MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Journal of the American Geriatrics Society' source. Wed, 08 Feb 2012 16:54:26 +0100 http://www.medworm.com/index.php?rid=5644260&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03816.x ConclusionBecause previous research favored care in the Netherlands to that in the United States, findings suggest improvement in end‐of‐life care and outcomes in the United States and stability in the Netherlands. Greater hospice use does not explain improvements in the United States directly and may relate, at least in part, to care provided by long‐term care staff themselves. Better understanding of the nature and process of these improvements may suggest areas for additional improvement. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5644260 Mon, 30 Jan 2012 05:00:00 +0100 5644260 http://www.medworm.com/index.php?rid=5644259&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03817.x ConclusionNYC ALFs were varied in terms of nursing services offered, characteristics, and residents’ needs; therefore, public health agencies may need to be flexible in their assistance. Public health agencies should consider strengthening relationships with ALFs to identify unmet needs and gaps in services. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5644259 Mon, 30 Jan 2012 05:00:00 +0100 5644259 http://www.medworm.com/index.php?rid=5644258&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03838.x ConclusionWalking programs may provide benefits in some aspects of cognition, QOL, and functional capacity including social interaction in elderly community members. This study could serve as the basis for implementation of a community‐based intervention to prevent mental decline. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5644258 Mon, 30 Jan 2012 05:00:00 +0100 5644258 http://www.medworm.com/index.php?rid=5644257&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03842.x ConclusionUse of atypical antipsychotics in older adults for conditions other than schizophrenia and bipolar disorder was associated with incident treatment of diabetes mellitus but not of hyperlipidemia, suggesting that older adults may be susceptible to the adverse metabolic consequences of these agents. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5644257 Mon, 30 Jan 2012 05:00:00 +0100 5644257 http://www.medworm.com/index.php?rid=5644256&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03843.x AbstractOlder adults are among the highest at risk for completing suicide, and they are more likely to seek mental health services from providers outside of traditional mental health care, but providers across the spectrum of care have limited training in suicide risk assessment and management and particularly lack training in suicide prevention for older adults. An educational program was developed to increase awareness and improve suicide risk assessment and management training for a range of healthcare providers who may see older adults in their care settings. One hundred thirty‐two participants from two Veterans Affairs Medical Centers participated in a 6.5‐hour‐long workshop in the assessment and management of suicide risk in older adults. Participants were asked to complete pre... Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5644256 Mon, 30 Jan 2012 05:00:00 +0100 5644256 http://www.medworm.com/index.php?rid=5644255&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03844.x ConclusionFactors that influence quality of life in late‐life disability were similar across ethnic groups. As the number of elderly adults from diverse backgrounds with late life disability increases in the United States, interventions should be targeted to maximize daily sense of control and dignity. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5644255 Mon, 30 Jan 2012 05:00:00 +0100 5644255 http://www.medworm.com/index.php?rid=5644254&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03847.x ConclusionPersons with cognitive impairment are frequently excluded from research, often without rationale or mention of exclusion as a limitation or any discussion of its potential effect on the evidence base in geriatrics. When necessary, exclusion should be done thoughtfully and with awareness that this may reduce the clinical utility of study findings. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5644254 Mon, 30 Jan 2012 05:00:00 +0100 5644254 http://www.medworm.com/index.php?rid=5644253&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03846.x The objective of this literature review is to gain insight into the efficacy of nonpharmacological interventions in chronic pain management in community‐dwelling older adults. An extensive search of pertinent databases was performed to identify reports of studies of nonpharmacological (physical and psychosocial) pain interventions. The review identifies intervention studies that used randomized controlled trials (RCTs) and summarizes existing evidence of effectiveness of nonpharmacological interventions. A literature search yielded 28 RCT intervention studies (18 for physical interventions and 10 for psychosocial interventions) that met inclusion criteria and are included in this review. Twenty‐one studies (75%) identified in this review demonstrated statistically significant differenc... Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5644253 Mon, 30 Jan 2012 05:00:00 +0100 5644253 http://www.medworm.com/index.php?rid=5644278&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03786.x ConclusionThe developed computational approaches applied to the nationally representative Medicare‐based data sets allow reconstruction of age patterns of disease incidence in the U.S. elderly population at the national level with unprecedented statistical accuracy and stability with respect to systematic biases. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5644278 Fri, 27 Jan 2012 05:00:00 +0100 5644278 http://www.medworm.com/index.php?rid=5644277&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03788.x ConclusionOlder adults with lifetime PTSD have high rates of several physical health conditions, many of which are chronic disorders of aging, and poorer physical functioning. Older adults with lifetime partial PTSD have higher rates of gastritis, angina pectoris, and arthritis and poorer physical functioning. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5644277 Fri, 27 Jan 2012 05:00:00 +0100 5644277 http://www.medworm.com/index.php?rid=5644276&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03818.x ConclusionElderly adults with CKD are at risk for anemia, hyperkalemia, acidosis, and hyperphosphatemia; age does not modify the relationship between GFR and development of metabolic complications. Elderly adults with low GFR should be monitored for metabolic complications, regardless of age. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5644276 Fri, 27 Jan 2012 05:00:00 +0100 5644276 http://www.medworm.com/index.php?rid=5644275&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03820.x ConclusionThe quality of physician documentation about decision‐making in these women was high. A great amount of thoughtful and complex decision‐making involving patients, family, and physicians occurs after a woman aged 80 and older is diagnosed with breast cancer. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5644275 Fri, 27 Jan 2012 05:00:00 +0100 5644275 http://www.medworm.com/index.php?rid=5644274&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03821.x ConclusionReported elder self‐neglect was associated with higher rates of hospitalization in this community population. Greater severity of self‐neglect was associated with a greater rate of hospitalization. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5644274 Fri, 27 Jan 2012 05:00:00 +0100 5644274 http://www.medworm.com/index.php?rid=5644273&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03822.x ConclusionOlder Mexican Americans had restricted life‐space, with approximately 80% limited to their home or neighborhood. Older age, female sex, stroke, high depressive symptoms, BMI of 35 kg/m2 or greater, and ADL disability were related to less life‐space. Future studies are needed to examine the association between life‐space and health outcomes and to characterize the trajectory of life‐space over time in this population. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5644273 Fri, 27 Jan 2012 05:00:00 +0100 5644273 http://www.medworm.com/index.php?rid=5644272&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03823.x ConclusionFor older adults admitted to the ED with infection, functional status did not predict complicated clinical course, but several other variables were predictive, including immunosuppression, several variables associated with hypoperfusion, and suspected bloodstream infection. Emergency physicians could consider these variables as potential indicators of complicated clinical course when making disposition decisions for this population. