Issue

In last month’s issue of Clinical Geriatrics, we ran a timely article on “Heat-Related Illness in the Elderly.”1 While there are many problems that can result from the heat itself, the elderly are more prone to many of the dangers inherent during this time of the year. Last year I wrote in a similar forum about items we should be well advised to think about and adopt into our daily summer routine regardless of one’s age. I thought it would be good to update these, as summer is here and the need to be aware of its potential dangers has not changed.

1. Avoid excessiv

One of the major health concerns for older persons is their potential risk for serious cardiovascular events, a risk that rises dramatically with increasing age.1,2 For example, the average annual rate of first major cardiovascular events rises from 7 per 1000 men at ages 35-44 years to 68 per 1000 men at ages 85-94; comparable rates occur in women 10 years later in life.3

Coronary heart disease (CHD) is more prevalent in the elderly, with over 83% of cardiovascular disease deaths in the United States occurring in individuals age 65 years or older.4 Individuals in the sixth decade of life o

Case Presentation

Mrs. D is a 78-year-old widowed woman who recently moved in with her daughter, Mrs. F. Mrs. D comes to see Dr. R for a check of her blood pressure and diet-controlled diabetes. Dr. R has been caring for Mrs. F for many years and is pleased to meet her mother. He finds that unlike her daughter, Mrs. D is considerably more critical of his office staff, waiting time, and the cold temperature of his office. When he brings up the fact that her blood pressure is elevated to 150/100 mm Hg and her finger stick blood glucose is nearly 300 mg/dL, Mrs. D takes notes and asks f

Introduction
For younger males with profound hypogonadism, such as those with hypogonadotropic hypogonadism due to Kallmann’s syndrome, testosterone is routinely prescribed to induce and maintain secondary sex characteristics, to allow for normal sexual function, to promote a male body composition, and to provide estrogen for bone health. The situation is more complex when it comes to older men with borderline low testosterone levels and nonspecific symptoms of hypogonadism. The Endocrine Society recently published a Clinical Practice Guideline entitled “Testosterone Therapy in Adu

The Medicare beneficiary is changing, and these changes are affecting how geriatric care providers practice. From the physical layout of the practice, to marketing, to management from an administrative and clinical aspect, all is about to change. The Medicare Payment Advisory Commission (MedPAC; www.MedPAC.gov) recently assessed for Congress the changing demographics of the Medicare beneficiary by identifying eight major changes,1 as follow:

Increase in Number of Beneficiaries as Baby Boomers Age
Everyone is aware of the aging baby boomers becoming Medicare-eligible, but the

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 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 1AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participat

August 2007
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 “Prevention and Prophylaxis of Malaria in Older Travelers,” which appears on pages 36-45 in this issue of Clinical Geriatrics.

ACCREDITATION
The Johns Hopkins University School of Medicine is accredited by the Accreditation Coun