For trained physicians, aging is often defined by the age-related diseases and disorders people experience as they grow older. In fact, aging is often portrayed as a disease that is amenable to treatment, just like any other elderly chronic diseases that physicians are trained to diagnose and treat. This is not an unexpected view of aging given the Western disease-oriented model of medical education. Examples of the conditions that anti-aging practitioners endeavor to treat or postpone include cardiovascular disease, cancer, sensory impairments, muscle and bone loss, loss of skin elasticity, and decline in sexual activity in elderly function. (more…)