Editors: Kim A. Collins and Roger W. Byard
Publisher:  Cambridge University Press – 663 pages
Book Review by: Nano Khilnani

The average age of people in industrialized countries has been increasing, the editors of this book, (published in 2020) writes Harold Sanchez, the author of chapter 1 of this book edited by Kim A. Collins and Roger W. Byard. In the 2014 Canadian Census, the number of senior citizens (defined as 60 years of age or older) was for the first time, larger than those who were under 14. In Japan the number of people over 60 is more than double the number of those under 14 years of age.

Geriatrics, specialty that studies the elderly population is a relatively new one n medicine. But this book goes much further. It provides information on not only the typical medical conditions of the elder population, but also their common ailments, disorders and diseases that are uncommon in younger patients. As you can see from the titles of its chapters below, its coverage is very broad:    

  1. A History of Geriatric Medicine and Geriatric Pathology
  2. Pathophysiology of Aging: An Overview of Specific Pathophysiological Changes in Elders
  3. Medico-legal Investigation of Elder Maltreatment and Deaths
  4. The Elder Autopsy
  5. Fatal and non-fatal Accidents
  6. Euthanasia
  7. Starvation, Dehydration, Malnutrition, and Neglect
  8. Physical Abuse and Elder Homicide
  9. The Aging Foot: Forensic Considerations
  10. Forensic Entomology
  11. Non-lethal Elder Abuse
  12. Sexual Assault in Elders
  13. Hypothermia and Hyperthermia in Elders
  14. Suicide and Social Isolation in Elders
  15. Cardiovascular Diseases in Elders
  16. Lungs of the Elder
  17. Infectious Conditions and the Immune System in Elders
  18. Neurodegenerative Diseases in Elders
  19. Other Neurological Conditions and Age-Related Changes
  20. Genitourinary Conditions in Elders
  21. The Elder organ and Tissue Donor
  22. The Gastrointestinal Tract in the Elder
  23. Hematological Conditions: An Overview of Diseases in Elders
  24. The Oral Cavity of the Elder: Aging, Disease, Falls, and Inflicted Trauma
  25. The Anthropology of Aging
  26. Endocrinology and Diabetes in the Elder
  27. Toxicology of the Elder
  28. Cardiopulmonary Resuscitation-Related Injuries in Elders
  29. Imaging of Elders
  30. Forensic Radiology and Elders
  31. Iatrogenic Deaths in Elders
  32. Residential Care Facility Deaths
  33. Morbid Obesity and Frailty: Problems with the Extremes of Weight in Elders
  34. Ancillary Testing and Special Dissections
  35. The Legal Regulation of the Consequences of Aging
  36. Death Certification

The number and variety of serious medical problems discussed in this book that the elderly are subject to, suffer, and even die from, is quite large, so the editors write that they “hope that this text will provide a focus and important resource for all medical examiners, medico-legal investigators, law enforcement officers, lawyers, forensic pathologists, trainees, forensic physicians, geriatricians, nursing staff, and allied services who deal with issues that arise with elders in our society.”

“Recognizing that these individuals deserve the respect and support of our society with appropriate medical investigations and diagnostic processes both before and after death is clear, but we just have to ensure that it happens.”

In a sense, reviewing and writing about this book turned out to be not just a typical book review but an incredibly real, shocking eye-opener for us. But we are glad to have provided to our audiences even just an outline of the forensic issues that geriatric patients in particular face in care facilities:

  • Medico-legal Investigations of Elder Maltreatment and Deaths
  • The Elder Autopsy
  • Fatal and non-fatal accidents
  • Euthanasia
  • Starvation, Dehydration, Malnutrition, and Neglect
  • Physical Abuse and Elder Homicide
  • Forensic Entomology
  • Non-lethal Elder Abuse
  • Sexual Assault in Elders
  • Hypothermia and Hyperthermia in Elders
  • Suicide and Social Isolation in Elders
  • Iatrogenic Deaths in Elders (e.g. unfavorable responses to medical or surgical treatments, unnecessary medication, surgery, infections in hospitals, negative effects of drugs)    



Kim A. Collins is a forensic pathologist with Newbery Pathology Associates and Medical Director for Sharinghope SC Organ and Tissue Donation Services in South Carolina.  

Roger W. Byard holds the George Richard Marks Chair of Pathology at the University of Adelaide and is a Senior Forensic Pathologist at Forensic Science SA in Adelaide, Australia.