Principles of Geriatric Medicine and Gerontology
Editors: Hazzard, WR; Blass, JP; Ettinger, WH; Halter, JB; Ouslander, JG; McGraw-Hill, New York, 1998
Reviewed by: Barry J. Goldlist, MD, FRCPC, FACP
This textbook is a massive multi-authored text that attempts to cover the entire spectrum of clinical geriatrics. For the most part it succeeds admirably. It represents a predominantly United States view of the speciality, with only 6 of the almost 200 contributors coming from other countries (3 from Canada, 2 from the United Kingdom, and 1 from the Netherlands).
The typeface is clear and easy to read, and diagrams and tables are used effectively throughout. Although many of the chapters focus on disease entities that are not exclusive to geriatrics, but rather are common in the elderly, these are not exhaustive chapters, and this book would not function as a replacement for a textbook of internal medicine. Rather, it would serve as an adjunct.
For the practicing physician, the most important section is that on geriatric syndromes. As in all multi-authored textbooks there is some unevenness in the chapters. Not surprising the chapter on urinary incontinence, co-authored by Dr. Ouslander is outstanding, as much because of its innovative presentation as the actual content. In contrast, one wonders whether a chapter on diarrhea in the elderly was even required. Other than an initial section warning us that diarrhea can be more lethal in the elderly and volume status more difficult to assess, it seems like a standard medical text chapter on diarrhea.
The initial chapters on principles of gerontology are well written, and lay a good framework for the clinical portions of the text. The chapter on gender differential in longevity might have been enhanced with some discussion concerning other mammalian species. These chapters, and in fact almost all, are very up to date, with many references from 1997 and some from 1998. This is a remarkable achievement in such a major text.
Who should buy this text? Most specialists in geriatric medicine, in my opinion, would rarely consult a book such as this in their day to day practice, preferring to rely on current literature, although they may purchase a copy for residents to use. A text such as this should be mandatory for every hospital library, and generalist physicians with a large number of elderly patients in their practice would find such a comprehensive text on geriatrics and gerontology a very useful purchase. Whether one should purchase this text or one of its competitors probably depends on style preference and the timing of the purchase. Frequently in a large comprehensive textbook, the one most recently published is the most prudent to buy.
