Journal of the American Geriatrics Society
-
Randomized Controlled Trial Comparative Study Clinical Trial
Exercise and weight loss in obese older adults with knee osteoarthritis: a preliminary study.
The purposes of this pilot study were to determine if a combined dietary and exercise intervention would result in significant weight loss in older obese adults with knee osteoarthritis, and to compare the effects of exercise plus dietary therapy with exercise alone on gait, strength, knee pain, biomarkers of cartilage degradation, and physical function. ⋯ Weight loss can be achieved and sustained over a 6-month period in a cohort of older obese persons with osteoarthritis of the knee through a dietary and exercise intervention. Both exercise and combined weight loss and exercise regimens lead to improvements in pain, disability, and performance. Moreover, the trends in the biomechanical data suggest that exercise combined with diet may have an additional benefit in improved gait compared with exercise alone. A larger study is indicated to determine if weight loss provides additional benefits to exercise alone in this patient population.
-
Randomized Controlled Trial Multicenter Study Clinical Trial
Pain and suffering in seriously ill hospitalized patients.
Previous studies had suggested a high prevalence of pain in hospitalized patients but had not specifically evaluated pain and other symptoms in seriously ill and older hospitalized patients. ⋯ Control of pain and other symptoms remains an important medical and ethical issue. Routine monitoring of pain and other symptoms should be linked to treatment strategies aimed at combinations of symptoms and tested to assuage concerns about side effects.
-
Randomized Controlled Trial Clinical Trial
Improvement in quality-of-life measures and stimulation of weight gain after treatment with megestrol acetate oral suspension in geriatric cachexia: results of a double-blind, placebo-controlled study.
Weight loss among older patients is a severe problem, associated with an increased incidence of infections, decubiti, and death. Megestrol acetate (MA) causes weight gain in cachectic cancer and AIDS patients, but its effects in older cachectic patients are unknown. ⋯ In geriatric patients with weight loss or low body weight MA improves appetite and well-being after 12 weeks of treatment. During the 3 months of MA treatment, there was no statistically significant weight gain (> or =4 lbs). Three months after treatment, weight gain (> or =4 lbs) was significantly increased in MA-treated patients.
-
Randomized Controlled Trial Multicenter Study Clinical Trial
Family satisfaction with end-of-life care in seriously ill hospitalized adults.
To examine factors associated with family satisfaction with end-of-life care in the Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments (SUPPORT). ⋯ Satisfaction scores suggest the need for improvement in end-of-life care, especially in communication and decision making. Further research is needed to understand how factors affect satisfaction with end-of-life care. An intervention like that used in SUPPORT may help family members.
-
Randomized Controlled Trial Clinical Trial
Chronic care clinics: a randomized controlled trial of a new model of primary care for frail older adults.
To determine whether a new model of primary care, Chronic Care Clinics, can improve outcomes of common geriatric syndromes (urinary incontinence, falls, depressive symptoms, high risk medications, functional impairment) in frail older adults. ⋯ Although intervention patients expressed high levels of satisfaction with Chronic Care Clinics, improved outcomes for selected geriatric syndromes were not demonstrated. These findings suggest the need for developing greater system-wide support for managing geriatric syndromes in primary care and illustrate the challenges of conducting practice improvement research in a rapidly changing delivery system.