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5644272 Fri, 27 Jan 2012 05:00:00 +0100 5644272 http://www.medworm.com/index.php?rid=5644271&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03824.x ConclusionThe review confirms the effectiveness of CBT for anxiety disorders in older people but is suggestive of lower efficacy in older than working‐age people. The small effect sizes in favor of CBT over an active control condition illustrate the need to investigate other treatment approaches that may be used to substitute or augment CBT to increase the effectiveness of treatment of anxiety disorders in older people. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5644271 Fri, 27 Jan 2012 05:00:00 +0100 5644271 http://www.medworm.com/index.php?rid=5644270&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03825.x ConclusionAlthough most studied characteristics of histoplasmosis were similar, notable age‐related differences were present. Chronic cavitary disease and asymptomatic histoplasmosis were more common with older age. In acute histoplasmosis, the lack of chest pain and hilar lymphadenopathy may hinder diagnosis in older adults. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5644270 Fri, 27 Jan 2012 05:00:00 +0100 5644270 http://www.medworm.com/index.php?rid=5644269&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03826.x ConclusionFrail elderly adults living in nursing homes with poor renal function had lower 1,25(OH)2D3 and higher intact PTH levels and were thus thought to have poorer vitamin D activating capacity. Supplementation with cholecalciferol may be insufficient in people who have poor renal function. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5644269 Fri, 27 Jan 2012 05:00:00 +0100 5644269 http://www.medworm.com/index.php?rid=5644268&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03828.x ConclusionIt is important to distinguish different dimensions of depression when assessing very old populations because some of the questions on the GDS are associated with fatigue, mild cognitive decline, and decline in physical functioning, which increase with aging. Future research should revisit the concept of depression in very late life. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5644268 Fri, 27 Jan 2012 05:00:00 +0100 5644268 http://www.medworm.com/index.php?rid=5644267&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03827.x ConclusionFor 85‐year‐olds, being obese, as opposed to overweight, is associated with self‐reported activity limitations and comorbidities. Overweight older adults living in their own homes in this population had well‐being similar to that of those with normal weight. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5644267 Fri, 27 Jan 2012 05:00:00 +0100 5644267 http://www.medworm.com/index.php?rid=5644266&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03829.x ConclusionDepressive symptoms are associated with fall risk in older adults and are mediated in part by chronic pain. Research is needed to determine effective strategies for reducing fall risk and related injuries in older people with pain and depressive symptoms. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5644266 Fri, 27 Jan 2012 05:00:00 +0100 5644266 http://www.medworm.com/index.php?rid=5644265&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03830.x ConclusionResults provide evidence that prefrailty is an “at risk” state from which older adults with high 25(OH)D levels are more likely to recover than to decline, but high 25(OH)D levels were not associated with recovery from frailty. Thus, 25(OH)D levels should be investigated as a potential therapy to treat prefrailty and prevent further decline. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5644265 Fri, 27 Jan 2012 05:00:00 +0100 5644265 http://www.medworm.com/index.php?rid=5644264&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03833.x ConclusionLower protein intake was associated with decline in muscle strength in persons with high levels of inflammatory markers. These results may help to understand the factors contributing to decline in muscle strength with aging and to identify the target population of older persons who may benefit from nutritional interventions aimed at preventing or reducing age‐associated muscle impairments and its detrimental consequences. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5644264 Fri, 27 Jan 2012 05:00:00 +0100 5644264 http://www.medworm.com/index.php?rid=5644263&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03834.x ConclusionCharacteristics of community‐dwelling older people with recurrent indoor and outdoor falls are different. If confirmed, these results suggest that different types of fall risk assessment are needed for specific categories of recurrent fallers. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5644263 Fri, 27 Jan 2012 05:00:00 +0100 5644263 http://www.medworm.com/index.php?rid=5644262&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03836.x ConclusionDiabetes mellitus is a risk factor for cardiovascular disease and mortality but is seen in persons who live into very old age. Aside from higher rates of anemia and use of more medications, few clinical correlates of DM were observed in centenarians. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5644262 Fri, 27 Jan 2012 05:00:00 +0100 5644262 http://www.medworm.com/index.php?rid=5644261&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03839.x ConclusionHistory of CAD may be a surrogate marker for clinically significant atherosclerosis, which also affects the brain. Structural MRI measures of WMHs and SBIs do not fully capture the potential adverse effects of atherosclerosis on the brain. Future longitudinal studies of cognition should incorporate direct measures of atherosclerosis in cerebral arteries, as well as more sensitive neuroimaging measures. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5644261 Fri, 27 Jan 2012 05:00:00 +0100 5644261 http://www.medworm.com/index.php?rid=5644252&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2012.03895.x ConclusionOnly a few differences in the concept of good death existed between elderly and younger adults. When caring for terminally ill elderly Japanese adults, medical staff should acknowledge that some elderly adults value the traditional paternalistic attitude of physicians and that not all people want to be actively involved in decision‐making. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5644252 Sun, 01 Jan 2012 05:00:00 +0100 5644252 http://www.medworm.com/index.php?rid=5627148&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03784.x ConclusionParticipants with limited life expectancy were less likely than those without to have controlled HbA1c levels and to receive treatment intensification, suggesting that providers treat these individuals less aggressively. Quality measurement and performance‐based reimbursement systems should acknowledge the different needs of this population. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5627148 Sun, 01 Jan 2012 05:00:00 +0100 5627148 http://www.medworm.com/index.php?rid=5580267&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03894.x (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5580267 Sun, 01 Jan 2012 05:00:00 +0100 5580267 http://www.medworm.com/index.php?rid=5580266&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03736.x (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5580266 Sun, 01 Jan 2012 05:00:00 +0100 5580266 http://www.medworm.com/index.php?rid=5580265&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03716.x (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5580265 Sun, 01 Jan 2012 05:00:00 +0100 5580265 http://www.medworm.com/index.php?rid=5580264&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03737.x (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5580264 Sun, 01 Jan 2012 05:00:00 +0100 5580264 http://www.medworm.com/index.php?rid=5580263&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03742.x (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5580263 Sun, 01 Jan 2012 05:00:00 +0100 5580263 http://www.medworm.com/index.php?rid=5580262&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03738.x (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5580262 Sun, 01 Jan 2012 05:00:00 +0100 5580262 http://www.medworm.com/index.php?rid=5580261&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03752.x (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5580261 Sun, 01 Jan 2012 05:00:00 +0100 5580261 http://www.medworm.com/index.php?rid=5580260&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03748.x (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5580260 Sun, 01 Jan 2012 05:00:00 +0100 5580260 http://www.medworm.com/index.php?rid=5580259&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03741.x (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5580259 Sun, 01 Jan 2012 05:00:00 +0100 5580259 http://www.medworm.com/index.php?rid=5580258&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03762.x (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5580258 Sun, 01 Jan 2012 05:00:00 +0100 5580258 http://www.medworm.com/index.php?rid=5580257&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03753.x (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5580257 Sun, 01 Jan 2012 05:00:00 +0100 5580257 http://www.medworm.com/index.php?rid=5580256&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03751.x (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5580256 Sun, 01 Jan 2012 05:00:00 +0100 5580256 http://www.medworm.com/index.php?rid=5580255&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03746.x (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5580255 Sun, 01 Jan 2012 05:00:00 +0100 5580255 http://www.medworm.com/index.php?rid=5580254&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03747.x (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5580254 Sun, 01 Jan 2012 05:00:00 +0100 5580254 http://www.medworm.com/index.php?rid=5580253&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03744.x (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5580253 Sun, 01 Jan 2012 05:00:00 +0100 5580253 http://www.medworm.com/index.php?rid=5580252&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03745.x (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5580252 Sun, 01 Jan 2012 05:00:00 +0100 5580252 http://www.medworm.com/index.php?rid=5580251&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03709.x (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5580251 Sun, 01 Jan 2012 05:00:00 +0100 5580251 http://www.medworm.com/index.php?rid=5580250&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03743.x (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5580250 Sun, 01 Jan 2012 05:00:00 +0100 5580250 http://www.medworm.com/index.php?rid=5580249&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03735.x (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5580249 Sun, 01 Jan 2012 05:00:00 +0100 5580249 http://www.medworm.com/index.php?rid=5580248&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03758.x (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5580248 Sun, 01 Jan 2012 05:00:00 +0100 5580248 http://www.medworm.com/index.php?rid=5580247&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03759.x (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5580247 Sun, 01 Jan 2012 05:00:00 +0100 5580247 http://www.medworm.com/index.php?rid=5580246&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03749.x (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5580246 Sun, 01 Jan 2012 05:00:00 +0100 5580246 http://www.medworm.com/index.php?rid=5580245&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03750.x (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5580245 Sun, 01 Jan 2012 05:00:00 +0100 5580245 http://www.medworm.com/index.php?rid=5580244&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03756.x (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5580244 Sun, 01 Jan 2012 05:00:00 +0100 5580244 http://www.medworm.com/index.php?rid=5580243&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03757.x (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5580243 Sun, 01 Jan 2012 05:00:00 +0100 5580243 http://www.medworm.com/index.php?rid=5580242&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03790.x (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5580242 Sun, 01 Jan 2012 05:00:00 +0100 5580242 http://www.medworm.com/index.php?rid=5580241&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03740.x Ethics, Public Policy and Medical EconomicsLeft ventricular assist devices (LVADs) are approved as “destination therapy” (permanent use without plans for transplantation) in individuals with advanced heart failure who are not candidates for a cardiac transplant; as such, these devices are increasingly being used in older adults. Although LVADs have been shown to increase quality of life and survival, the associated treatment burdens and complications deserve careful consideration. The current study illustrates myriad clinical challenges that can arise during long‐term mechanical support using an older adult case history. Current data on LVAD use in older adults is reviewed, and a discussion of relevant points to consider before LVAD implantation in older adults, including advance car... Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5580241 Sun, 01 Jan 2012 05:00:00 +0100 5580241 http://www.medworm.com/index.php?rid=5580240&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03763.x ConclusionA family physician‐aligned community care management approach reduces frail older adults’ risk of mortality and permanent residential care placement. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5580240 Sun, 01 Jan 2012 05:00:00 +0100 5580240 http://www.medworm.com/index.php?rid=5580239&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03773.x ConclusionAddition of insulin glargine to oral antidiabetic drugs in older adults with poor glycemic control may have modestly better glycemic benefits than adding NPH insulin, with low risk of hypoglycemia. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5580239 Sun, 01 Jan 2012 05:00:00 +0100 5580239 http://www.medworm.com/index.php?rid=5580238&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03652.x CONCLUSIONA risk‐prediction model specific to older adults can identify excellent KT candidates. Appropriate referral could result in significantly greater rates of KT in older adults. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5580238 Sun, 01 Jan 2012 05:00:00 +0100 5580238 http://www.medworm.com/index.php?rid=5580237&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03789.x ConclusionIn Chinese older men who are vitamin D replete and have a high level of baseline physical function, vitamin D may not have an important role in physical function and muscle mass. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5580237 Sun, 01 Jan 2012 05:00:00 +0100 5580237 http://www.medworm.com/index.php?rid=5552906&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03768.x ConclusionAmong Japanese‐American men, having a healthy lifestyle in midlife is associated with a lower risk of dementia in late life. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5552906 Wed, 28 Dec 2011 05:00:00 +0100 5552906 http://www.medworm.com/index.php?rid=5552905&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03770.x ConclusionsOlder adults’ accompaniment to physician visits typically persists, most often by consistently involved family companions. Findings have implications for the patient–physician partnership and the patient‐centered medical home. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5552905 Wed, 28 Dec 2011 05:00:00 +0100 5552905 http://www.medworm.com/index.php?rid=5552904&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03778.x ConclusionThe intensive, dementia‐adjusted training was feasible and substantially improved motor performance in frail, older people with dementia and may represent a model for structured rehabilitation or outpatient training. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5552904 Wed, 28 Dec 2011 05:00:00 +0100 5552904 http://www.medworm.com/index.php?rid=5552903&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03779.x ConclusionLifestyle and physical health earlier in life determine rate of muscle strength decline in old age. Efforts should be made to recognize persons at risk in a timely manner and target early interventions to middle‐aged persons to slow down muscle strength decline and prevent future functional limitations and disability. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5552903 Wed, 28 Dec 2011 05:00:00 +0100 5552903 http://www.medworm.com/index.php?rid=5552902&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03780.x ConclusionMOF was strongly and independently associated with all measures of physical performance in men and with the TUG test in women after adjustment for various confounders, suggesting that age‐related declines in masticatory and skeletal muscle functions share common mechanistic pathways in older age, particularly in men. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5552902 Wed, 28 Dec 2011 05:00:00 +0100 5552902 http://www.medworm.com/index.php?rid=5552901&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03785.x ConclusionCarefully selected elderly individuals experience similar perioperative outcomes and overall survival to those of younger individuals after resection of pancreatic cancer. There appears to be a significant disparity in the use of adjuvant therapy between young and elderly individuals. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5552901 Wed, 28 Dec 2011 05:00:00 +0100 5552901 http://www.medworm.com/index.php?rid=5552900&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03787.x Expert communication is essential to high‐quality care for older patients with serious illness. Although the importance of communication skills is widely recognized, formal curricula for teaching communication skills to geriatric and palliative medicine fellows is often inadequate or unavailable. The current study drew upon the educational principles and format of an evidence‐based, interactive teaching method to develop an intensive communication skills training course designed specifically to address the common communication challenges that geriatric and palliative medicine fellows face. The 2‐day retreat, held away from the hospital environment, included large‐group overview presentations, small‐group communication skills practice, and development of future skills practice com... Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5552900 Wed, 28 Dec 2011 05:00:00 +0100 5552900 http://www.medworm.com/index.php?rid=5552899&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03791.x ConclusionPoor dental status was associated with a higher risk of onset of functional disability in older Japanese people. Sociodemographic, behavioral, and health status covariates explained the association between eating ability and onset of disability. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5552899 Wed, 28 Dec 2011 05:00:00 +0100 5552899 http://www.medworm.com/index.php?rid=5552907&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03777.x ConclusionWork‐related stress, including low job control and low social support at work, may increase the risk of dementia, particularly VaD. Modification to work environment, including attention to social context and provision of meaningful roles for employees, may contribute to efforts to promote cognitive health. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5552907 Fri, 16 Dec 2011 05:00:00 +0100 5552907 http://www.medworm.com/index.php?rid=5516353&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03775.x ConclusionThe expert panel considered screening older people to prevent functional decline appropriate for insufficient physical activity and smoking and cardiovascular risk in specific groups. For other conditions, sufficient evidence does not support screening. Based on their experience, panelists expected benefit from developing tests and interventions, especially for vulnerable older people. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5516353 Fri, 16 Dec 2011 05:00:00 +0100 5516353 http://www.medworm.com/index.php?rid=5516354&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03772.x ConclusionADRs, determined using a validated causality algorithm, are a common cause of unplanned hospitalization in older veterans, are frequently preventable, and are associated with polypharmacy. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5516354 Thu, 08 Dec 2011 05:00:00 +0100 5516354 http://www.medworm.com/index.php?rid=5496644&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03726.x ConclusionDiabetes mellitus was managed more intensively in older veterans with dementia and cognitive impairment, and dementia and cognitive impairment were independently associated with greater risk of hypoglycemia. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5496644 Thu, 08 Dec 2011 05:00:00 +0100 5496644 http://www.medworm.com/index.php?rid=5496643&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03761.x ConclusionFindings indicate that aerobic and extended cognitive practice training interventions for healthy older adults improve performance on untrained cognitive tasks. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5496643 Thu, 08 Dec 2011 05:00:00 +0100 5496643 http://www.medworm.com/index.php?rid=5496642&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03765.x ConclusionThe VAT (cued recall of pictorial material) is superior to other tasks for the recognition of dementia in terms of higher specificity and PPV. Age‐specific cutoff scores may improve the validity of all tests. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5496642 Thu, 08 Dec 2011 05:00:00 +0100 5496642 http://www.medworm.com/index.php?rid=5496641&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03766.x ConclusionAge, dementia severity at study entry, and quality of educational experience are important explanatory factors in understanding the existing discrepancies in MMSE performance between Caucasian and African‐American adults. These findings support the use of unadjusted MMSE scores when screening older African Americans for dementia, with an unadjusted MMSE cut score of 22/23 yielding optimal classification accuracy. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5496641 Thu, 08 Dec 2011 05:00:00 +0100 5496641 http://www.medworm.com/index.php?rid=5496640&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03767.x ConclusionObesity appears to be associated with greater risk of falling in older adults, as well as a higher risk of greater ADL disability after a fall. Obesity (BMI ≥ 40 kg/m2) may reduce the risk of injury from a fall. Further investigation of the mechanisms of obesity on falls and related health outcomes is warranted. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5496640 Thu, 08 Dec 2011 05:00:00 +0100 5496640 http://www.medworm.com/index.php?rid=5496639&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03769.x ConclusionModerate or higher pain was independently associated with frailty. Although causality cannot be ascertained in a cross‐sectional analysis, interventions to improve pain management may help prevent or ameliorate frailty. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5496639 Thu, 08 Dec 2011 05:00:00 +0100 5496639 http://www.medworm.com/index.php?rid=5496645&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03776.x ConclusionThe data suggest that exercise and AAS together may be effective in enhancing not only muscle strength, but also combined variables of muscle mass and walking speed and of muscle mass and strength in sarcopenic women. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5496645 Mon, 05 Dec 2011 05:00:00 +0100 5496645 http://www.medworm.com/index.php?rid=5480753&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03774.x ConclusionMCI subtypes exhibit distinctive, sex‐dependent risk profiles. This is consistent with MCI subtypes having different etiologies and outcomes and supports the idea that subtyping MCI may offer predictive validity and clinical application. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5480753 Mon, 05 Dec 2011 05:00:00 +0100 5480753 http://www.medworm.com/index.php?rid=5480754&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03699.x ConclusionUsing a function‐focused approach in AL may help prevent some of the functional decline commonly noted in these settings. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5480754 Tue, 08 Nov 2011 05:00:00 +0100 5480754 http://www.medworm.com/index.php?rid=5428171&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03717.x Language‐related communication barriers between minority patients and their physicians may contribute to racial and ethnic disparities in mental health care. Accordingly, the current study sought to examine whether perceived mental health needs and discussion of these needs differed as a function of race or ethnicity and language concordance in older Latinos and Asian and Pacific Islanders (APIs). Using the 2007 California Health Interview Survey, the analytical sample included Latinos and APIs aged 55 and older (N = 2,960) who reported having seen a primary care provider within the past 2 years. Multivariable logistic regression was used to examine differences according to race or ethnicity and language concordance status (three groups: English‐language concordant, other‐language... Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5428171 Tue, 08 Nov 2011 05:00:00 +0100 5428171 http://www.medworm.com/index.php?rid=5428170&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03714.x ConclusionProviding medical care for AL residents presents unique challenges and opportunities for physicians. Nursing presence and physician oversight and familiarity and communicating with AL staff who are highly familiar with a given resident and can monitor care may facilitate care. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5428170 Tue, 08 Nov 2011 05:00:00 +0100 5428170 http://www.medworm.com/index.php?rid=5428169&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03718.x ConclusionBlack race, Hispanic ethnicity, and other functional and social characteristics are correlates of in‐hospital death, even after controlling for the role of HCI. Further work must be done to determine whether preferences, provider characteristics and practice patterns, or differential access to medical and community services drive this difference. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5428169 Tue, 08 Nov 2011 05:00:00 +0100 5428169 http://www.medworm.com/index.php?rid=5428168&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03713.x Bisphosphonates are used worldwide as a successful treatment for people with osteoporosis, which is the major underlying cause of fractures in postmenopausal women and older adults. These agents are successful at increasing bone mass and bone trabecular thickness, decreasing the risk of fracture, and decreasing bone pain, enabling individuals to have better quality of life. Bisphosphonates are also used to treat multiple myeloma, bone metastasis, and Paget's disease; however, bisphosphonate treatment may result in negative side effects, including osteonecrosis of the jaw (ONJ). ONJ involves necrotic, exposed bone in the jaw, pain, possible secondary infection, swelling, painful lesions, and various dysesthesias, although less‐severe cases may be asymptomatic. First‐generation bisphosph... Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5428168 Tue, 08 Nov 2011 05:00:00 +0100 5428168 http://www.medworm.com/index.php?rid=5428167&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03700.x A cornerstone of American medical ethics is the right to say, “Keep your hands off of me,” to decline medical treatment. A central problem is how to decide about individuals who have become incapacitated and can no longer request or refuse potentially life‐sustaining treatment. An advance directive is a formal attempt to protect people's right to autonomy when they are no longer autonomous. As such, it assumes that previously expressed wishes are precise and immutable, but many families make decisions together, and individuals may negotiate, compromise, and modify their genuine preferences, especially when novel threats arise, and the stakes are high. The current article describes a case in which two daughters overruled a patient's explicit preference to refuse life‐sustaining trea... Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5428167 Tue, 08 Nov 2011 05:00:00 +0100 5428167 http://www.medworm.com/index.php?rid=5428172&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03719.x ConclusionThe findings of previous studies could not be confirmed. Moreover, positive CMV serology was found to be negatively associated with frailty. These apparently contradictory results may reflect a survival effect because the current study population was considerably older than the populations of older adults in previous studies. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5428172 Mon, 07 Nov 2011 05:00:00 +0100 5428172 http://www.medworm.com/index.php?rid=5383408&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03731.x ConclusionSpending less percentage of time in REM sleep and greater percentage of time in Stage 1 sleep and having higher levels of nocturnal hypoxemia were associated with poorer cognition in older men. Further studies are needed to clarify the direction of these associations and to explore potential mechanisms. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5383408 Mon, 07 Nov 2011 05:00:00 +0100 5383408 http://www.medworm.com/index.php?rid=5383407&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03729.x ConclusionConcern for postoperative delirium should not prevent the use of opioid analgesic therapy sufficient to achieve a generally accepted level of comfort in individuals with or without preexisting cognitive impairment. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5383407 Mon, 07 Nov 2011 05:00:00 +0100 5383407 http://www.medworm.com/index.php?rid=5383406&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03724.x ConclusionBehavioral and antimuscarinic therapy are effective when added to alpha‐blocker therapy for OAB in men without outlet obstruction. Behavioral treatment is at least as effective as antimuscarinic therapy. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5383406 Mon, 07 Nov 2011 05:00:00 +0100 5383406 http://www.medworm.com/index.php?rid=5383409&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03721.x ConclusionACE inhibitors and statins widely prescribed to treat hypertension and hypercholesterolemia, respectively, do not lower risk of mobility limitation, an important indicator of quality of life. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5383409 Fri, 04 Nov 2011 04:00:00 +0100 5383409 http://www.medworm.com/index.php?rid=5383410&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03720.x The “Geriatric Health Literacy Workshop for Medical Students and Residents” developed by Seema Limaye, MD, introduces medical students and residents to important concepts in communicating with older adults with low health literacy through a variety of teaching modalities. The workshop is available on the Portal of Geriatric Online Education (POGOe) and includes a didactic session, role‐playing exercises, and a critique of patient education handouts. A preworkshop health literacy module and postworkshop clinical observation sessions reinforce the workshop content. The activity is designed to take approximately 2.5 hours to administer to small groups of three to five learners and is also suitable for interdisciplinary teams of health professions trainees. This POGOe product review hig... Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5383410 Mon, 31 Oct 2011 04:00:00 +0100 5383410 http://www.medworm.com/index.php?rid=5363557&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03697.x ConclusionCMS nurse staffing rating, leadership turnover, and questionnaire response rate are associated with adherence to a CRT intervention. Pretrial evaluation of NH staffing rating by CMS and of response to a questionnaire can help investigators improve trial efficiency by screening for NHs likely to adhere to a CRT intervention. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5363557 Mon, 31 Oct 2011 04:00:00 +0100 5363557 http://www.medworm.com/index.php?rid=5363556&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03715.x ConclusionNeither seasonal nor pandemic influenza A(H1N1) viruses were detected in the network, despite widespread community transmission of seasonal and influenza A(H1N1) virus. ILI incidence trends corresponded to virological trends. Sentinel surveillance of ILI combining clinical and virological data in NHs increases understanding of transmission risks in this specific vulnerable population. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5363556 Mon, 31 Oct 2011 04:00:00 +0100 5363556 http://www.medworm.com/index.php?rid=5363555&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03730.x ConclusionThe clinical profile of participants aged 75 and older with TTC was different from that of those younger than 75 with TTC, and they had a higher in‐hospital complication rate. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5363555 Mon, 31 Oct 2011 04:00:00 +0100 5363555 http://www.medworm.com/index.php?rid=5363554&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03712.x (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5363554 Mon, 31 Oct 2011 04:00:00 +0100 5363554 http://www.medworm.com/index.php?rid=5363553&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03728.x This study explored interactions between medical residents and patient surrogates in order to clarify resident understanding of roles and relationships, resident emotional experience, and resident learning processes. Qualitative analysis of in‐depth interviews were used involving three family medicine residency programs serving culturally diverse, urban, underserved patient populations. Eighteen second‐ and third‐year trainees described a memorable interaction with a surrogate and then were prompted to discuss their learning experience and their role in the interaction. Interviews were transcribed verbatim and analyzed through an iterative process. Residents experienced significant emotional burden during interactions yet continued to value their relationships with surrogates. Despit... Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5363553 Mon, 31 Oct 2011 04:00:00 +0100 5363553 http://www.medworm.com/index.php?rid=5363552&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03760.x This activity teaches knowledge and skills regarding the assessment and management of geriatric depression to second‐year medical students. Students actively participate in a standardized patient scenario with a “collateral source,” which the authors define as a relative, friend, neighbor, healthcare power of attorney, or healthcare provider of a cognitively impaired patient who can provide additional history that might be more accurate than that obtained from the patient. Students also discuss proposed physical examination items, formulate a management plan with assistance from a handout on geriatric depression and facilitation by a faculty member, and receive feedback from the standardized patient and a “collateral source.” This activity is designed to take c approximately 2 h... Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5363552 Mon, 31 Oct 2011 04:00:00 +0100 5363552 http://www.medworm.com/index.php?rid=5363551&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03739.x ConclusionNormative aging‐related declines in driver performance as assessed using on‐road tests emerge slowly. Even in the presence of conservative controls, such as previous driving ability, age, and visual sensory and motor functioning, cognitive functioning predicted future on‐road driving performance 1 and 2 years later. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5363551 Mon, 31 Oct 2011 04:00:00 +0100 5363551 http://www.medworm.com/index.php?rid=5363558&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03664.x ConclusionDepression in elderly Koreans is associated with low body mass and sarcopenia, especially in men. