Archives of gerontology and geriatrics
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Arch Gerontol Geriatr · May 2010
Older people's use of pre-hospital emergency medical services in Izmir, Turkey.
The aim of this study is to determine the use of pre-hospital emergency medical services (EMS) in elderly people aged 65 years and over in Izmir, Turkey. In this descriptive study, older patients admitted to pre-hospital EMS of Izmir Province Health Directorate between 2004 and 2005 years was evaluated through the review of Emergency Call Registry Forms. The study data included socioeconomic characteristics, reasons of calling, distribution of calling times in the day, distribution of ambulance callers and preclinical diagnosis. ⋯ The most frequent pre-hospital EMS caller were persons in family (70.7%), and utilization of ambulance services was the highest in winter. Medically related incidents accounted for 89.1% of all emergency ambulance calls and cardiovascular diseases accounted for most common cause (32.6%) of calls. The utilization rate of pre-hospital EMS among older persons was approximately four times higher than that of the younger age groups.
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Arch Gerontol Geriatr · May 2010
Validation of the Chinese-Canadian study of health and aging clinical frailty scale (CSHA-CFS) telephone version.
This was a cross-sectional validation study of the Chinese-Canadian study of health and aging clinical frailty scale telephone version (CSHA-CFS TV). The study pool consisted of 67 patients of outpatient clinics at a tertiary medical center in Taipei, Taiwan. They were enrolled in the program comprehensive geriatric assessment and the frailty study of elderly patients (CGAFSEP). ⋯ Criterion validity was achieved with weighted kappa of 0.689 (p<0.0001) and Kendal's tau of 0.612 (p<0.0001) between the TV and the PV scores. Divergent validity was demonstrated with significant correlation but only fair agreements comparing both TV and PV scores with the cardiovascular health survey (CHS) phenotypic definition of frailty. One could conclude that the CSHA-CFS TV appears to be a quick, reliable, and valid frailty screening instrument for community-dwelling elderly.
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Arch Gerontol Geriatr · May 2010
Comparative StudyDeveloping a self-reported comorbidity index to predict mortality of community-dwelling older adults.
Current common comorbidity measures have poor to moderate predictive validity of mortality of community-dwelling older adults. Hence, our aim is to develop a simpler resource-efficient self-reported comorbidity index in the prediction of survival. 113 older adults in Greater Manchester, United Kingdom attended a routine medical examination whereby information gathered was used to construct Charlson Comorbidity Index (CCI). They completed the Cornell Medical Index (CMI) questionnaire and reported the number of medication prescribed to them. ⋯ Remarkably, by means of forward step-wise Cox-regression, two variables emerged significant: (i) number of medicine (beta coefficient=0.229, SE=0.090 and p=0.011) and (ii) age (beta coefficient=0.106, SE=0.051 and p=0.037). We demonstrated that simple count of medication predicted mortality of community-dwelling older adults over the next 7 years more accurately than CMI or CCI. Further works involving a larger scale of subjects is needed for use in epidemiological study of survival where cost and resources are concerned.
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Arch Gerontol Geriatr · Mar 2010
Importance of end-of-life support to minimize caregiver's regret during bereavement of the elderly for better subsequent adaptation to bereavement.
This study examined whether the quality of end-of-life home medical care affected caregiver's psychological recovery from bereavement. We analyzed survey responses from an anonymous self-administered questionnaire from 147 bereaved family members (caregivers). ⋯ Aspects of end-of-life support that were statistically significant at minimizing regret during bereavement were: (1) fulfilled home medical care service system, (2) peaceful death of the patient, and (3) providing direct care by the caregiver. These findings suggest that end-of-life support to minimize caregiver regret during bereavement was crucial for better subsequent adaptation to bereavement.
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Arch Gerontol Geriatr · Jan 2010
Comparative StudyThe value of glycosylated hemoglobin (HbA1c) as a predictive risk factor in the diagnosis of diabetes mellitus (DM) in the elderly.
In order to evaluate the significance of HbA1c in the diagnosis of Diabetes Mellitus (DM) and the risk of future DM in the elderly, the HbA1c and the fasting glycemia of 2167 elderly subjects of 65-84 years were determined, taking part in the epidemiological Italian Longitudinal Study on Aging (ILSA). The subjects were divided in 3 groups according to their glycemic values, namely those with normal fasting glucose (NFG), with impaired fasting glucose (IFG), and diabetics. ⋯ The identification of new cases of DM in a follow-up of 3 years was modest: in the NFG group (2.35% among those who had an HbA1c<7.02 and of 2.99% of those who had HbA1c>7.02%), while in the IFG group the same analysis gave 14.14% of those with normal HbA1c, increasing progressively in parallel with the increase of the HbA1c values above 7.02%, reaching 19.59%. It is evident from these results, in agreement with the multifactorial characteristics of type 2 DM that one has to look for other predictive factors, such as the dysmetabolic lipid components, and first of all the genetic ones in the predictive diagnosis of DM.