Journal of the American Geriatrics Society
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Comparative Study
Screening for preexisting cognitive impairment in older intensive care unit patients: use of proxy assessment.
To determine the prevalence of preexisting cognitive impairment (CI) in patients admitted to the medical intensive care unit (ICU) and compare two different proxy measures of preexisting CI in ICU patients. ⋯ There is a high prevalence of preexisting CI in patients admitted to the medical ICU. Both the MBDRS and IQCODE can be used to screen for preexisting CI in situations where direct patient assessment is not feasible. Future studies are needed to address physician recognition of CI and its effect on patient care decisions and outcomes.
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To examine the association between muscle strength and total and cause-specific mortality and the plausible contributing factors to this association, such as presence of diseases commonly underlying mortality, inflammation, nutritional deficiency, physical inactivity, smoking, and depression. ⋯ In older disabled women, handgrip strength was a powerful predictor of cause-specific and total mortality. Presence of chronic diseases commonly underlying death or the mechanisms behind decline in muscle strength in chronic disease, such as inflammation, poor nutritional status, disuse, and depression, all of which are independent predictors of mortality, did not explain the association. Handgrip strength, an indicator of overall muscle strength, may predict mortality through mechanisms other than those leading from disease to muscle impairment. Grip strength tests may help identify patients at increased risk of deterioration of health.
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To review published reports of interventions for caregivers (CGs) of persons with dementia, excluding respite care, and provide recommendations to clinicians. ⋯ Some CG interventions can reduce CG psychological morbidity and help people with dementia stay at home longer. Programs that involve the patients and their families and are more intensive and modified to CGs' needs may be more successful. Future research should try to improve clinicians' abilities to prescribe interventions.
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Randomized Controlled Trial Clinical Trial
Efficacy of percutaneous electrical nerve stimulation for the treatment of chronic low back pain in older adults.
To determine the efficacy of a complementary analgesic modality, percutaneous electrical nerve stimulation (PENS), for the treatment of chronic low back pain (CLBP) in community-dwelling older adults. ⋯ This preliminary study suggests that PENS may be a promising treatment modality for community-dwelling older adults with CLBP, as demonstrated by reduction in pain intensity and self-reported disability, and improvement in mood, life control, and physical performance. Larger studies with longer duration of follow-up are needed to validate these findings and support the use of PENS in clinical practice.