TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Tina Winters TI - Alzheimer's Disease and Related Dementias: Experience and Caregiving, Epidemiology, and Models of Care: Proceedings of a Workshop–in Brief DO - 10.17226/25694 PY - 2020 UR - https://nap.nationalacademies.org/catalog/25694/alzheimers-disease-and-related-dementias-experience-and-caregiving-epidemiology-and-models-of-care PB - The National Academies Press CY - Washington, DC LA - English KW - Behavioral and Social Sciences KW - Health and Medicine AB - On August 14, 2019, the Committee on Developing a Behavioral and Social Science Research Agenda on Alzheimer's Disease and Alzheimer's Disease-Related Dementias convened a public workshop in Washington, D.C., as part of the study "Developing a Behavioral and Social Science Research Agenda on Alzheimer's Disease and Alzheimer's Disease-Related Dementias." As the first public event of the study, the workshop was designed to inform the public about the study and to gather information on how dementia affects individuals, families, and communities; the epidemiology of dementia; and how best to provide care to individuals with dementia. To achieve these goals, the workshop included four panel discussions: sponsors' perspectives on the study; perspectives from individuals living with Alzheimer's disease and other dementias and caregivers; epidemiological perspectives; and a discussion on models of care initiatives. This Proceedings of a Workshop - in Brief summarizes the key points made by the participants. ER - TY - BOOK AU - Institute of Medicine A2 - Dan G. Blazer A2 - Kristine Yaffe A2 - Catharyn T. Liverman TI - Cognitive Aging: Progress in Understanding and Opportunities for Action SN - DO - 10.17226/21693 PY - 2015 UR - https://nap.nationalacademies.org/catalog/21693/cognitive-aging-progress-in-understanding-and-opportunities-for-action PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - For most Americans, staying "mentally sharp" as they age is a very high priority. Declines in memory and decision-making abilities may trigger fears of Alzheimer's disease or other neurodegenerative diseases. However, cognitive aging is a natural process that can have both positive and negative effects on cognitive function in older adults - effects that vary widely among individuals. At this point in time, when the older population is rapidly growing in the United States and across the globe, it is important to examine what is known about cognitive aging and to identify and promote actions that individuals, organizations, communities, and society can take to help older adults maintain and improve their cognitive health. Cognitive Aging assesses the public health dimensions of cognitive aging with an emphasis on definitions and terminology, epidemiology and surveillance, prevention and intervention, education of health professionals, and public awareness and education. This report makes specific recommendations for individuals to reduce the risks of cognitive decline with aging. Aging is inevitable, but there are actions that can be taken by individuals, families, communities, and society that may help to prevent or ameliorate the impact of aging on the brain, understand more about its impact, and help older adults live more fully and independent lives. Cognitive aging is not just an individual or a family or a health care system challenge. It is an issue that affects the fabric of society and requires actions by many and varied stakeholders. Cognitive Aging offers clear steps that individuals, families, communities, health care providers and systems, financial organizations, community groups, public health agencies, and others can take to promote cognitive health and to help older adults live fuller and more independent lives. Ultimately, this report calls for a societal commitment to cognitive aging as a public health issue that requires prompt action across many sectors. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Alexandra Andrada A2 - Kat M. Anderson A2 - Sharyl J. Nass TI - Addressing the Rising Mental Health Needs of an Aging Population: Proceedings of a Workshop SN - DO - 10.17226/27340 PY - 2024 UR - https://nap.nationalacademies.org/catalog/27340/addressing-the-rising-mental-health-needs-of-an-aging-population PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Existing systems are not prepared to provide the mental health care services needed by the growing population of older adults. The National Academies Forum on Mental Health and Substance Use Disorders hosted a public workshop in May 2023 to highlight the current state of mental health care for older adults, outline the challenges they face, and explore potential long-term strategies and solutions for addressing unmet mental health needs. Discussions emphasized information about wellness and prevention, social determinants of health in aging populations, the impact of workforce shortages and gaps, the need for supportive healthy communities, and strategies to promote positive mental health.This publication summarizes the presentations and discussion of the workshop. ER - TY - BOOK AU - Institute of Medicine A2 - Rebecca Koehler A2 - Erin E. Wilhelm