• oral/written
• may or may not designate surrogate decision maker

• cure is not expected
• focus on function, wellness, psychosocial

conditions believed to adversely affect the aging experience

1. intellectual impairment
2. immobility
3. instability
4. incontinence
5. iatrogenic drug reactions

• study of disease in old age

• period immediately before menopause
• continue for at least 1 yr after cessation of periods
• clinical features of approaching menopause commence

• 2nd most common cancer for men
• hard to diagnose, lack of symptoms
• 1/6 men diagnosed
• more common in African American men
• family hx increases chances

3 types of intellectual impairments

1. progressive intellectual impairment (dementia)
2. mood disorder (depression)
3. acute confusion (delirium)

• women more likely to have
• so use more health services

• MVA, poisoning, drowning
• suicide is 2nd leading cause of death for adolescents

• 3.1 million (underreported)
• occurs in all races, incomes, ethnic groups

• 1921 American Birth Control league -> 1942 Planned Parenthood
• birth control became legal for married couples in 1965

• began to monitor national health policy in 1974
• clearinghouse & advocate for women's health
• important for development of policy & legislation

• 4000 babies born with spina bifida or anencephaly each year
• intake of folic acid can reduce by 50-70%
• need preconceptual counseling to reduce lack of awareness among low socioeconomic groups
• CDC launched national campaign to increase awareness

• 1/2 American women over 50 will have an osteoporosis-related fracture
• maybe from falling estrogen
• limit alcohol, no smoking, 20 min of sun per day, weight bearing exercise

• 2nd leading cause of cancer deaths among women
• higher in white women; but African American women more likely to die from it

• most common solid tumor males 15-40
• survival rate 87-96%

• 1/8 men, 1/5 women will develop
• CHD #1 killer
• most common risk factor for premature CHD: smoking
• HTN: 1/3 adults
• screen all adults over 18
• majority of risk factors preventable
• 42% of women die w/in first year after MI, 25% men
• screen women 45+ for lipid disorders
• women develop CHD 10 yrs later than men

• 20.8 million; 1/12 adults

• women more than men
• 26% of men report high level of depression (poor health, low education are risk factors)
• Men 25-64 highest risk for suicide
• online chat room support groups may help men express emotions

• women mostly infected by heterosexual sex
• 73% are men
• 60% from MSM (men sex with men), 13% heterosexual, 19% intravenous drugs, 7% MSM+drugs
• leading cause of death for African American men 35-44
• 3rd leading cause of death for Hispanics

• 25-29 overweight
• 30-39 obese
• 40+ extremely obese

• 1900: 47
• 2002: 77
• if you reach 65, then avg is to live 18 more years
• women live 7 years longer
• 145/100 women to men ratio
• only 18% of older adults are minorities

• interventions to facilitate good health for older person caregivers
• T: training in care techniques, safe med, recognition of abnormalities, available resources
• L: leaving care situation periodically for respite
• C: care for themselves

• offer counseling regarding calcium/vitamin D supplementation, nutrition to reduce complications from rickets
• develop exercise program for those with CVD
• teach health behaviors to HIV-positive men
• provide diabetes clinic