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Gerontology is de ned as the study of aging and gerontologic neurology as the study of the effects of aging both of aging itself and of the age-related diseases on the nervous system In comparison to pediatric neurology, these disciplines have not aroused much interest The young physician is more excited by acute disease than by the seemingly immutable changes due to aging and is inclined to question whether medicine has a signi cant role to play

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in treating the neurologic disorders of the elderly The authors would answer this question af rmatively for the simple reason that a majority of all neurologic patients seen in practice are elderly, especially if one includes those with vascular diseases of the brain Furthermore, many of their diseases are preventable or therapeutically controllable Some of the age-related chemical de ciencies (ie, vitamin B de ciencies, diabetes mellitus) and many of the common restricted involutional changes (presbyopia, etc) can be corrected Others can even be turned into assets; the forgetfulness of the aged and their deafness may serve to excuse many of their shortcomings and to spare them effort and annoyance And always, there is the need to counsel the elderly patient on matters pertaining to health and daily activities This was appreciated even in the time of Cicero, who, in his De Senectute, urged the practice of moderation in exercise and giving due attention to the mind, which must be kept active or, like a lamp that is not supplied with oil, it will grow dim As medical science and public health measures have brought diseases of aging and other diseases under control, the number of elderly persons has increased and will continue to do so The US Census Bureau has estimated that in the year 2000 there were 31 million persons over the age of 65 in the United States and that 13 million of them were more than 75 years old As the number of elderly increases, the need to look after them will occupy more and more of the energies of physicians and the resources of society at large Once an old person declines physically and mentally to a vegetative state, the issue of euthanasia and all the ethical problems it entails will arise from time to time The authors reject this solution while committing themselves to measures that prevent pain and suffering.

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In this chapter, you have learned about the different migration methodologies for migrating databases to the Exadata Database Machine These methodologies have been proven to be successful in real-world migrations that have complex requirements In order for you to navigate a large migration project, the details listed in this chapter will help you plan the outcome that will be successful, the most cost effective, and the one that applies best in your environment

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ALBERT ML, KNOEFEL JE (eds): Clinical Neurology of Aging, 2nd ed New York, Oxford University Press, 1994 ALBERT MS: Memory decline: The boundary between aging and agerelated disease Ann Neurol 51:282, 2002 ANTEL JP, MINUK J: Neuroimmunology of aging, in Albert ML, Knoefel JE (eds): Clinical Neurology of Aging, 2nd ed New York, Oxford University Press, 1994, pp 121 135 BALL MJ: Neuronal loss, neuro brillary tangles and granulovacuolar degeneration in the hippocampus with aging and dementia Acta Neuropathol 27:111, 1977 BENASSI G, D ALESSANDRO R, GALLASSI R, et al: Neurological examination in subjects over 65 years: An epidemiological survey Neuroepidemiology 9:27, 1990 BLESSED G, TOMLINSON BE, ROTH M: The association between quantitative measures of dementia and of senile change in the cerebral grey matter of elderly subjects Br J Psychiatry 114:797, 1968 BUELL SJ, COLEMAN PD: Dendritic growth in the aged human brain and failure of growth in senile dementia Science 206:854, 1979 COLEMAN PD, FLOOD DG: Neuron numbers and dendritic extent in normal aging and Alzheimer s disease Neurobiol Aging 8:521, 1987 COMFORT A: The Biology of Senescence, 3rd ed New York, Elsevier, 1979 CRITCHLEY M: The neurology of old age Lancet 1:1221, 1931 CRITCHLEY M: Neurologic changes in the aged J Chronic Dis 3:459, 1956 CROOK T, BARTUS RT, FERRIS SH, et al: Age-associated memory impairment: Proposed diagnostic criteria and measures of clinical change Report of a National Institute of Mental Health Work Group Dev Neuropsychol 2:261, 1986 CRUM RM, ANTHONY JC, BASSETT SS, FOLSTEIN MF: Population-based norms for the mini-mental status examination by age and educational level JAMA 18:2386, 1993 DAM AM: The density of neurons in the human hippocampus Neuropathol Appl Neurobiol 5:249, 1979 DECKER MW: The effects of aging on hippocampal and cortical projections of the forebrain cholinergic system Brain Res 434:423, 1987 FISHER CM: Hydrocephalus as a cause of disturbances of gait in the elderly Neurology 32:1358, 1982 FOLSTEIN MF, FOLSTEIN SE, MCHUGH PR: Mini-mental state : A practical method for grading the cognitive state of patients for the clinician J Psychiatr Res 12:189, 1975 FRIES JF: Aging, natural death, and the compression of morbidity N Engl J Med 303:130, 1980 FRIES JF, CRAPO LM: Vitality and Aging San Francisco, Freeman, 1981 HAZZARD WR, BLASS JP, ETTINGER WH, et al (eds): Principles of Geriatric Medicine and Gerontology, 4th ed New York, McGraw-Hill, 1999 JENKYN LR, REEVES AG, WARREN T, et al: Neurologic signs in senescence Arch Neurol 42:1154, 1985 KALLMAN FJ: Genetic factors in aging: Comparative and longitudinal observations on a senescent twin population, in Hoch PH, Zubin J (eds): Psychopathology of Aging New York, Grune & Stratton, 1961 KAYE JA, OKEN BS, HOWIESON DB, et al: Neurologic evaluation of the optimally healthy oldest old Arch Neurol 51:1205, 1994.

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