Journal of the American Geriatrics Society
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To quantify prescription analgesic use of elderly nursing home (NH) residents with persistent noncancer pain and to identify individual and facility traits associated with no treatment. ⋯ Through 2008, pain remained undertreated in NHs, especially in certain subpopulations, including cognitively impaired and older residents. Changes in pain management practice and policies may be necessary to target these vulnerable residents.
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Observational Study
Variability of Delirium Motor Subtype Scale-Defined Delirium Motor Subtypes in Elderly Adults with Hip Fracture: A Longitudinal Study.
To examine changes in motor subtype profile in individuals with delirium. ⋯ Motor subtype profile was variable in the majority of participants, although changes that occurred were often related to changes from or to no motor subtype, suggesting evolving or resolving delirium. Changes appeared not be associated with demographic or clinical characteristics, suggesting that evidence from cross-sectional studies of motor subtypes could be applied to many individuals with delirium. Further longitudinal studies should be performed to clarify the stability of motor subtypes in different clinical populations.
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To investigate time trends in incidence of activity of daily living (ADL) disability of Chinese older adults and to explore factors potentially contributing to trends. ⋯ The incidence of ADL disability decreased from 1993 to 2006 in older adults in China, especially in transferring and bathing, independent of sociodemographic, lifestyle, and chronic health conditions.
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Randomized Controlled Trial Multicenter Study
An Occupational Therapy Fall Reduction Home Visit Program for Community-Dwelling Older Adults in Hong Kong After an Emergency Department Visit for a Fall.
To investigate the effects of an occupational therapy fall reduction home visit program for older adults admitted to the emergency department (ED) for a fall and discharged directly home. ⋯ One OT visit after a fall was more effective than a well-wishing visit at reducing future falls at 6 months. A booster OT visit at 6 months is suggested.
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To explore barriers to anticoagulation in older adults with atrial fibrillation (AF) at high risk of stroke and to identify opportunities for interventions that might increase use of oral anticoagulants (OACs). ⋯ Despite very high stroke risk, more than 40% of participants were not discharged with an OAC. Dominant reasons included fall risk, poor prognosis, older age, and dementia. These individuals' high 1-year mortality rate confirmed their high level of comorbidity. To improve anticoagulation decisions and outcomes in this population, future research should focus on strategies to mitigate fall risk, improve assessment of risks and benefits of anticoagulation in individuals with AF, and determine whether newer anticoagulants are safer in complex elderly and frail individuals.