Preventive Care for Elderly People. - book reviews

Cambridge: Cambridge University Press, 1993. 321 pp. Price 45.00[pounds] (hardback); 17.95[pounds] (paperback).

The logic of the allegory of health promotion refocusing upstream, to where people are being thrown into the river rather than conventional health care, which merely tries to pull them out downstream, is far more complex than is immediately apparent. To examine this, a number of goals are defined and tasks are outlined for elderly people, their carers, health providers and society. A succinct up-to-the-minute critique of the worth, risks and costs of preventive care is provided: 64 common health problems affecting elderly people are identified and the research evidence on the available preventive care is discussed: for instance regarding osteoporosis, depression, memory impairment. Where I am able to check the evidence, it is certainly up-to-date and discussed in a balanced way according to accepted principles defined in the beginning. Meta-analyses have shown an effect of comprehensive geriatric assessment in the home setting on mortality, use of nursing homes and hospitals and quality of life. We hardly know which parts of those programmes are the most effective. This analysis of preventive care supplies us with tools for planning of health promotion programmes for elderly people with a wider look at the cost implications.

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