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5363558 Sat, 22 Oct 2011 04:00:00 +0100 5363558 http://www.medworm.com/index.php?rid=5348155&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03654.x ConclusionThese results should raise awareness about the prevalence and potential inappropriateness of concomitant use of ChIs and AChs and promote evaluations of practices intended to improve care standards. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5348155 Sat, 22 Oct 2011 04:00:00 +0100 5348155 http://www.medworm.com/index.php?rid=5348154&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03656.x ConclusionWith the exception of feeding tubes and antibiotic use in residents with orders for no antibiotics, the use of medical treatments was nearly always consistent with POLST orders to provide or withhold life‐sustaining interventions. The POLST program is a useful tool for ensuring that the treatment preferences of nursing facility residents are honored. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5348154 Sat, 22 Oct 2011 04:00:00 +0100 5348154 http://www.medworm.com/index.php?rid=5348153&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03655.x ConclusionMetabolic costs of daily activities are substantially different from normative values in older adults, and having mobility impairments increases this metabolic cost. These results may have implications for practitioners to appropriately prescribe daily physical activities for healthy and mobility‐impaired older adults. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5348153 Sat, 22 Oct 2011 04:00:00 +0100 5348153 http://www.medworm.com/index.php?rid=5348152&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03661.x ConclusionThe combination of marked participation preferences and impairments in the decisional capacity of individuals with aMCI and early AD constitute an ethical and practical challenge. A thorough implementation of structured probes of the patients’ decisional capacity combined with interventions that aid patients in their decision‐making capability might help to overcome some of these challenges. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5348152 Sat, 22 Oct 2011 04:00:00 +0100 5348152 http://www.medworm.com/index.php?rid=5348151&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03665.x ConclusionThis model developed from a large sample of older individuals identified factors worth targeting in future social and health policy initiatives for this age group. It also indicates that chronic illness is not necessarily a barrier to successful aging. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5348151 Sat, 22 Oct 2011 04:00:00 +0100 5348151 http://www.medworm.com/index.php?rid=5348158&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03666.x ConclusionOnce‐yearly IV ZOL 5 mg increases bone mass at the hip and femoral neck in men within 90 days of repair of a low‐trauma hip fracture. Increases were of a similar magnitude to those observed in women in the same study. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5348158 Fri, 21 Oct 2011 04:00:00 +0100 5348158 http://www.medworm.com/index.php?rid=5348157&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03698.x ConclusionThe CAPABLE intervention was acceptable to participants and feasible to provide and showed promising results, suggesting that this multicomponent intervention to reduce disability should be evaluated in a larger trial. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5348157 Fri, 21 Oct 2011 04:00:00 +0100 5348157 http://www.medworm.com/index.php?rid=5348156&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03667.x ConclusionParticipants with AD had higher incidence of serious upper and lower GI events, compared to those without AD. Physicians should recognize the high risk of serious GI events that exists in individuals with AD. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5348156 Fri, 21 Oct 2011 04:00:00 +0100 5348156 http://www.medworm.com/index.php?rid=5317262&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03662.x ConclusionA multicomponent intervention program led to a substantial reduction in use of belts, full‐enclosure bedrails, and sleep suits without increasing the use of other physical restraints, psychoactive drugs, or falls and fall‐related injuries. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5317262 Wed, 12 Oct 2011 04:00:00 +0100 5317262 http://www.medworm.com/index.php?rid=5317261&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03657.x ConclusionA screening battery that could be performed in less than 10 minutes predicted with good accuracy failure rate for the on‐road driving test in this sample of older drivers with dementia. A probability of failure calculator is provided from a logistic regression model that may be useful for clinicians in their decision to refer impaired older adults for further testing. More studies are needed in larger community‐based samples, along with discussions with patients, families, and clinicians, with regard to acceptable levels of test uncertainty. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5317261 Wed, 12 Oct 2011 04:00:00 +0100 5317261 http://www.medworm.com/index.php?rid=5317260&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03599.x ConclusionComprehensive quality measurement applied to vulnerable older adults enrolled in one mature SNP showed that the Evercare nurse model addresses important deficits in physician care for geriatric conditions. Such measurement should be applied to other SNP models and to compare SNP care with that for complex, older, fee‐for‐service Medicare cohorts. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5317260 Wed, 12 Oct 2011 04:00:00 +0100 5317260 http://www.medworm.com/index.php?rid=5317263&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03663.x ConclusionGeriatric syndromes were highly prevalent. Many patients did not return to their premorbid function and acquired new syndromes. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5317263 Mon, 10 Oct 2011 04:00:00 +0100 5317263 http://www.medworm.com/index.php?rid=5317264&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03628.x ConclusionThis intervention was effective in reducing rehospitalizations and ED visits for very elderly participants 3 but not 6 months after their discharge from the AGU. Future research should investigate the effect of this intervention of transitional care in a larger population and in usual acute and subacute geriatric care. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5317264 Tue, 27 Sep 2011 04:00:00 +0100 5317264 http://www.medworm.com/index.php?rid=5268612&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03658.x ConclusionAll participants improved functionally regardless of cognition. Likelihood of institutionalization, mortality, length of stay, and adverse incidents was higher with lower MMSE scores. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5268612 Fri, 23 Sep 2011 04:00:00 +0100 5268612 http://www.medworm.com/index.php?rid=5249669&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03660.x ConclusionPsychotropic medication use is common in community‐dwelling older adults with dementia. Caregivers appear to have a substantial effect on whether an antipsychotic is prescribed, which adds additional complexity to conversations discussing the risk:benefit ratio of this medication class. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5249669 Fri, 23 Sep 2011 04:00:00 +0100 5249669 http://www.medworm.com/index.php?rid=5249676&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03593.x ConclusionHigher total cholesterol was associated with a lower risk of noncardiovascular mortality in older adults. This association varied across the late‐life span and was stronger in older age groups. Further research is required to examine the mechanisms underlying this association. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5249676 Wed, 21 Sep 2011 04:00:00 +0100 5249676 http://www.medworm.com/index.php?rid=5249675&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03601.x ConclusionVitamin D deficiency was common and was associated with poorer physical performance, lower muscle strength, and prevalent mobility and ADL disability in community‐dwelling older adults. Moreover, vitamin D deficiency predicted incident mobility disability. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5249675 Wed, 21 Sep 2011 04:00:00 +0100 5249675 http://www.medworm.com/index.php?rid=5249674&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03633.x ConclusionSeveral modifiable health behaviors contribute to higher‐level functional decline. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5249674 Wed, 21 Sep 2011 04:00:00 +0100 5249674 http://www.medworm.com/index.php?rid=5249673&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03634.x ConclusionHigh cardiometabolic risk in caregivers decreased to the level of that of noncaregivers within 3 months of death of the spouse with AD, although placement, a transition in the course of dementia caregiving, did not benefit cardiovascular health in highly distressed caregivers. