Issue

CASE PRESENTATION
Mr. C is an 84-year-old married male who lives with his wife. They have lived in the same suburban town their entire lives. They raised three sons who are now married and living in other states. The couple enjoys taking trips to visit their children and grandchildren. Mr. C suffers from osteoarthritis, coronary artery disease, a history of coronary artery stent placement1 year ago, and recently underwent cataract surgery with intraocular lens implantation in both eyes. Mrs. C suffers from macular degeneration and
stopped driving 3 years ago. Mr. C drives almost daily. He ta

INTRODUCTION
Under Medicare Part B of an Initial Preventive Physical Examination (IPPE), physicians or other qualified nonphysician practitioners (NPPs) are encouraged to utilize hearing screening questionnaires in order to assist in a review of an elderly individual’s functional ability and level of safety, and to provide the appropriate counseling and referral as part of the screening.1

Elderly persons rely on auditory input to maintain safety, social contact, awareness of their environment, and overall functional ability. Hearing function declines with age, yet relatively few elderly

CASE PRESENTATION
A 66-year-old male had a routine physical examination. He had a moderately enlarged benign prostate gland. The prostate-specific antigen (PSA) was 7.7, and the ratio of free/total PSA was 9% (normal > 25%). A prostate biopsy revealed multiple cores of adenocarcinoma of the prostate, Gleason score 3 + 4. He was treated with I-125 brachytherapy plus 20 Gy of external beam therapy to the periprostatic tissue, and the PSA nadir was 0.7 ng/mL 6 months after the radiation therapy. However, 6 months later the PSA increased to2.7, and repeat PSA testing demonstrated progressive inc

ACCREDITATION
The Johns Hopkins University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The Johns Hopkins University School of Medicine takes responsibility for the content, quality, and scientific integrity of this CME activity.

CREDIT DESIGNATION STATEMENT
The Johns Hopkins University School of Medicine designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their particip

This continuing medical education activity is presented by the Johns Hopkins University School of Medicine, Baltimore, Maryland. The Johns Hopkins University School of Medicine takes responsibility for the content, quality, and scientific integrity of this CME activity.

These examination questions are based on the article “Laxative Use and Abuse in the Older Adult: Part II,” which appears on pages 38-45 in this issue of Clinical Geriatrics.

ACCREDITATION
The Johns Hopkins University School of Medicine is accredited by the Accreditation Council for Continuing Medical Educat

I was recently asked to serve on a committee looking at establishing a palliative care program at my primary hospital. Although we have hospice care affiliated with our health system, the notion of palliative care is a concept that has gained growing interest from several key faculty members, mostly oncologists. While there have been several attempts to develop a specific pain program, pain management is currently left to the individual medical teams caring for patients, with consultation available from several members of the Anesthesia or Physical Medicine and Rehabilitation departments as ne

We and our patients benefit greatly when basic research leads to new approaches to preventing, diagnosing, and treating common health problems. The flow of information from “bench to bedside” is critical to advancing patient care. By the same token, the flow of clinical observations and information from bedside—the clinical setting—to bench is also invaluable. Clinical observations inform basic research.

That’s why it’s good news that the National Institute on Aging (NIA) recently renewed funding for the American Geriatrics Society’s (AGS) “Bedside to Bench” research confe

Most people have had a close call with another car, a person walking, or an object while driving.

Many people have also had car accidents. How do older adults and caregivers know when these situations are cause for concern?

Q. How old is too old to drive?
A. People can be great drivers or bad drivers at any age. Generally, young, new drivers tend to have the worst driving records. Experienced, middle-aged drivers are likely to have the best driving records. Overall, older drivers make appropriate adjustments for their abilities and limitations and are pretty safe too. In fact, the to