By Asenath LaRue
It is a privilege to be requested to jot down the foreword for thus first-class a booklet, so well timed and rather a lot wanted by way of the sector. not just is it most unique nowadays to have a unmarried authored quantity on so wide a subject matter, yet Dr. los angeles Rue has performed an exceptional activity of offering either a scholarly treatise and a realistic guide. With a burgeoning aged inhabitants and the corresponding bring up in geriatric psychopathology, the desires of psychological well-being providers are exceeding through a ways the provision of applicable companies. with the intention to meet this desire, psychiatry, drugs, neurology, pharmacology, psychology, nursing, and social paintings have all made the availability of educating in geriatrics and gerontology a excessive priority-but I worry we're wasting the race. for instance, multidisciplinary groups that investigate, diagnose, and deal with psychological health and wellbeing issues in aged sufferers are incomplete with no medical psychologists and neuropsy chologists, and but there's slightly a handful of medical psychologists expert in facing geriatric sufferers. we will expect our hands the extra ones graduated every year. In hospitals, clinics, and personal practices around the kingdom, in a different way expert psychologists are unprepared to reply to the certain psychological well-being wishes of the aged. a couple of CME courses are supporting to deal with this want, yet they're essentially now not enough.
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Additional info for Aging and Neuropsychological Assessment
Structures similar to senile plaques are often clustered around these denervated capillaries, a finding leading to the hypothesis that microvascular changes may playa role in the development of Alzheimertype pathology (Scheibel, 1992). , hypertension or diabetes), narrowing or blockage of capillaries may produce a localized hypoxic state that could result in small areas of tissue loss (see Chapter 9 for further discussion). Neuroanatomical Changes and Cognitive Performance Lesion Studies There is an extensive neuropsychological literature on cogmtlve functions of patients with focal brain lesions (for reviews, see Kolb & Wishaw, 1984; Lezak, 1983; THE AGING BRAIN 31 Strub & Black, 1988).
Medicare provides the largest single source of funding for health care costs of older people, and the greatest proportion (69%) of the Medicare funds are spent on short-stay hospital care. For older people in nursing homes, one of the primary funding sources is Medicaid, which covered 42% of the costs of long-term care in 1985. It is also important to note that the elderly paid one-third of their own medical costs in 1984 through direct payments or through insurance premiums, and that more than half (52%) of nursing-home costs in 1985 had to be covered by direct patient payments (U.
1983) and a multitrial object recall test (Fuld, 1981). Neuroanatomical data were obtained from eight brain regions, including the midfrontal, superior temporal, and inferior parietal cortex, hippocampus, substantia nigra, and locus ceruleus. Subjects were separated into groups based on their cognitive test scores. Of 29 cognitively normal individuals, more than one-third (n = 10) had brain findings consistent with Alzheimer's disease, including moderate levels of neuritic plaques and decreased choline acetyltransferase (see "The Cholinergic System," below).