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A PARADIGM SHIFT? Questions for thought? Cardiovascular risk factors have been identified and subsequent patient education and behavior modification have positively impacted on pts. Can we similiarly intervene and decrease the burden of skin disorders ? Can we move away from terms such as Elderly, Senior, Old Geriatric ( US Census age 65 plus) to discuss Dermatologic needs for the Evolving, Aging aka Generational patient?

My Practice address Wendy E. Roberts MD Bob Hope Drive Rancho Mirage California

and Oldest Patient

THE FACE OF GENERATIONAL DERMATOLOGY In One Century the rate of growth of the 65 plus yo per, has increased by a factor of > 11 3 million in 1900 to 35 million in By 2030 about 1 in 5 Americans will be labeled “elderly” The “elderly’’ is the fastest growing poulation in the United States”....because

HAPPY BIRTHDAY!! The leading edge of Baby Boomers just turned 65 in January With Increased longevity new dermatologic issues arise because skin has to last longer. Many Generationals want their skin to reflect “how they feel, not their numeric age” Some Generationals are choosing to remain or renter the workforce until the 7th and 8th decade. There is an understanding that healthy and youthful skin gives them value in what can be a competitive yourh oriented workforce

Generational BOOM Over 76 million babies were born in USA between , (US Census Bureau) Landon Jones coined the term”baby boomer” in his book Great Expectations: America and the Baby Boom Generation 80% of personal financial assets > 50% of all consumer spending 61% of OTC medications 77% of all prescription drugs

Dermatologic disorders in the Generational (Geriatric) patient Alopecia BCC, SCC, MM Varicose & spider veins Foot ulcers Rosacea seborrheic keratosissolar lentiginesxerosisstasis dermatitisHyperkeratosis & nail dz. Pruritus Cosmetic issues

Preventative Dermatology The total estimated annual cost of the 22 skin-disease categories analyzed in this study is $39.3 billion in 2004 US dollars, including the value of medical costs and lost productivity. The total direct and indirect costs for each of these categories range from $157 million for cutaneous drug eruptions to $12 billion for skin ulcers and wounds. Techniques and strategies for medical intervention and treatment of aging generational skin can be categorized into a new paradigm using nomenclature from the broader house of medicine., The Integumnet or Skin undergoes an Aging process similar to the other major organs of the Human Body, It is the goal of this meeting to focus on interventional strategies JAAD volume 21 issue 3 Primary prevention - Reduction of risk factors before a disease or condition has occurred. Secondary prevention - Early detection of disease, potentially while still asymptomatic, to allow positive interference to prevent, postpone, or attenuate the symptomatic clinical condition. Tertiary prevention -Treatment of an existing symptomatic disease process to ameliorate its effects or delay its progress These treatments can further be classified in a manner similar to other medical interventions based on the type of clinical evidence used to demonstrate their efficacy

The practice of Geriatric/Generational Dermatology supports the concept that we are experts in disorders of skin, hair and nails throughout a patient;s lifetime and we are positioned to insure “Organ Sucess” for our patient’s duration.

Generational Photodamage Seventy years Young

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