Journal of the American Geriatrics Society
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To present baseline data from a prospective study of postprandial hypotension in 499 elderly persons in a long-term health care facility. ⋯ A more severe reduction in postprandial systolic blood pressure correlates with a history of syncope or falls in the previous 6 months. Long-term follow-up is being planned to determine whether a marked reduction in postprandial systolic blood pressure in elderly persons correlates with a higher incidence of falls, syncope, new coronary events, new stroke, and total mortality.
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To examine variation in elders' choices of therapies in different clinical scenarios and to assess the validity of extending preferences expressed in scenarios of usual health, terminal illness, and coma to preferences in a scenario of moderately advanced Alzheimer disease. ⋯ (1) Use of a scenario-based advance directive may be limited to the precise scenario described. (2) The common acceptance of interventions in the Alzheimer disease scenario differs from findings in earlier studies, possibly because of differences in populations surveyed or the stage of the disease described, highlighting the variability of preferences in this scenario. (3) Trial of intervention is attractive to many respondents, perhaps because it allows the advantage of potentially beneficial therapies without commitment to a course of therapy not leading to cure. (4) Results of this study should be interpreted in light of the study population, consisting largely of well educated, healthy Caucasians. Findings are likely not to be generalizable to other populations.
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To examine changes in the rate of falling of an experimental group of restrained subjects who underwent restraint reduction, and to compare their rate of falling with a group of subjects who did not have restraint orders during the study period. ⋯ The increase in nonserious falls among the experimental group may be attributed to restraint reduction. The mean weekly fall rate in the experimental group postintervention (25 weeks) became comparable to the mean weekly fall rate for the control group during the entire study period (50 weeks). In light of such findings, policy makers have to confront the ethical choice between tying some frail, elderly subjects to beds and chairs versus exposing them to the risks of freedom in their old age.