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INTRODUCTION

On average, each day longer you live, the longer you are likely to live, yet the closer to dying you become. The goal of health maintenance (HM) is to help people live as long and as healthy as possible.

GENERAL CONSIDERATIONS

In this chapter, the findings and positions of the US Preventative Services Task Force (USPSTF) are emphasized because it generates the most comprehensive and evidence-based recommendations of any organization. Hence, knowing the USPSTF grading system for its recommendations is important (Table 15–1). The USPSTF is sponsored by the Agency for Healthcare Research and Quality (AHRQ) and is the leading independent panel of private-sector experts in prevention and primary care.

Table 15–1.US Preventive Services Task Force (USPSTF) grade definitions.

This chapter describes prevention and then presents HM by the following age groups: 18–39, 40–49, 50–59, 60–74, and ≥75 years. USPSTF Grade A and B recommendations are emphasized. Due to multiple recent studies that call into question prior and current recommendations concerning the use of aspirin for prevention of heart disease, at the time of publication, we are unable to offer clear guidance and suggest accessing the USPSTF website for these evolving recommendations. HM involves three types of prevention: primary, secondary, and tertiary (Figure 15–1).

Figure 15–1.

The three types of disease prevention.

PREVENTION

A. Primary Prevention

Targets individuals who may ...

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