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5249673 Wed, 21 Sep 2011 04:00:00 +0100 5249673 http://www.medworm.com/index.php?rid=5249672&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03659.x ConclusionThe modified MNA‐SFs represent a valuable tool for rapid and reliable nutritional screening. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5249672 Wed, 21 Sep 2011 04:00:00 +0100 5249672 http://www.medworm.com/index.php?rid=5249671&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03597.x An operational definition of frailty is important for clinical care, research, and policy planning. The literature on the clinical definitions, screening tools, and severity measures of frailty were systematically reviewed as part of the Canadian Initiative on Frailty and Aging. Searches of MEDLINE from 1997 to 2009 were conducted, and reference lists of retrieved articles were pearled, to identify articles published in English and French on the identification of frailty in community‐dwelling people aged 65 and older. Two independent reviewers extracted descriptive information on study populations, frailty criteria, and outcomes from the selected papers, and quality rankings were assigned. Of 4,334 articles retrieved from the searches and 70 articles retrieved from the pearling, 22 met s... Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5249671 Wed, 21 Sep 2011 04:00:00 +0100 5249671 http://www.medworm.com/index.php?rid=5249670&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03591.x ConclusionIn older adults, the risk of injury with zolpidem exceeded that with alprazolam and lorazepam and was similar to that with diazepam. If the associations are causal, then the high incidence of these fractures implies that these treatment induce a substantial number of fractures and consequential costs. Further study of the association is imperative. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5249670 Wed, 21 Sep 2011 04:00:00 +0100 5249670 http://www.medworm.com/index.php?rid=5249677&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03629.x ConclusionA decision aid about feeding options in advanced dementia reduced decisional conflict for surrogates and increased their knowledge and communication about feeding options with providers. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5249677 Thu, 15 Sep 2011 04:00:00 +0100 5249677 http://www.medworm.com/index.php?rid=5221683&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03543.x CONCLUSION: SMCs are associated with objective cognitive status and may be considered by primary care physicians in determining whether follow‐up is warranted. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5221683 Thu, 15 Sep 2011 04:00:00 +0100 5221683 http://www.medworm.com/index.php?rid=5221682&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03630.x Singapore is one of the fastest‐aging countries in the world. The proportion of adults aged 65 and older is projected to increase from 8.7% to 20% over the next 20 years. The country has developed various strategies to meet the needs of this increase in older adults. There is an acute shortage of geriatricians and a need to train more healthcare workers to care for older adults. Geriatric medicine is a relatively new specialty, and a small number of geriatricians have been tasked with providing an increasing load of clinical service, education, and research. Hence, there is a need to develop a cohesive structure of support for faculty development and retention, advanced specialty trainee recruitment, leadership in medical education, research, and clinical service to care for the rapidly... Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5221682 Thu, 15 Sep 2011 04:00:00 +0100 5221682 http://www.medworm.com/index.php?rid=5221684&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03573.x CONCLUSION: Universal health outcomes may provide a common metric for measuring the effects of multiple conditions and their treatments. The varying effects of the conditions across universal outcomes could inform care priorities. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5221684 Tue, 30 Aug 2011 04:00:00 +0100 5221684 http://www.medworm.com/index.php?rid=5180408&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03559.x CONCLUSION: HEDIS HRME drug exposure decreased slightly in an integrated healthcare system. Risk factors for exposure were not consistent across drug groups. Future studies should examine whether interventions to further reduce HEDIS HRME use improve health outcomes. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5180408 Mon, 29 Aug 2011 23:00:00 +0100 5180408 http://www.medworm.com/index.php?rid=5180407&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03564.x CONCLUSION: This study suggests that in people with ESRD, the relationship between age and cardiomyopathy is largely dependent on age‐related risk factors and that interventions focused on modifiable risk factors linked to age (e.g., malnutrition and inflammation) could attenuate the detrimental effect of aging on cardiovascular risk in the dialysis population. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5180407 Mon, 29 Aug 2011 23:00:00 +0100 5180407 http://www.medworm.com/index.php?rid=5180406&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03567.x CONCLUSION: Receipt of PIMs in older adults undergoing surgery is common and varies widely between providers and geographic regions and according to participant characteristics. Interventions aimed at reducing the use of PIMs in the perioperative period should be considered in quality improvement efforts. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5180406 Mon, 29 Aug 2011 23:00:00 +0100 5180406 http://www.medworm.com/index.php?rid=5180405&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03569.x CONCLUSION: Trouble staying asleep was associated with weight loss over 12 months in older women. Practitioners should inquire about sleep habits of patients presenting with weight loss, because this may identify a marker of declining health and may be a factor that can be modified. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5180405 Mon, 29 Aug 2011 23:00:00 +0100 5180405 http://www.medworm.com/index.php?rid=5180404&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03571.x CONCLUSION: Treatment with an oral bisphosphonate for 5 years was cost‐effective for all women, regardless of quartile of life expectancy. Advanced age should not prevent consideration of osteoporosis treatment based on cost effectiveness, and strategies to improve care, such as nurse‐led screening programs or electronic medical record tools, are needed. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5180404 Mon, 29 Aug 2011 23:00:00 +0100 5180404 http://www.medworm.com/index.php?rid=5180403&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03572.x In conclusion, physician follow‐up protects against readmission after adjusting for important covariates and is associated with significantly lower expenditures. Future efforts should ensure that patients have adequate physician follow‐up. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5180403 Mon, 29 Aug 2011 23:00:00 +0100 5180403 http://www.medworm.com/index.php?rid=5180409&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03585.x ConclusionAs clinical programs face financially challenging times, it is important to find effective ways to justify their operations to decision‐makers. Strategies described here may help clinically effective and cost‐effective programs sustain themselves and thus may help improve care in their institutions. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5180409 Sun, 28 Aug 2011 23:00:00 +0100 5180409 http://www.medworm.com/index.php?rid=5180410&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03576.x CONCLUSION: Disease‐related symptoms and impairments accounted for much of the significant associations between the four chronic diseases and the universal health outcomes. Results support considering universal health outcomes as common metrics across diseases in clinical decision‐making, perhaps by targeting the disease‐related symptoms and impairments that contribute most strongly to the effect of the disease on the universal health outcomes. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5180410 Tue, 23 Aug 2011 23:00:00 +0100 5180410 http://www.medworm.com/index.php?rid=5160400&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03539.x CONCLUSIONS: Structural MRI and neuropsychological assessment are diagnostic methods of first choice if AD is suspected. CSF and FDG‐PET add little to these diagnostic techniques, especially in older adults. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5160400 Tue, 23 Aug 2011 23:00:00 +0100 5160400 http://www.medworm.com/index.php?rid=5160399&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03542.x CONCLUSION: Potentially inappropriate ICD use appears significantly less—and at modest rates—in older Americans than in younger age groups. Overall, almost one‐quarter of individuals may have received ICDs inappropriately based on their risk of death. Physicians appear to be conservatively referring older adults and wisely deferring those with high comorbid burden. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5160399 Tue, 23 Aug 2011 23:00:00 +0100 5160399 http://www.medworm.com/index.php?rid=5160398&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03545.x CONCLUSION: Although there may be clinical uncertainty regarding PPI discontinuation, more than one‐quarter of participants prescribed a PPI upon admission to long‐term care had it discontinued within 180 days. Targeting individuals prescribed PPIs for medication appropriateness review may reduce prescribing of potentially nonindicated medications. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5160398 Tue, 23 Aug 2011 23:00:00 +0100 5160398 http://www.medworm.com/index.php?rid=5160397&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03551.x CONCLUSION: These results highlight the potential of a structured fitness center–based intervention and a home‐based lifestyle intervention in the battle against inactivity in older adults. Lifestyle programs are especially valuable because they require fewer resources and less time from health institutions and health practitioners. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5160397 Tue, 23 Aug 2011 23:00:00 +0100 5160397 http://www.medworm.com/index.php?rid=5160396&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03555.x Falls are a major problem in older adults, and physicians receive inadequate training in falls evaluation. A multicomponent program (lecture, academic detailing, and case studies) was implemented to enhance medical residents' knowledge, skills, decisions, and interventions made about falls as part of a larger project to improve assessment and care of older adults. Electronic medical record (EMR) template modifications provided cues and reminders, decision support, and documentation into the visit note. Nursing staff and the EMR prompted residents to evaluate patients with a history of falls. Knowledge and confidence were assessed using a pre‐ and postintervention questionnaire, and an attending physician assessed skills by direct observation of the Timed Up and Go Test (TUG). Effect on c... Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5160396 Tue, 23 Aug 2011 23:00:00 +0100 5160396 http://www.medworm.com/index.php?rid=5160395&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03556.x CONCLUSION: NH staff rated fewer hospital transfers as avoidable than published estimates. Greater attention to the complex array of reasons that staff provide for hospital transfer should be considered in strategies to reduce avoidable hospitalizations of NH residents. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5160395 Tue, 23 Aug 2011 23:00:00 +0100 5160395 http://www.medworm.com/index.php?rid=5160394&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03557.x CONCLUSION: Disease burden was independently and significantly associated with frailty. These results emphasize that typically unrecognized physiological changes may contribute significantly to frailty. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5160394 Tue, 23 Aug 2011 23:00:00 +0100 5160394 http://www.medworm.com/index.php?rid=5160393&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03558.x CONCLUSION: In community‐dwelling adults, higher plasma klotho concentrations are independently associated with a lower likelihood of having CVD. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5160393 Tue, 23 Aug 2011 23:00:00 +0100 5160393 http://www.medworm.com/index.php?rid=5160392&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03560.x CONCLUSION: Results from this sample of women recovering from hip fracture provide only limited support for the 0.10‐m/s cut point for substantial meaningful change previously identified in community‐dwelling older adults experiencing declines in walking abilities. Anchor‐based estimates and cut points derived from receiver operating characteristic curve analysis suggest that greater improvements in gait speed may be required for substantial perceived mobility improvement in female hip fracture patients. Furthermore, gait speed change performed poorly in discriminating change in self‐reported mobility. Estimates of meaningful change in gait speed may differ based on the direction of change (improvement vs decline) or between patient populations. (Source: Journal of the American Ger... Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5160392 Tue, 23 Aug 2011 23:00:00 +0100 5160392 http://www.medworm.com/index.php?rid=5160391&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03561.x CONCLUSION: Psychoactive medication usage was associated with greater risk of a motor vehicle crash requiring hospitalization in older drivers. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5160391 Tue, 23 Aug 2011 23:00:00 +0100 5160391 http://www.medworm.com/index.php?rid=5160390&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03562.x CONCLUSION: Frontal dysfunction, particularly perseverative errors and responses, was associated with moderate to severe CKD in the population studied. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5160390 Tue, 23 Aug 2011 23:00:00 +0100 5160390 http://www.medworm.com/index.php?rid=5160389&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03570.x CONCLUSION: Low levels of inflammatory markers are associated with better survival in older adults, independent of age and other clinical and functional variables. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5160389 Tue, 23 Aug 2011 23:00:00 +0100 5160389 http://www.medworm.com/index.php?rid=5160388&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03575.x CONCLUSION: Delirium in older adults acutely admitted for hip fracture may be linked with higher cortisol concentrations, but it may be that this association reflects an association between higher cortisol and preexisting cognitive and functional impairment. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5160388 Tue, 23 Aug 2011 23:00:00 +0100 5160388 http://www.medworm.com/index.php?rid=5160401&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03524.x CONCLUSION: The prevalence of Rx‐DIS was common in older VA outpatients. Future studies should examine the risk of Rx‐DIS exposure on health outcomes using separate analyses for each type of Rx‐DIS separately before combining all Rx‐DIS into a single measure of exposure. Studies that examine the effectiveness of interventions to reduce Rx‐DIS exposure will also be helpful in improving the quality of care for older adults. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5160401 Tue, 09 Aug 2011 23:00:00 +0100 5160401 http://www.medworm.com/index.php?rid=5112614&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03501.x CONCLUSION: This “real world” comparative effectiveness research extends randomized controlled trial results by documenting the relative survival benefit of OX in older adults with Stage III colon cancer. The associated shift in treatment away from 5FU/LV alone or IRI toward OX is consistent with evidence‐based medicine from real‐world outcomes research. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5112614 Tue, 09 Aug 2011 23:00:00 +0100 5112614 http://www.medworm.com/index.php?rid=5112617&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03522.x CONCLUSION: Potential problems with the use of antidepressants were frequently observed in older U.S. veteran CLC residents. Future studies are needed to examine the true risks and benefits of antidepressant use in CLC and non‐VA nursing homes. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5112617 Sun, 07 Aug 2011 23:00:00 +0100 5112617 http://www.medworm.com/index.php?rid=5112616&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03534.x CONCLUSION: In this age‐homogenous cohort of the oldest old, high LVMI and LAVI and indices of systolic but not diastolic function as assessed according to Doppler were associated with limitations in ADLs. (Source: Journal of the American Geriatrics Society) Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5112616 Sun, 07 Aug 2011 23:00:00 +0100 5112616 http://www.medworm.com/index.php?rid=5112615&cid=s_28409_18_f&fid=28409&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1532-5415.2011.03554.x The aging of the U.S. population poses one of the greatest future challenges for family medicine and internal medicine residency training. One important barrier to providing quality education and training in geriatric medicine to residents is a serious and growing shortage of practicing geriatricians and geriatrics faculty. The Accreditation Council for Graduate Medical Education currently accredits 45 family medicine–based and 107 internal medicine–based geriatric medicine fellowships in the United States. There are 13 American Osteopathic Association–certified geriatric medicine fellowship programs. In this article, the authors examine the rationale for the development of additional geriatric medicine fellowship programs and offer some practical suggestions and pointers for those i... Journal of the American Geriatrics Society journals http://www.medworm.com/rss/comments.php?id=5112615 Sun, 07 Aug 2011 23:00:00 +0100 5112615