A2 - Ira Shoulson TI - Cognitive Rehabilitation Therapy for Traumatic Brain Injury: Evaluating the Evidence SN - DO - 10.17226/13220 PY - 2011 UR - https://nap.nationalacademies.org/catalog/13220/cognitive-rehabilitation-therapy-for-traumatic-brain-injury-evaluating-the-evidence PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Traumatic brain injury (TBI) may affect 10 million people worldwide. It is considered the "signature wound" of the conflicts in Iraq and Afghanistan. These injuries result from a bump or blow to the head, or from external forces that cause the brain to move within the head, such as whiplash or exposure to blasts. TBI can cause an array of physical and mental health concerns and is a growing problem, particularly among soldiers and veterans because of repeated exposure to violent environments. One form of treatment for TBI is cognitive rehabilitation therapy (CRT), a patient-specific, goal-oriented approach to help patients increase their ability to process and interpret information. The Department of Defense asked the IOM to conduct a study to determine the effectiveness of CRT for treatment of TBI. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Lisa Bain A2 - Noam I. Keren A2 - Sheena M. Posey Norris A2 - Clare Stroud TI - Neuroforensics: Exploring the Legal Implications of Emerging Neurotechnologies: Proceedings of a Workshop SN - DO - 10.17226/25150 PY - 2018 UR - https://nap.nationalacademies.org/catalog/25150/neuroforensics-exploring-the-legal-implications-of-emerging-neurotechnologies-proceedings-of PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine KW - Behavioral and Social Sciences AB - Technological advances in noninvasive neuroimaging, neurophysiology, genome sequencing, and other methods together with rapid progress in computational and statistical methods and data storage have facilitated large-scale collection of human genomic, cognitive, behavioral, and brain-based data. The rapid development of neurotechnologies and associated databases has been mirrored by an increase in attempts to introduce neuroscience and behavioral genetic evidence into legal proceedings. In March 2018, the National Academies of Science, Engineering and Medicine organized a workshop in order to explore the current uses of neuroscience and bring stakeholders from neuroscience and legal societies together in both the United Kingdom and the United States. Participants worked together to advance an understanding of neurotechnologies that could impact the legal system and the state of readiness to consider these technologies and where appropriate, to integrate them into the legal system. This publication summarizes the presentations and discussions from the workshop. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Mark D. Hayward A2 - Malay K. Majmundar TI - Future Directions for the Demography of Aging: Proceedings of a Workshop SN - DO - 10.17226/25064 PY - 2018 UR - https://nap.nationalacademies.org/catalog/25064/future-directions-for-the-demography-of-aging-proceedings-of-a PB - The National Academies Press CY - Washington, DC LA - English KW - Behavioral and Social Sciences AB - Almost 25 years have passed since the Demography of Aging (1994) was published by the National Research Council. Future Directions for the Demography of Aging is, in many ways, the successor to that original volume. The Division of Behavioral and Social Research at the National Institute on Aging (NIA) asked the National Academies of Sciences, Engineering, and Medicine to produce an authoritative guide to new directions in demography of aging. The papers published in this report were originally presented and discussed at a public workshop held in Washington, D.C., August 17-18, 2017. The workshop discussion made evident that major new advances had been made in the last two decades, but also that new trends and research directions have emerged that call for innovative conceptual, design, and measurement approaches. The report reviews these recent trends and also discusses future directions for research on a range of topics that are central to current research in the demography of aging. Looking back over the past two decades of demography of aging research shows remarkable advances in our understanding of the health and well-being of the older population. Equally exciting is that this report sets the stage for the next two decades of innovative research–a period of rapid growth in the older American population. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine TI - Reducing the Impact of Dementia in America: A Decadal Survey of the Behavioral and Social Sciences SN - DO - 10.17226/26175 PY - 2021 UR - https://nap.nationalacademies.org/catalog/26175/reducing-the-impact-of-dementia-in-america-a-decadal-survey PB - The National Academies Press CY - Washington, DC LA - English KW - Behavioral and Social Sciences KW - Health and Medicine AB - As the largest generation in U.S. history - the population born in the two decades immediately following World War II - enters the age of risk for cognitive impairment, growing numbers of people will experience dementia (including Alzheimer's disease and related dementias). By one estimate, nearly 14 million people in the United States will be living with dementia by 2060. Like other hardships, the experience of living with dementia can bring unexpected moments of intimacy, growth, and compassion, but these diseases also affect people's capacity to work and carry out other activities and alter their relationships with loved ones, friends, and coworkers. Those who live with and care for individuals experiencing these diseases face challenges that include physical and emotional stress, difficult changes and losses in their relationships with life partners, loss of income, and interrupted connections to other activities and friends. From a societal perspective, these diseases place substantial demands on communities and on the institutions and government entities that support people living with dementia and their families, including the health care system, the providers of direct care, and others. Nevertheless, research in the social and behavioral sciences points to possibilities for preventing or slowing the development of dementia and for substantially reducing its social and economic impacts. At the request of the National Institute on Aging of the U.S. Department of Health and Human Services, Reducing the Impact of Dementia in America assesses the contributions of research in the social and behavioral sciences and identifies a research agenda for the coming decade. This report offers a blueprint for the next decade of behavioral and social science research to reduce the negative impact of dementia for America's diverse population. Reducing the Impact of Dementia in America calls for research that addresses the causes and solutions for disparities in both developing dementia and receiving adequate treatment and support. It calls for research that sets goals meaningful not just for scientists but for people living with dementia and those who support them as well. By 2030, an estimated 8.5 million Americans will have Alzheimer's disease and many more will have other forms of dementia. Through identifying priorities social and behavioral science research and recommending ways in which they can be pursued in a coordinated fashion, Reducing the Impact of Dementia in America will help produce research that improves the lives of all those affected by dementia. ER - TY - BOOK AU - Institute of Medicine TI - Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Initial Assessment SN - DO - 10.17226/13364 PY - 2012 UR - https://nap.nationalacademies.org/catalog/13364/treatment-for-posttraumatic-stress-disorder-in-military-and-veteran-populations PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Prior to the military conflicts in Iraq and Afghanistan, wars and conflicts have been characterized by such injuries as infectious diseases and catastrophic gunshot wounds. However, the signature injuries sustained by United States military personnel in these most recent conflicts are blast wounds and the psychiatric consequences to combat, particularly posttraumatic stress disorder (PTSD), which affects an estimated 13 to 20 percent of U.S. service members who have fought in Iraq or Afghanistan since 2001. PTSD is triggered by a specific traumatic event - including combat - which leads to symptoms such as persistent re-experiencing of the event; emotional numbing or avoidance of thoughts, feelings, conversations, or places associated with the trauma; and hyperarousal, such as exaggerated startle responses or difficulty concentrating. As the U.S. reduces its military involvement in the Middle East, the Departments of Defense (DoD) and Veterans Affairs (VA) anticipate that increasing numbers of returning veterans will need PTSD services. As a result, Congress asked the DoD, in consultation with the VA, to sponsor an IOM study to assess both departments' PTSD treatment programs and services. Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Initial Assessment is the first of two mandated reports examines some of the available programs to prevent, diagnose, treat, and rehabilitate those who have PTSD and encourages further research that can help to improve PTSD care. ER - TY - BOOK AU - National Research Council A2 - Norman B. Anderson A2 - Rodolfo A. Bulatao A2 - Barney Cohen TI - Critical Perspectives on Racial and Ethnic Differences in Health in Late Life SN - DO - 10.17226/11086 PY - 2004 UR - https://nap.nationalacademies.org/catalog/11086/critical-perspectives-on-racial-and-ethnic-differences-in-health-in-late-life PB - The National Academies Press CY - Washington, DC LA - English KW - Behavioral and Social Sciences KW - Health and Medicine AB - In their later years, Americans of different racial and ethnic backgrounds are not in equally good--or equally poor--health. There is wide variation, but on average older Whites are healthier than older Blacks and tend to outlive them. But Whites tend to be in poorer health than Hispanics and Asian Americans. This volume documents the differentials and considers possible explanations. Selection processes play a role: selective migration, for instance, or selective survival to advanced ages. Health differentials originate early in life, possibly even before birth, and are affected by events and experiences throughout the life course. Differences in socioeconomic status, risk behavior, social relations, and health care all play a role. Separate chapters consider the contribution of such factors and the biopsychosocial mechanisms that link them to health. This volume provides the empirical evidence for the research agenda provided in the separate report of the Panel on Race, Ethnicity, and Health in Later Life. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Laura Aiuppa A2 - Maria Hewitt A2 - Sharyl J. Nass TI - Long-Term Survivorship Care After Cancer Treatment: Proceedings of a Workshop SN - DO - 10.17226/25043 PY - 2018 UR - https://nap.nationalacademies.org/catalog/25043/long-term-survivorship-care-after-cancer-treatment-proceedings-of-a PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - The 2006 Institute of Medicine (IOM) consensus study report From Cancer Patient to Cancer Survivor: Lost in Transition made recommendations to improve the quality of care that cancer survivors receive, in recognition that cancer survivors are at risk for significant physical, psychosocial, and financial repercussions from cancer and its treatment. Since then, efforts to recognize and address the unique needs of cancer survivors have increased, including an emphasis on improving the evidence base for cancer survivorship care and identifying best practices in the delivery of high-quality cancer survivorship care. To examine progress in cancer survivorship care since the Lost in Transition report, the National Cancer Policy Forum of the National Academies of Sciences, Engineering, and Medicine held a workshop in July 2017, in Washington, DC. Workshop participants highlighted potential opportunities to improve the planning, management, and delivery of cancer survivorship care. This publication summarizes the presentations and discussions from the workshop. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Alan I. Leshner A2 - Story Landis A2 - Clare Stroud A2 - Autumn Downey TI - Preventing Cognitive Decline and Dementia: A Way Forward SN - DO - 10.17226/24782 PY - 2017 UR - https://nap.nationalacademies.org/catalog/24782/preventing-cognitive-decline-and-dementia-a-way-forward PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Societies around the world are concerned about dementia and the other forms of cognitive impairment that affect many older adults. We now know that brain changes typically begin years before people show symptoms, which suggests a window of opportunity to prevent or delay the onset of these conditions. Emerging evidence that the prevalence of dementia is declining in high-income countries offers hope that public health interventions will be effective in preventing or delaying cognitive impairments. Until recently, the research and clinical communities have focused primarily on understanding and treating these conditions after they have developed. Thus, the evidence base on how to prevent or delay these conditions has been limited at best, despite the many claims of success made in popular media and advertising. Today, however, a growing body of prevention research is emerging. Preventing Cognitive Decline and Dementia: A Way Forward assesses the current state of knowledge on interventions to prevent cognitive decline and dementia, and informs future research in this area. This report provides recommendations of appropriate content for inclusion in public health messages from the National Institute on Aging. ER - TY - BOOK AU - National Research Council TI - Potential Health Risks to DOD Firing-Range Personnel from Recurrent Lead Exposure SN - DO - 10.17226/18249 PY - 2013 UR - https://nap.nationalacademies.org/catalog/18249/potential-health-risks-to-dod-firing-range-personnel-from-recurrent-lead-exposure PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine KW - Conflict and Security Issues AB - Lead is a ubiquitous metal in the environment, and its adverse effects on human health are well documented. Lead interacts at multiple cellular sites and can alter protein function in part through binding to amino acid sulfhydryl and carboxyl groups on a wide variety of structural and functional proteins. In addition, lead mimics calcium and other divalent cations, and it induces the increased production of cytotoxic reactive oxygen species. Adverse effects associated with lead exposure can be observed in multiple body systems, including the nervous, cardiovascular, renal, hematologic, immunologic, and reproductive systems. Lead exposure is also known to induce adverse developmental effects in utero and in the developing neonate. Lead poses an occupational health hazard, and the Occupational Safety and Health Administration (OSHA) developed a lead standard for general industry that regulates many workplace exposures to this metal. The standard was promulgated in 1978 and encompasses several approaches for reducing exposure to lead, including the establishment of a permissible exposure limit (PEL) of 50 μg/m3 in air (an 8-hour time-weighted average [TWA]), exposure guidelines for instituting medical surveillance, guidelines for removal from and return to work, and other risk-management