Areas of Expertise

Alzheimer's Disease and other forms of Dementia

The confusion and impairment of memory often associated with aging are manifestations of dementia, a group of conditions characterized by progressive decline in all forms of mental functioning caused by destruction of brain cells.

The most common form of dementia, Alzheimer’s disease, affects 4.5 million Americans, ten percent of all Americans over 65 and nearly half of those over 85; a rare, inherited form of the disease can strike as early as 30 or 40.

Early identification and treatment can delay progress of dementia and modify its symptoms. The S+AGE™ team specialize in the diagnosis and care of patients with dementia. They employ the most current treatments to maintain the patients’ ability to be as normal as possible for as long as possible. The doctors and the staff provide sympathetic support for the patients and for their caregivers.

Falls, Gait and Balance Problems

Unfortunately, because of a variety of age-related conditions, elderly people tend

to fall. When they fall they hurt themselves in falls that would have been harmless before their reflexes slowed and their bones became weakened by osteoporosis.

Muscle weakness, gait and balance disorders, visual impairment, memory impairment, depression, and multiple medications are all associated with aging and they are all associated with falling. Moreover, in the elderly, initial injury may develop into permanent impairment of function; many with fall-related hip fractures never recover their prefracture level of function.

S+AGE™ geriatricians help sort out these risk factors and initiate programs designed to decrease the incidence of falling and injury.

Excessive Weight Loss

Maintaining adequate nutrition is essential for maintaining good health. Aging is often accompanied by loss of appetite which may decrease eating, leading to weight loss, and a variety of adverse effects on health. Social factors such as poverty and isolation, and the inability to function independently will lead to weight loss, as will psychological factors such as depression and bereavement. Medical factors that range from poor dentition, ill-fitting dentures, dry mouth, alcoholism, and acute or chronic disease can lead to weight loss.

S+AGE™ geriatricians will work to determine the cause and help reverse the weight loss.

Depression

Older adults with depression rarely complain of feeling sad. Symptoms common to older adults with depression include insomnia, loss of appetite, weight loss, irritability, difficulty with concentration, and fatigue.

Since these symptoms of depression are similar to and mimic symptoms of other illnesses the depression may be overlooked or misinterpreted. The diagnosis of depression should be considered in all older persons who report somatic complaints, particularly in those having chronic symptoms that appear to have no definite organic basis.

Depression can be treated.

S+AGE™ psychologists and physicians are trained to make the diagnosis and appropriately treat depression.

Loss of Bladder Control

Urinary incontinence, the involuntary loss of urine sufficient to be a problem is common in older persons. Approximately 15% to 30% of older persons, most of them women, will be affected. The social and psychological impacts of UI include significant changes in social activities outside of the home, depression, social isolation, anxiety about potential disclosure to friends, and embarrassment about accidents in public.

Urinary incontinence is treatable.

S+AGE™ geriatricians will help devise a treatment protocol.

Excessive Use of Medications

Polypharmacy is generally defined as the use of more medications, both prescription and over-the-counter, than are clinically necessary. There is no specific number of medications that constitutes polypharmacy.

Since the elderly tend to have more chronic illnesses and more frequent illnesses than do younger people they are more likely to have multiple physicians treating them, all prescribing specific medications.

Changes as we age make many older individuals more sensitive to some drugs and they become more susceptible to side effects at a given dose or responsive to lower doses of medications.

The selection of a medication to use in the elderly should take into consideration therapeutic value, side effects, ease of administration, cost, and potential interactions with other medications.

S+AGE™ geriatricians will review the medications taken to make certain that they are appropriate.

Training Tomorrow's Geriatricians

Since 1986, S+AGE™ has served as a teaching site for the UCLA School of Medicine, Department of Geriatrics. Under the direction of Dr. Dan Osterweil and Dr. David Stern, physicians who have been accepted into the Geriatric Fellowship program at UCLA learn the intricacies of practicing geriatric medicine in our outpatient clinic setting.