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More than 2.3 million Americans are now age 85 and older, and the population total in this age group is steadily expanding. This book brings together leading researchers to review current knowledge about the demography, health, epidemiology and social status of the oldest old. From ussions of the impact of Alzheimer's disease to an examination of changing social and medical policies, this book provides much needed information about this oft-neglected but growing group.The special problems attendant to information gathering among the oldest old, such as interviews and research, are also addressed. Special intercultural perspectives inform chapters on "The Black Oldest Old", and "Institutional Long-term Care from an International Perspective". This is essential reading for gerontologists, public health professionals, epidemiologists, and policy makers. The book's broad scope enlarges our understanding of the current needs of the oldest old, and indicates areas of public concern.

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• Part I Introduction
• 1 Introducing the Oldest Old
• 2 A Demographic Portrait
• 3 Cohort Succession
• 4 An International Comparison
• Part II Problems in Studying the Oldest Old
• 5 Conceptual Issues in the Design and Analysis of National Longitudinal Surveys
• 6 Collecting Data: Problems and Procedures
• 7 Interview Surveys
• 8 Mortality and Life Expectancy Changes
• 9 Causes of Death Among the Oldest Old
• Part III The Dynamics of Becoming the Oldest Old
• 10 Disability and Mortality: Implications for Current and Future Health and Long-term Care Service Needs
• 11 Institutional Long-term Care from an International Perspective
• 12 Epidemiology of Physical and Cognitive Disability
• 13 The Impact of Alzheimer's Disease in the United States Population
• Part IV A Social Portrait of the Oldest Old
• 14 Living Arrangements
• 15 The Black Oldest Old: Health, Functioning and Informal Support
• 16 The Robust Oldest Old: Optimistic Perspectives for Increasing Healthy Life Expectancy
• 17 Making It Last: Economic Resources
• Part V Social and Medical Policy Toward the Oldest Old
• 18 Sharing Increasing Costs on Declining Income: The Visible Dilemma of the Invisible Aged
• 19 Intergenerational Equity

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CHOICE Review

Comprising papers from an AAAS meeting and updated articles previously published in the Milbank Memorial Fund Quarterly, this collection escapes the unevenness that characterizes many edited works. Essays examine the nature, characteristics, and size of the US population over 85, often referred to as the oldest old. Following an introduction, Part 2 consists of three demographic chapters, including an outstanding statistical portrait of the oldest old, by Taueber et al. The next section considers methodological and conceptual problems in studying the oldest old, emphasizing longitudinal and cross-sectional differences and mortality changes. Section 4 covers health and long-term care issues, and includes an excellent article on the impact of Alzheimer's disease, by Evans et al. Other essays focus on socioeconomic issues, such as the social environment, minority elderly, and economic resources. The last section discusses policy issues of cost and intergenerational equity. In general, this is a thoughtful and timely volume that addresses major policy and programmatic issues raised by the unprecedented growth in this very old population group. Highly readable with clearly understandable charts and tables, the collection is an important contribution to both demography and gerontology. Advanced undergraduate; graduate; faculty. L. A. Baumhover; University of Alabama