Homeostatic Function and Aging. Davis, Bernard B. and Wood, W. Gibson (eds). New York, Raven, 1985.
This compilation of clinical papers originated from a 1984 Veterans' Administration GRECC (Geriatric Research , Education , and Clinical Center) conference held in St. Louis, Missouri. The authors are medical doctors, physiologists, anatomists, psychologists, and geriatricians, without any indication of nursing input. The volume is the latest in an extended series of edited volumes published by Raven Press since 1978 pertaining to various scientific aspects of aging.
Although there are four major components in this volume, half of the pages are devoted to endocrine and metabolic function and dysfunction. The remaining pages cover central nervous system conditions, thermoregulation, and psychosocial factors.
Emphasis throughout is upon biomedical research findings relevant to homeostatic function in the aging process. The clinical research report emanated from a variety of aging rodent studies, but have clear-cut implications for human aging. Some of the fascinating findings reported about aging include:
1. Decreased toleration and adaptation of the elderly to calcium, phosphorus, and water deprivation;
2. Production of homeostatic signals of parathormone, low plasma phosphorus, and antidiuretic factors do not change with aging, but renal responsiveness to the signals does decrease;
3. Aging kidneys have diminished capacity to retain phosphates;
4. Aging kidneys progressively decline in glomerular filtration and renal blood flow, thus making older adults more susceptible to toxic side effects of medications;
5. Some age-related neurologic impairments can be reversed if sufficient calcium can be made to enter aging cells;
6. Carbohydrate homeostasis decreases with age;
7. Physical findings in hyperthyroidism are atypical and nearly nonexistent in the elderly;
8. A combination of increased fibrin deposition, elevated plasmofibrinogen and elevated serum cholesterol predispose the elderly to thromboembolic vascular disease;
9. Decreased brain levels of norepinephrine in the elderly may contribute to decreased stress response and slowed arousal regulation;
10. Membrane function decreases with age, but may be reversible through modification of fluids and lipids;
11. Lipofuscin pigment is a reliable marker of neuronal aging;
12. Homeostenosis is a term describing impaired adaptability and regulation in the elderly.
The final chapter by gerontologist Dr. Sheldon Tobin on psychological adaptation to stress is outstanding. He emphasizes that maintaining self identification is essential in the confrontation of "assaults associated with being old."
The volume is an excellent reference for some of the current research in aging. These basic studies reported in progress are extremely useful to clarify the differences between disease and aging.