Journal of the American Geriatrics Society
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Randomized Controlled Trial Multicenter Study
Determining care management activities associated with mastery and relationship strain for dementia caregivers.
To identify specific care management activities within a dementia care management intervention that are associated with 18-month change in caregiver mastery and relationship strain. ⋯ Home assessments for specific needs of caregivers and persons with dementia are associated with improvements in caregivers' sense of mastery. Future work is needed to determine whether this increase is sustained over time and decreases the need for institutionalization.
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Randomized Controlled Trial Comparative Study
Inflammatory biomarkers and physical function in older, obese adults with knee pain and self-reported osteoarthritis after intensive weight-loss therapy.
To describe the relationships between proinflammatory biomarkers and self-reported and performance-based physical function and to examine the effect of weight loss on these markers of inflammation. ⋯ These results indicate that an intensive weight-loss intervention in older obese adults with knee pain can help improve inflammatory biomarkers and that changes in these concentrations showed associations with physical function.
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Randomized Controlled Trial
Substitutive "hospital at home" versus inpatient care for elderly patients with exacerbations of chronic obstructive pulmonary disease: a prospective randomized, controlled trial.
To evaluate hospital readmission rates and mortality at 6-month follow-up in selected elderly patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). ⋯ Physician-led substitutive hospital-at-home care as an alternative to inpatient care for elderly patients with acute exacerbations of COPD is associated with a substantial reduction in the risk of hospital readmission at 6 months, lower healthcare costs, and better quality of life.
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Randomized Controlled Trial
Psychometric properties of the activities-specific balance confidence scale and the survey of activities and fear of falling in older women.
To compare the psychometric properties of the Activities-specific Balance Confidence Scale (ABC) and the Survey of Activities and Fear of Falling in the Elderly (SAFE). ⋯ The ABC and SAFE demonstrated strong internal-consistency reliability and validity when self-administered. The ABC had stronger associations with physical functioning and may be more appropriate for studies focused on improving physical function. Both instruments demonstrated ceiling effects, which may explain the lack of responsiveness to change in relatively nonfrail older women. Instruments sensitive to measuring lower levels of fear of falling are needed to capture the full range of this phenomenon in this population.
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Randomized Controlled Trial Multicenter Study
Empirical assessment of a research advance directive for persons with dementia and their proxies.
To evaluate a research advance directive for persons with established dementia diagnoses and their family caregivers or proxies. ⋯ Patient and proxy experience making hypothetical decisions in the interview may have affected enrollment decisions by the PAT and control groups. Although the low number of recruitment attempts and the natural attrition of the geriatric population limit conclusions about effectiveness that may be drawn from this unique data set, the feasibility of a research advance directive is clearly demonstrated.