strategies. An action level of 30 μg/m3 (an 8-hour TWA) for lead was established to trigger medical surveillance in employees exposed above that level for more than 30 days per year. Another provision is that any employee who has a blood lead level (BLL) of 60 μg/dL or higher or three consecutive BLLs averaging 50 μg/dL or higher must be removed from work involving lead exposure. An employee may resume work associated with lead exposure only after two BLLs are lower than 40 μg/dL. Thus, maintaining BLLs lower than 40 μg/dL was judged by OSHA to protect workers from adverse health effects. The OSHA standard also includes a recommendation that BLLs of workers who are planning a pregnancy be under 30μg/dL. In light of knowledge about the hazards posed by occupational lead exposure, the Department of Defense (DOD) asked the National Research Council to evaluate potential health risks from recurrent lead exposure of firing-range personnel. Specifically, DOD asked the National Research Council to determine whether current exposure standards for lead on DOD firing ranges protect its workers adequately.The committee also considered measures of cumulative lead dose. Potential Health Risks to DOD Firing-Range Personnel from Recurrent Lead Exposure will help to inform decisions about setting new air exposure limits for lead on firing ranges, about whether to implement limits for surface contamination, and about how to design lead-surveillance programs for range personnel appropriately. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine TI - Evaluation of the Disability Determination Process for Traumatic Brain Injury in Veterans SN - DO - 10.17226/25317 PY - 2019 UR - https://nap.nationalacademies.org/catalog/25317/evaluation-of-the-disability-determination-process-for-traumatic-brain-injury-in-veterans PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - The Veterans Benefits Administration (VBA) provides disability compensation to veterans with a service-connected injury, and to receive disability compensation from the Department of Veterans Affairs (VA), a veteran must submit a claim or have a claim submitted on his or her behalf. Evaluation of the Disability Determination Process for Traumatic Brain Injury in Veterans reviews the process by which the VA assesses impairments resulting from traumatic brain injury for purposes of awarding disability compensation. This report also provides recommendations for legislative or administrative action for improving the adjudication of veterans' claims seeking entitlement to compensation for all impairments arising from a traumatic brain injury. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine TI - Social Isolation and Loneliness in Older Adults: Opportunities for the Health Care System SN - DO - 10.17226/25663 PY - 2020 UR - https://nap.nationalacademies.org/catalog/25663/social-isolation-and-loneliness-in-older-adults-opportunities-for-the PB - The National Academies Press CY - Washington, DC LA - English KW - Behavioral and Social Sciences KW - Health and Medicine AB - Social isolation and loneliness are serious yet underappreciated public health risks that affect a significant portion of the older adult population. Approximately one-quarter of community-dwelling Americans aged 65 and older are considered to be socially isolated, and a significant proportion of adults in the United States report feeling lonely. People who are 50 years of age or older are more likely to experience many of the risk factors that can cause or exacerbate social isolation or loneliness, such as living alone, the loss of family or friends, chronic illness, and sensory impairments. Over a life course, social isolation and loneliness may be episodic or chronic, depending upon an individual's circumstances and perceptions. A substantial body of evidence demonstrates that social isolation presents a major risk for premature mortality, comparable to other risk factors such as high blood pressure, smoking, or obesity. As older adults are particularly high-volume and high-frequency users of the health care system, there is an opportunity for health care professionals to identify, prevent, and mitigate the adverse health impacts of social isolation and loneliness in older adults. Social Isolation and Loneliness in Older Adults summarizes the evidence base and explores how social isolation and loneliness affect health and quality of life in adults aged 50 and older, particularly among low income, underserved, and vulnerable populations. This report makes recommendations specifically for clinical settings of health care to identify those who suffer the resultant negative health impacts of social isolation and loneliness and target interventions to improve their social conditions. Social Isolation and Loneliness in Older Adults considers clinical tools and methodologies, better education and training for the health care workforce, and dissemination and implementation that will be important for translating research into practice, especially as the evidence base for effective interventions continues to flourish. ER - TY - BOOK AU - National Research Council A2 - Richard W. Pew A2 - Susan B. Van Hemel TI - Technology