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Title Page

Mark H. Beers, M.D. and Robert Berkow, M.D.

Senior Assistant Editors
Robert M. Bogin, M.D.; Andrew J. Fletcher, M.B., B.Chir.; Mirza I. Rahman, M.D., M.P.H.

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Editorial Board
Richard W. Besdine, M.D.; Robert N. Butler, M.D.; Christine K. Cassel, M.D.; Terry T. Fulmer, Ph.D., R.N., F.A.A.N.; Edward G. Lakatta, M.D.; John E. Morley, M.B., B.Ch.; Mary E. Tinetti, M.D.

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Editorial and Production Staff
Keryn A.G. Lane, Executive Editor | Susan T. Schindler, Senior Staff Editor | Julie Kostecky, Staff Editor | Sandra J. Masse, Staff Editor | Debra Share, Staff  Editor | Roger I. Schreck, M.D., Contributing Editor | Diane C. Zenker, Textbook Production Coordinator | Diane Cosner-Bobrin, Project Manager | Dorothy A. Bailey, Medical Textbook Coordinator | Jean Perry, Executive Assistant | Marcia Yarbrough, Adminstrative Assistant | Lorraine B. Kilmer, Designer | Michael Reingold, Ilustrator | Susan Thomas, Ph.D., Indexer | Gary Zelko, Publisher | Pamela J. Barnes, Advertising and Promotional Supervisor

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Barbara Amelia Nace

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The Merck Manual of Geriatrics, like all the Merck manuals and The Merck Index, is published by Merck & Co., Inc., on a not-for-profit basis.

A Special Note to Readers:

The authors, reviewers, and editors of this book have made extensive efforts to ensure that treatments, drugs, and dosage regimens are accurate and conform to the standards accepted at the time of publication. However, constant changes in information resulting from continuing research and clinical experience, reasonable differences in opinions among authorities, unique aspects of individual clinical situations, and the possibility of human error in preparing such an extensive text require that the reader exercise individual judgment when making a clinical decision and, if necessary, consult and compare information from other sources. In particular, the reader is advised to check the product information provided by the manufacturer of a drug product before prescribing or administering it, especially if the drug is unfamiliar or is used infrequently.

With each printing, we have the opportunity to make corrections in our printed books. However, because the electronic versions are more flexible in this regard, we can make changes at any time. Thus, the text in this web site may be slightly different from that in the most recent printing of the book.

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