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Essentials of Clinical Geriatrics
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Third edition. Robert L. Kane, Joseph C. Ouslander, and Itamar B. Abrass; eds. 524 pages. New York: McGraw-Hill; 1994. $30.00.
A pocket-sized, inexpensive manual of geriatric medicine was an attractive idea when the first edition was published 10 years ago. The book was appropriately received and widely used, as the publication of a third edition proves.
Seventeen chapters are organized in three sections: "The Aging Patient and Geriatric Assessment," "Differential Diagnosis and Management," and "General Management Strategies." Although authors of individual chapters are not identified, some of the best pieces reflect major interests of the three editors. These include chapters on demography and epidemiology, evaluation of the elderly patient, incontinence, and nursing home care. In a book that aims at conciseness, some omissions are bound to occur, but it is surprising to find cancer, the second cause of death among the elderly, mentioned only in passing, with clinical detail given only for cancer of the thyroid. Other problems commonly afflicting the elderly but not covered here include sexuality, alcoholism, low-back pain, and herpes zoster.
The new edition retains most of the merits of the first: portability, compactness, readable style, and modest cost. Proliferation of research and other information in the field over the past decade, however, have also caused some of the disadvantages of the first edition to become more evident: limited information about pathophysiology and differential diagnosis, heavy reliance on small-print lists as summaries, and the fact that the book has become too bulky for any but the most capacious white-coat pockets. This is a ready handbook for quick reference, probably most useful for primary care practitioners and other health care workers who have not had training in geriatrics, but definitely not an exhaustive scholarly work, as the lists of references and suggested readings at the end of each chapter are only occasionally keyed to the text.
Essentials of Clinical Geriatrics has found its place as a practical vade mecum, at the plain-vanilla end of the spectrum of geriatric textbooks, a spectrum that now extends to heavy concoctions, such as those of Brocklehurst, Evans and Williams, and Cassel. Until geriatrics takes its full place in the medical curriculum and in residency training, this book will continue to be a useful stop-gap for practitioners who struggle to cope with the mounting tide of older persons in need of care.
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