for Adaptive Aging SN - DO - 10.17226/10857 PY - 2004 UR - https://nap.nationalacademies.org/catalog/10857/technology-for-adaptive-aging PB - The National Academies Press CY - Washington, DC LA - English KW - Behavioral and Social Sciences KW - Health and Medicine AB - Emerging and currently available technologies offer great promise for helping older adults, even those without serious disabilities, to live healthy, comfortable, and productive lives. What technologies offer the most potential benefit? What challenges must be overcome, what problems must be solved, for this promise to be fulfilled? How can federal agencies like the National Institute on Aging best use their resources to support the translation from laboratory findings to useful, marketable products and services? Technology for Adaptive Aging is the product of a workshop that brought together distinguished experts in aging research and in technology to discuss applications of technology to communication, education and learning, employment, health, living environments, and transportation for older adults. It includes all of the workshop papers and the report of the committee that organized the workshop. The committee report synthesizes and evaluates the points made in the workshop papers and recommends priorities for federal support of translational research in technology for older adults. ER - TY - BOOK AU - National Research Council A2 - Rodolfo A. Bulatao A2 - Norman B. Anderson TI - Understanding Racial and Ethnic Differences in Health in Late Life: A Research Agenda SN - DO - 10.17226/11036 PY - 2004 UR - https://nap.nationalacademies.org/catalog/11036/understanding-racial-and-ethnic-differences-in-health-in-late-life PB - The National Academies Press CY - Washington, DC LA - English KW - Behavioral and Social Sciences KW - Health and Medicine AB - As the population of older Americans grows, it is becoming more racially and ethnically diverse. Differences in health by racial and ethnic status could be increasingly consequential for health policy and programs. Such differences are not simply a matter of education or ability to pay for health care. For instance, Asian Americans and Hispanics appear to be in better health, on a number of indicators, than White Americans, despite, on average, lower socioeconomic status. The reasons are complex, including possible roles for such factors as selective migration, risk behaviors, exposure to various stressors, patient attitudes, and geographic variation in health care. This volume, produced by a multidisciplinary panel, considers such possible explanations for racial and ethnic health differentials within an integrated framework. It provides a concise summary of available research and lays out a research agenda to address the many uncertainties in current knowledge. It recommends, for instance, looking at health differentials across the life course and deciphering the links between factors presumably producing differentials and biopsychosocial mechanisms that lead to impaired health. ER - TY - BOOK AU - National Research Council A2 - Paul C. Stern A2 - Laura L. Carstensen TI - The Aging Mind: Opportunities in Cognitive Research SN - DO - 10.17226/9783 PY - 2000 UR - https://nap.nationalacademies.org/catalog/9783/the-aging-mind-opportunities-in-cognitive-research PB - The National Academies Press CY - Washington, DC LA - English KW - Behavioral and Social Sciences KW - Health and Medicine AB - Possible new breakthroughs in understanding the aging mind that can be used to benefit older people are now emerging from research. This volume identifies the key scientific advances and the opportunities they bring. For example, science has learned that among older adults who do not suffer from Alzheimer's disease or other dementias, cognitive decline may depend less on loss of brain cells than on changes in the health of neurons and neural networks. Research on the processes that maintain neural health shows promise of revealing new ways to promote cognitive functioning in older people. Research is also showing how cognitive functioning depends on the conjunction of biology and culture. The ways older people adapt to changes in their nervous systems, and perhaps the changes themselves, are shaped by past life experiences, present living situations, changing motives, cultural expectations, and emerging technology, as well as by their physical health status and sensory-motor capabilities. Improved understanding of how physical and contextual factors interact can help explain why some cognitive functions are impaired in aging while others are spared and why cognitive capability is impaired in some older adults and spared in others. On the basis of these exciting findings, the report makes specific recommends that the U.S. government support three major new initiatives as the next steps for research. ER - TY - BOOK AU - Institute of Medicine TI - Chronic Multisymptom Illness in Gulf War Veterans: Case Definitions Reexamined SN - DO - 10.17226/18623 PY - 2014 UR - https://nap.nationalacademies.org/catalog/18623/chronic-multisymptom-illness-in-gulf-war-veterans-case-definitions-reexamined PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - More