Journal of the American Geriatrics Society
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We sought to describe epidemiological patterns of acute injuries treated in emergency department (ED) and outpatient primary care settings in the United States. ⋯ Medically attended injuries area common in older adults, and their incidence increases with advancing age. Half of all initial visits for acute injuries in older adults are to primary care clinics. Most injured individuals are discharged home, and injury prevention counseling is rarely documented. To inform injury prevention efforts appropriately and to avoid underestimating the burden of injury, future injury studies should include a range of outpatient and inpatient care settings.
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Observational Study
Association of experience with illness and end-of-life care with advance care planning in older adults.
To examine whether experiences with illness and end-of-life care are associated with readiness to participate in advance care planning (ACP). ⋯ Older individuals who have experience with end-of-life care of others demonstrate greater readiness to participate in ACP. Discussions with older adults regarding these experiences may be a useful tool in promoting ACP.
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Randomized Controlled Trial Multicenter Study
Structured pharmaceutical analysis of the Systematic Tool to Reduce Inappropriate Prescribing is an effective method for final-year medical students to improve polypharmacy skills: a randomized controlled trial.
Medical students may not be adequately trained to prescribe appropriately to older adults with polypharmacy. This study addressed how to teach students to minimize inappropriate polypharmacy. Final-year medical students (N = 106) from two Dutch schools of medicine participated in this randomized controlled trial with a pre/posttest design. ⋯ E-learning did not have a different effect from that of non-E-learning methods. Students were satisfied with the method. The STRIP method is effective in helping final-year medical students improve their prescribing skills.
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To examine whether preclinical disability in performance of cognitively focused instrumental activity of daily living (C-IADL) tasks can discriminate between older adults with normal cognitive function and those with mild cognitive impairment (MCI) and, secondarily, to determine the two tasks with the strongest psychometric properties and assess their discriminative ability so as to generate diagnosis-relevant information about cognitive changes associated with MCI and mild neurocognitive disorder according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, criteria. ⋯ This is the first demonstration of the discriminative ability of preclinical disability to distinguish older adults with MCI from cognitively normal older adults. These findings highlight potential tasks that, when measured using the observation-based PASS, demonstrate greater effort for individuals with MCI. These tasks may be considered when attempting to diagnose MCI or mild neurocognitive disorder in clinical practice and research.
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Comparative Study
Association between Physician Orders for Life-Sustaining Treatment for Scope of Treatment and in-hospital death in Oregon.
To examine the relationship between Physician Orders for Life-Sustaining Treatment (POLST) for Scope of Treatment and setting of care at time of death. ⋯ The association with numbers of deaths in the hospital suggests that end-of-life preferences of people who wish to avoid hospitalization as documented in POLST orders are honored.