This study confirms the high rate of delirium among hospitalized older persons and the associated adverse outcomes of prolonged hospital stays and increased risk of death. Patients can be stratified according to their risk for developing delirium using relatively few clinical characteristics which should be assessed, on all hospitalized older persons.

Estimates of the upper limits to human longevity have important policy implications that directly affect forecasts of life expectancy, active life expectancy, population aging, and social and medical programs tied to the size and health status of the elderly population. In the past, investigators have based speculations about the upper limits of human longevity on observations of past trends in mortality. Here the estimate of the upper bound is based on hypothesized reductions in current mortality rates necessary to achieve a life expectancy at birth from 80 to 120 years and an expectation of life at age 50 from 30 to 70 years. With the use of conditional probabilities of death from complete life tables for the United States, reductions in mortality required to achieve extreme longevity (that is, 80 to 120 years) were compared with those resulting from hypothetical cures for all cardiovascular diseases, ischemic heart disease, diabetes, and cancer. Results indicate that in order for life expectancy at birth to increase from present levels to what has been referred to as the average biological limit to life (age 85), mortality rates from all causes of death would need to decline at all ages by 55%, and at ages 50 and over by 60%. Given that hypothetical cures for major degenerative diseases would reduce overall mortality by 75%, it seems highly unlikely that life expectancy at birth will exceed the age of 85.

History of Present Illness:A 28-year-old Spanish-speaking-only female presents to your office complaining of a two-day history of headache. The pain started approximately 36 hours and lasted for eight hours and gradually improved and resolved spontaneously, so the patient decided not to seek additional care. Approximately 18 hours ago, the pain returned with worsened severity and has persisted. The patient rates the pain at "15 out of 10" and reports that it is located on the right side of her head, though she is unable to localize it any further. She has been nauseous with the second episode and has vomited twice. The pain is described as a squeezing sensation. The patients reports that her headache has caused her to "lay in her bed" all day, though this has not improved the headache. Past Medial History: Asthma Measles as a child Did not receive any childhood vaccinations Past surgical History: Appendectomy at age 14 Medications: Oral contraceptives Albuterol rescue inhaler Occasional ibuprofen for back pain Family History: Father died in an automobile accident at age 35 Mother with diabetes and hypertension

A substantial proportion of physicians in the United States report that they receive requests for physician-assisted suicide and euthanasia, and about 7 percent of those who responded to our survey have complied with such requests at least once.