than 2 decades have passed since the 1990-1991 conflict in the Persian Gulf. During the intervening years, many Gulf War veterans have experienced various unexplained symptoms that many associate with service in the gulf region, but no specific exposure has been definitively associated with symptoms. Numerous researchers have described the pattern of signs and symptoms found in deployed Gulf War veterans and noted that they report unexplained symptoms at higher rates than nondeployed veterans or veterans deployed elsewhere during the same period. Gulf War veterans have consistently shown a higher level of morbidity than the nondeployed, in some cases with severe and debilitating consequences. However, efforts to define a unique illness or syndrome in Gulf War veterans have failed, as have attempts to develop a uniformly accepted case definition. Chronic Multisymptom Illness in Gulf War Veterans is a comprehensive review of the available scientific and medical literature regarding symptoms for chronic multisymptom illness (CMI) among the 1991 Gulf War Veterans. This report evaluates and summarizes the literature in an effort to identify appropriate terminology to use in referring to CMI in Gulf War Veterans. While the report does not recommend one specific case definition over another, Chronic Multisymptom Illness in Gulf War Veterans does recommend the consideration of two case definitions on the basis of their concordance with the evidence and their ability to identify specific symptoms commonly reported by Gulf War veterans. This report recommends that the Department of Veterans Affairs use the term Gulf War illness rather than CMI. The report recommends that that the Department of Veterans Affairs, to the extent possible, systematically assess existing data to identify additional features of Gulf War illness, such as onset, duration, severity, frequency of symptoms, and exclusionary criteria to produce a more robust case definition. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Paul A. Volberding A2 - Carol Mason Spicer A2 - Tom Cartaxo A2 - Laura Aiuppa TI - Childhood Cancer and Functional Impacts Across the Care Continuum SN - DO - 10.17226/25944 PY - 2021 UR - https://nap.nationalacademies.org/catalog/25944/childhood-cancer-and-functional-impacts-across-the-care-continuum PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Since the late 1960s, the survival rate in children and adolescents diagnosed with cancer has steadily improved, with a corresponding decline in the cancer-specific death rate. Although the improvements in survival are encouraging, they have come at the cost of acute, chronic, and late adverse effects precipitated by the toxicities associated with the individual or combined use of different types of treatment (e.g., surgery, radiation, chemotherapy). In some cases, the impairments resulting from cancer and its treatment are severe enough to qualify a child for U.S. Social Security Administration disability benefits. At the request of Social Security Administration, Childhood Cancer and Functional Impacts Across the Care Continuum provides current information and findings and conclusions regarding the diagnosis, treatment, and prognosis of selected childhood cancers, including different types of malignant solid tumors, and the effect of those cancers on children’s health and functional capacity, including the relative levels of functional limitation typically associated with the cancers and their treatment. This report also provides a summary of selected treatments currently being studied in clinical trials and identifies any limitations on the availability of these treatments, such as whether treatments are available only in certain geographic areas. ER - TY - BOOK AU - National Research Council A2 - Linda G. Martin A2 - Beth J. Soldo TI - Racial and Ethnic Differences in the Health of Older Americans SN - DO - 10.17226/5237 PY - 1997 UR - https://nap.nationalacademies.org/catalog/5237/racial-and-ethnic-differences-in-the-health-of-older-americans PB - The National Academies Press CY - Washington, DC LA - English KW - Behavioral and Social Sciences KW - Health and Medicine AB - Older Americans, even the oldest, can now expect to live years longer than those who reached the same ages even a few decades ago. Although survival has improved for all racial and ethnic groups, strong differences persist, both in life expectancy and in the causes of disability and death at older ages. This book examines trends in mortality rates and selected causes of disability (cardiovascular disease, dementia) for older people of different racial and ethnic groups. The determinants of these trends and differences are also investigated, including differences in access to health care and experiences in early life, diet, health behaviors, genetic background, social class, wealth and income. Groups often neglected in analyses of national data, such as the elderly Hispanic and Asian Americans of different origin and immigrant generations, are compared. The volume provides understanding of research bearing on the health status and survival of the fastest-growing segment of the American population. ER -