Journal of the American Geriatrics Society
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Randomized Controlled Trial Multicenter Study Clinical Trial
A randomized, double-blind, placebo-controlled study of the efficacy and safety of donepezil in patients with Alzheimer's disease in the nursing home setting.
To evaluate the safety and efficacy of donepezil in the management of patients with Alzheimer's disease (AD) residing in nursing home facilities. ⋯ Patients treated with donepezil maintained or improved in cognition and overall dementia severity in contrast to placebo-treated patients who declined during the 6-month treatment period. The safety and tolerability profile was comparable with that reported in outpatient studies of donepezil. These findings also suggest that advanced age, comorbid illnesses, and high concomitant medication usage should not be barriers to donepezil treatment. Given the apparent improvement in behavior in the placebo group, and the high use of concomitant medications in both groups, the impact of donepezil on behavior in the nursing home setting is unresolved and merits further investigation. In summary, effects on cognition, overall dementia severity, and safety and tolerability findings are consistent with previous findings in outpatients and support the use of donepezil in patients with AD who reside in nursing homes.
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Randomized Controlled Trial Comparative Study Clinical Trial
Task-specific resistance training to improve the ability of activities of daily living-impaired older adults to rise from a bed and from a chair.
To determine the effect of a 12-week intervention to improve the ability of disabled older adults to rise from a bed and from a chair. ⋯ Task-specific resistance training increased the overall ability and decreased the rise time required to perform a series of bed- and chair-rise tasks. The actual rise-time improvement was clinically small but may be useful over the long term. Future studies might consider adapting this exercise program and the focus on trunk function to a frailer cohort, such as in rehabilitation settings. In these settings, the less challenging rise tasks (such as rising from an elevated chair) and the ability to perform intermediate tasks (such as hip bridging) may become important intermediate rehabilitation goals.
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Randomized Controlled Trial Clinical Trial
Preventing falls in older people: outcome evaluation of a randomized controlled trial.
To evaluate the outcome of an intervention to reduce hazards in the home on the rate of falls in seniors. ⋯ The intervention failed to achieve a reduction in the occurrence of falls. This was most likely because the intervention strategies had a limited effect on the number of hazards in the homes of intervention subjects. The study provides evidence that a one-time intervention program of education, hazard assessment, and home modification to reduce fall hazards in the homes of healthy older people is not an effective strategy for the prevention of falls in seniors.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Rapid emergency department intervention for older people reduces risk of functional decline: results of a multicenter randomized trial.
To determine the effectiveness of a two-stage (screening and nursing assessment) intervention for older patients in the emergency department (ED) who are at increased risk of functional decline and other adverse outcomes. ⋯ A two-stage ED intervention, consisting of screening with the ISAR tool followed by a brief, standardized nursing assessment and referral to primary and home care services, significantly reduced the rate of subsequent functional decline.
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Randomized Controlled Trial Multicenter Study Clinical Trial
A randomized trial of exercise programs among older individuals living in two long-term care facilities: the FallsFREE program.
To use two different exercise programs over a 2-year period to reduce falls and their sequelae among residents of two long-term care facilities. ⋯ There were no significant differences in falls among the two exercise groups and the control group. Lack of treatment differences and low adherence rates suggest that residents of long-term care facilities may require individualized exercise interventions that can be adapted to their changing needs.