Journal of the American Geriatrics Society
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Findings from several studies suggest a relationship between Alzheimer's disease and Down's syndrome. It has long been known that advanced maternal age is a risk factor for Down's syndrome, and that mothers who give birth to a child with this syndrome have characteristics consistent with accelerated aging. Little is known about risk factors for Alzheimer's disease, other than age. In this study, documentation is supplied for a hypothesis concerning a relationship between Alzheimer's disease and advanced maternal age.
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Comparative Study
Knowledge of and compliance with drug regimens in the elderly.
In an interview study of 545 patients recently discharged from The Johns Hopkins Hospital, data were collected on the patients' knowledge of their diseases, knowledge of drug purpose, and compliance with the prescribed drug regimen. The interrelationships of these variables were compared in patients under age 65 and patients aged 65 or older. ⋯ Knowledge of and compliance with drug regimens may reflect doctor-patient relationships. Understanding the patterns of drug use offers a potential for appropriate strategies in clinical practice.
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Comparative Study
Geriatric psychiatry in the emergency department: characteristics of geriatric and non-geriatric admissions.
A study was made of the Emergency Department records of 49 elderly (65 years old or older) and 49 middle-aged (40-64 years old) patients seen in an urban hospital's psychiatric emergency service. The data were compared for demographic and admission information, psychiatric treatment history, presenting complaints, symptoms, diagnoses, and final disposition status. For the elderly patients, the referral was more likely to be their first contact with psychiatric treatment, and they were more likely to be referred (accompanied) by family or friends than to be self-referred. ⋯ Access to treatment was fairly consistent for both groups as measured by the hospital's priority code, total time spent in the emergency department, and final disposition. These results raise important issues concerning the unique psychosocial characteristics and psychiatric treatment needs of elderly patients. This applies particularly to the emergency-department medical clearance of elderly patients with symptoms of organic brain syndrome.
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This study reports on the development of a comprehensive set of objectives for the education of undergraduates, graduates, and fellows in geriatric medicine. The objectives were derived from reviews of available educational materials and programs, and their significance was validated through consensus techniques that included over 100 workers with special expertise in geriatrics and gerontology from the United States. ⋯ A related and supplementary investigation, which also used consensus methods, uncovered ten general and disease-specific objectives considered to be essential outcomes of the education of geriatric fellows. Academic departments and specialty and subspecialty organizations should find the total set of objectives useful for planning and evaluating educational programs in geriatrics.
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In a long-term care facility, the fecal guaiac test for occult blood was used as a screening method to detect gastrointestinal (GI) bleeding lesions. The study involved 450 chronically ill hospitalized patients whose average age was 70 years. Each underwent 6 fecal guaiac tests for three consecutive days while receiving a standardized meat-free, high-fiber diet. ⋯ In 20 of the 21 patients with positive test findings, a lesion of the GI tract was found. The therapeutic implications of such screening are important. This study emphasizes the value of routine fecal hemoccult testing of whole institutional populations once or twice a year.