Journal of the American Geriatrics Society
-
Randomized Controlled Trial Multicenter Study Clinical Trial
Exercise rehabilitation improves functional outcomes and peripheral circulation in patients with intermittent claudication: a randomized controlled trial.
To determine the effects of a 6-month exercise program on ambulatory function, free-living daily physical activity, peripheral circulation, and health-related quality of life (QOL) in disabled older patients with intermittent claudication. ⋯ Improvements in claudication following exercise rehabilitation in older PAOD patients are dependent on improvements in peripheral circulation and walking economy. Improvement in treadmill claudication distances in these patients translated into increased accelerometer-derived physical activity in the community, which enabled the patients to become more functionally independent.
-
Randomized Controlled Trial Clinical Trial
Reducing delirium after hip fracture: a randomized trial.
Delirium (or acute confusional state) affects 35% to 65% of patients after hip-fracture repair, and has been independently associated with poor functional recovery. We performed a randomized trial in an orthopedic surgery service at an academic hospital to determine whether proactive geriatrics consultation can reduce delirium after hip fracture. ⋯ Proactive geriatrics consultation was successfully implemented with good adherence after hip-fracture repair. Geriatrics consultation reduced delirium by over one-third, and reduced severe delirium by over one-half. Our trial provides strong preliminary evidence that proactive geriatrics consultation may play an important role in the acute hospital management of hip-fracture patients.
-
Randomized Controlled Trial Clinical Trial
Dementia family caregiver training: affecting beliefs about caregiving and caregiver outcomes.
Family caregiving is an integral part of the care system for persons with dementing disorders, such as Alzheimer's disease. This study tested role-training intervention as a way to help family caregivers appreciate and assume a more clinical belief set about caregiving and thereby ameliorate the adverse outcomes associated with caregiving. ⋯ A caregiver training intervention focused on the work of caregiving and targeted at knowledge, skills, and beliefs benefits caregivers in important outcome dimensions. The results suggest the benefits of providing information, linkage, and role coaching to dementia family caregivers.
-
Randomized Controlled Trial Multicenter Study Clinical Trial
The effect of aging on circulating levels of proinflammatory cytokines during septic shock. Norasept II Study Investigators.
As the proportion of the population that is older continues to rise, infection in older people has become an important healthcare problem. Although aging is associated with multiple abnormalities in immune function, the effect of aging on the production of proinflammatory cytokines has not been well studied under conditions of clinical stress. ⋯ Contrary to our expectations, we found that aging was not associated with a decline in the circulating levels of proinflammatory cytokines.
-
Randomized Controlled Trial Clinical Trial
Exercise training for rehabilitation and secondary prevention of falls in geriatric patients with a history of injurious falls.
To determine the safety and efficacy of an exercise protocol designed to improve strength, mobility, and balance and to reduce subsequent falls in geriatric patients with a history of injurious falls. ⋯ Progressive resistance training and progressive functional training are safe and effective methods of increasing strength and functional performance and reducing fall-related behavioral and emotional restrictions during ambulant rehabilitation in frail, high-risk geriatric patients with a history of injurious falls.